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DIGGING DEEPER: INSIGHTS INTO PHYSICAL AND COGNITIVE HEALTH USING NOVEL METHODS FOR ACCELEROMETRY AND FUNCTION.

ABSTRACT: AbstractThis symposium will focus on new methods to interpret and understand physical and cognitive health outcomes using data from wearable accelerometers and a traditional 400-meter walk protocol. Using data from the Baltimore Longitudinal Study of Aging (BLSA) and the Patient Reported Outcomes of Mood Pain and faTigue (PROMPT) study, we will discuss new insights into accelerometer-based activity metrics, as well as modeling of 400-meter lap-time variability, to enhance our knowledge of factors contributing to physical and cognitive health outcomes in older adults. Specifically, we will demonstrate methods to: (i) quantify objective physical activity volume, fragmentation, and bout lengths as predictors of mortality, (ii) link characteristics of daily physical activity (e.g., volume, fragmented patterns) to cognitive domains including memory, executive function, and visuospatial function, (iii) demonstrate a novel method to quantify lap-time variability during the 400m walk, and (iv) examine ecological momentary assessments of pain and activity patterns. Collectively, these presentations will present novel, advanced, and yet simple approaches to analyze and interpret objective measures of activity and function to reveal unexplored characteristics of healthy aging and maintenance of well-being. Further development and application of the methodology presented in this symposium will: (i) highlight cutting-edge methods to assess the effects of activity patterns on physical and cognitive outcomes with aging, and (ii) contribute to future efforts to optimize interventions that extend healthy longevity and delay adverse health outcomes related to aging.

SUBMITTER: Schrack JA

PROVIDER: S-EPMC6228129 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Project description:BackgroundFunctional capacity assessment is a core component of current perioperative cardiovascular evaluation and management guidelines for noncardiac surgery. The authors investigated the ability of standardized physical function questions to predict whether participants engaged in moderate physical activity as measured by hip accelerometers.MethodsParticipant responses to physical functioning questions and whether they engaged in moderate physical activity were extracted from the National Health and Nutrition Examination Survey (2003 to 2004 and 2005 to 2006). Physical activity intensity was measured using hip accelerometers. Adult participants with at least one Revised Cardiac Risk Index condition were included in the analysis. Standardized physical function questions were evaluated using a classification and regression tree analysis. Training and test datasets were randomly generated to create and test the analysis.ResultsFive hundred and twenty-two participants were asked the physical functioning questions and 378 of 522 (72.4%) had a bout of moderate-vigorous activity. Classification and regression tree analysis identified a "no difficulty" response to walking up 10 stairs and the ability to walk two to three blocks as the most sensitive questions to predict the presence of a 2-min bout of moderate activity. Participants with positive responses to both questions had a positive likelihood ratio of 3.7 and a posttest probability greater than 90% of a 2-min bout of moderate-vigorous activity. The sensitivity and specificity of positive responses to physical functioning questions in the pruned tree were 0.97 (95% CI, 0.94 to 0.98) and 0.16 (95% CI, 0.10 to 0.23) for training data, and 0.88 (95% CI, 0.75 to 0.96) and 0.10 (95% CI, 0.00 to 0.45) for the test data. Participants with at least one 2-min bout of moderate activity had a greater percentage of overall daily active time (35.4 ± 0.5 vs. 26.7 ± 1.2; P = 0.001) than those without.ConclusionsStandardized physical function questions are highly sensitive but poorly specific to identify patients who achieve moderate physical activity. Additional strategies to evaluate functional capacity should be considered.

Project description:BackgroundWhen tested in a controlled clinic environment, individuals with neuromuscular-related symptoms may complete motor tasks within normal predicted ranges. However, measuring activity at home may better reflect typical motor performance. The accuracy of accelerometry measurements in individuals with congenital muscular dystrophy (CMD) is unknown. We aimed to compare accelerometry and manual step counts and assess free-living physical activity intensity in individuals with CMD using accelerometry.MethodsAmbulatory pediatric CMD participants (n = 9) performed the 6-minute walk test in clinic while wearing ActiGraph GT3X accelerometer devices. During the test, manual step counting was conducted to assess concurrent validity of the ActiGraph step count in this population using Bland-Altman analysis. In addition, activity intensity of 6 pediatric CMD participants was monitored at home with accelerometer devices for an average of 7 days. Cut-point values previously validated for neuromuscular disorders were used for data analysis.ResultsBland-Altman and intraclass correlation analyses showed no concurrent validity between manual and ActiGraph-recorded step counts. Fewer steps were recorded by ActiGraph step counts compared with manual step counts (411 ± 74 vs 699 ± 43, respectively; P = .004). Although improved, results were in the same direction with the application of low-frequency extension filters (587 ± 40 vs 699 ± 43, P = .03). ActiGraph step-count data did not correlate with manual step count (Spearman ρ = 0.32, P = .41; with low-frequency extension: Spearman ρ = 0.45, P = .22). Seven-day physical activity monitoring showed that participants spent more than 80% of their time in the sedentary activity level.ConclusionsIn a controlled clinic setting, step count was significantly lower by ActiGraph GT3X than by manual step counting, possibly because of the abnormal gait in this population. Additional studies using triaxial assessment are needed to validate accelerometry measurement of activity intensity in individuals with CMD. Accelerometry outcomes may provide valuable measures and complement the 6-minute walk test in the assessment of treatment efficacy in CMD.

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DIGGING DEEPER: INSIGHTS INTO PHYSICAL AND COGNITIVE HEALTH USING NOVEL METHODS FOR ACCELEROMETRY AND FUNCTION.

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