Abstract

Objectives: In older adults with aortic stenosis, we evaluated whether accelerometer-measured physical activity provides distinct clinical information apart from self-reported surveys or performance-based function tests (PBFT). Background: Wearable accelerometers can objectively quantify and monitor activity counts over an extended period of time, making them an ideal tool for measuring physical activity in older adults with cardiovascular disease; however, the relationship between accelerometer-measured activity and self-reported surveys or PBFT is unknown. Methods: We employed wrist-mounted accelerometry in 54 subjects with severe aortic stenosis prior to TAVR. Daily daytime activity was estimated using the maximum 10 hours of daily accelerometer-measured activity (M10) reported in activity counts. Subjects completed baseline surveys (NYHA, SF12, KCCQ, EQ-5D, LOT-R, Life Space, Detailed Activity Form) and PBFT (short physical performance battery, 6 minute walk test, grip strength) to estimate functional status. Simple and multiple linear regression models were used to evaluate the relationship between accelerometer-measured activity and survey data and PBFT. Results: The mean age was 87 years, 61% were female. Median ejection fraction was 63% (IQR 12). Most were NYHA Class III (65%), none were Class IV. There was a weak negative association between M10 and SF-12 Mental Composite Score (R2=0.1970, P=0.04) and between M10 and grip strength (R2=0.1568, P=0.004). However, neither multiple linear regression of overall survey data (R2=0.6159, P=0.23) nor PBFT (R2=0.1743, P=0.10) predicted M10. Conclusions: Self-reported surveys and performance-based function tests did not correlate well with maximal 10 hours of daily accelerometer-measured activity in older adults with aortic stenosis. Further studies will evaluate the distinct utility of accelerometer-measured activity in older adults with aortic stenosis predicting outcomes of TAVR.

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