Dataset Information

Fractal Complexity of Daily Physical Activity Patterns Differs With Age Over the Life Span and Is Associated With Mortality in Older Adults.

ABSTRACT:

Background

Accelerometers are included in a wide range of devices that monitor and track physical activity for health-related applications. However, the clinical utility of the information embedded in their rich time-series data has been greatly understudied and has yet to be fully realized. Here, we examine the potential for fractal complexity of actigraphy data to serve as a clinical biomarker for mortality risk.

Methods

We use detrended fluctuation analysis (DFA) to analyze actigraphy data from the National Health and Nutrition Examination Survey (NHANES; n = 11,694). The DFA method measures fractal complexity (signal self-affinity across time-scales) as correlations between the amplitude of signal fluctuations in time-series data across a range of time-scales. The slope, ?, relating the fluctuation amplitudes to the time-scales over which they were measured describes the complexity of the signal.

Results

Fractal complexity of physical activity (?) decreased significantly with age (p = 1.29E-6) and was lower in women compared with men (p = 1.79E-4). Higher levels of moderate-to-vigorous physical activity in older adults and in women were associated with greater fractal complexity. In adults aged 50-79 years, lower fractal complexity of activity (?) was associated with greater mortality (hazard ratio = 0.64; 95% confidence interval = 0.49-0.82) after adjusting for age, exercise engagement, chronic diseases, and other covariates associated with mortality.

Conclusions

Wearable accelerometers can provide a noninvasive biomarker of physiological aging and mortality risk after adjusting for other factors strongly associated with mortality. Thus, this fractal analysis of accelerometer signals provides a novel clinical application for wearable accelerometers, advancing efforts for remote monitoring of physiological health by clinicians.

SUBMITTER: Raichlen DA

PROVIDER: S-EPMC6696714 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Fractal Complexity of Daily Physical Activity Patterns Differs With Age Over the Life Span and Is Associated With Mortality in Older Adults.

Raichlen David A DA Klimentidis Yann C YC Hsu Chiu-Hsieh CH Alexander Gene E GE

The journals of gerontology. Series A, Biological sciences and medical sciences 20190801 9

<h4>Background</h4>Accelerometers are included in a wide range of devices that monitor and track physical activity for health-related applications. However, the clinical utility of the information embedded in their rich time-series data has been greatly understudied and has yet to be fully realized. Here, we examine the potential for fractal complexity of actigraphy data to serve as a clinical biomarker for mortality risk.<h4>Methods</h4>We use detrended fluctuation analysis (DFA) to analyze act ...[more]

PMID: 30371743

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Project description:BACKGROUND:Fall-related psychological concerns are common among older adults, potentially contributing to functional decline as well as to restriction of activities and social participation. To effectively prevent such negative consequences, it is important to understand how even very low concern about falling could affect physical activity behavior in everyday life. We hypothesized that concern about falling is associated with a reduction in diversity, dynamics, and performance of daily activities, and that these features can be comprehensively quantified in terms of complexity of physical activity patterns. METHODS:A sample of 40 community-dwelling older adults were assessed for concern about falling using the Falls Efficacy Scale-International (FES-I). Free-living physical activity was assessed using a set of metrics derived from data recorded with a chest-worn tri-axial accelerometer. The devised metrics characterized physical activity behavior in terms of endurance (total locomotion time, longest locomotion period, usual walking cadence), performance (cadence of longest locomotion period, locomotion periods with at least 30 steps and 100 steps/min), and complexity of physical activity patterns. Complexity was quantified according to variations in type, intensity, and duration of activities, and was considered as an adaptive response to environmental exigencies over the course of the day. RESULTS:Based on FES-I score, participants were classified into two groups: not concerned at all/fully confident (n = 25) and concerned/less confident (n = 15). Demographic and health-related variables did not differ significantly between groups. Comparison of physical activity behavior indicated no significant differences for endurance-related metrics. In contrast, performance and complexity metrics were significantly lower in the less confident group compared to the fully confident group. Among all metrics, complexity of physical activity patterns appeared as the most discriminative feature between fully confident and less confident participants (p = 0.001, non-parametric Cliff's delta effect size = 0.63). CONCLUSIONS:These results extend our understanding of the interplay between low concern about falling and physical activity behavior of community-dwelling older persons in their everyday life context. This information could serve to better design and evaluate personalized intervention programs in future prospective studies.

Project description:Typically, gait rehabilitation uses an invariant stimulus paradigm to improve gait related deficiencies. However, this approach may not be optimal as it does not incorporate gait complexity, or in more precise words, the variable fractal-like nature found in the gait fluctuations commonly observed in healthy populations. Aging which also affects gait complexity, resulting in a loss of adaptability to the surrounding environment, could benefit from gait rehabilitation that incorporates a variable fractal-like stimulus paradigm. Therefore, the present study aimed to investigate the effect of a variable fractal-like visual stimulus on the stride-to-stride fluctuations of older adults during overground walking. Additionally, our study aimed to investigate potential retention effects by instructing the participants to continue walking after turning off the stimulus. Older adults walked 8 min with i) no stimulus (self-paced), ii) a variable fractal-like visual stimulus and iii) an invariant visual stimulus. In the two visual stimuli conditions, the participants walked 8 additional minutes after the stimulus was turned off. Gait complexity was evaluated with the widely used fractal scaling exponent calculated through the detrended fluctuation analysis of the stride time intervals. We found a significant ~20% increase in the scaling exponent from the no stimulus to the variable fractal-like stimulus condition. However, no differences were found when the older adults walked to the invariant stimulus. The observed increase was towards the values found in the past to characterize healthy young adults. We have also observed that these positive effects were retained even when the stimulus was turned off for the fractal condition, practically, acutely restoring gait complexity of older adults. These very promising results should motivate researchers and clinicians to perform clinical trials in order to investigate the potential of visual variable fractal-like stimulus for gait rehabilitation.

Project description:BackgroundVisually impaired older adults have a greater risk of falling, making them particularly susceptible to fall-related health consequences and restricted physical activity. Unclear however, is the relationship between having falls and longitudinal changes in daily patterns of objectively measured physical activity in older adults with visual impairments.MethodsWe created a three-year prospective cohort study (Falls in Glaucoma Study) of older adults with primary or suspected glaucoma at the Johns Hopkins Wilmer Eye Institute from 2013 to 2015. Cumulative incidence of falls was determined through self-reported fall calendars over 12 months. Participants were then classified into one of three groups: multiple fallers (≥2 falls), single fallers (1 fall), and non-fallers (0). Daily physical activity was measured over 1 week using a waist-bound accelerometer during baseline and three-year follow-ups. Activity fragmentation was defined as the reciprocal of the mean activity bout length, with higher fragmentation reflecting shorter, more fractured bouts of continuous activity. Multivariate linear mixed-effects models were used to assess three-year longitudinal changes in: 1) activity fragmentation, and 2) accumulation of activity across six three-hour intervals from 5 AM to 11 PM.FindingsIn adjusted models accounting for visual field damage and other factors, multiple fallers demonstrated greater annual declines (per year) in daily active bouts (-1.79 bouts/day, 95% confidence interval [CI]: -3.35, -0.22), daily active minutes (-17.15 min/day, 95% CI: -26.35, -7.94), and increased fragmentation (1%, 95% CI: 0, 2%) over the three-year follow-up period as compared to non-fallers; no such changes were seen when comparing single fallers and non-fallers. In time-of-day analyses, multiple fallers experienced greater annual declines in average hourly steps over all periods of the day, though the rate of decline was only significant between 5 PM and 8 PM (-27.07 steps/hour, 95% CI: -51.15, -2.99) compared to non-fallers.InterpretationIn an older population with visual impairment, multiple falls over 12 months were associated with more transient and fragmented activity over a subsequent three-year period, and activity declines during evening hours, compared to non-fallers. These findings suggest that multiple fallers with visual impairment may be at high risk for a decline in physical capacity and endurance, warranting clinical interventions.FundingThe research was supported in part by National Institutes of Health Grant EY022976.

Dataset Information

Fractal Complexity of Daily Physical Activity Patterns Differs With Age Over the Life Span and Is Associated With Mortality in Older Adults.

Background

Methods

Results

Conclusions

Publications

Fractal Complexity of Daily Physical Activity Patterns Differs With Age Over the Life Span and Is Associated With Mortality in Older Adults.

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