Abstract
BackgroundGlobally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide.AimThe aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults.MethodElectronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS).ResultsTwenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty.ConclusionsWearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.
Highlights
The population of older adults is increasing
This systematic review was undertaken to examine which parameters of mobility and physical activity (PA) obtained from a wearable sensor have been used to assess and quantify frailty, which type of body-worn sensors and specific body-locations have been used and how different parameters are associated with discrimination of stages of frailty
The review highlights the heterogeneity of parameters examined in relation to frailty identification and the body-locations used
Summary
The population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will have almost doubled, representing over 21% of the world’s population [1]. Fried’s Frailty Phenotype (FFP) [2], the most commonly used frailty assessment tool [3] defines frailty as the presence of three or more of the five identified phenotypes; sarcopaenia, weakness as demonstrated by reduced grip-strength and slow gait-speed, fatigue and reduced level of activity [2]. It is considered the greatest challenge facing an ageing population [4, 5] affecting an estimated 16% of community-dwelling populations worldwide [6] and 21.5% of over 65’s in Ireland [5]. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide
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