Toward using wearables to remotely monitor cognitive frailty in community-living older adults: An observational study

Javad Razjouyan, Bijan Najafi, Molly Horstman, Amir Sharafkhaneh, Mona Amirmazaheri, He Zhou, Mark E. Kunik, Aanand Naik

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Physical frailty together with cognitive impairment (Cog), known as cognitive frailty, is emerging as a strong and independent predictor of cognitive decline over time. We examined whether remote physical activity (PA) monitoring could be used to identify those with cognitive frailty. A validated algorithm was used to quantify PA behaviors, PA patterns, and nocturnal sleep using accelerometer data collected by a chest-worn sensor for 48-h. Participants (N = 163, 75 ± 10 years, 79% female) were classified into four groups based on presence or absence of physical frailty and Cog: PR-Cog-, PR+Cog-, PR-Cog+, and PR+Cog+. Presence of physical frailty (PR-) was defined as underperformance in any of the five frailty phenotype criteria based on Fried criteria. Presence of Cog (Cog-) was defined as a Mini-Mental State Examination (MMSE) score of less than 27. A decision tree classifier was used to identify the PR-Cog-individuals. In a univariate model, sleep (time-in-bed, total sleep time, percentage of sleeping on prone, supine, or sides), PA behavior (sedentary and light activities), and PA pattern (percentage of walk and step counts) were significant metrics for identifying PR-Cog-(p < 0.050). The decision tree classifier reached an area under the curve of 0.75 to identify PR-Cog-. Results support remote patient monitoring using wearables to determine cognitive frailty.

Original languageEnglish (US)
Article number2218
JournalSensors (Switzerland)
Issue number8
StatePublished - Apr 2 2020


  • Cognitive frailty
  • Cognitive impairment
  • Digital health
  • Motoric cognitive risk syndrome
  • Remote patient monitoring
  • Telehealth
  • Wearable

ASJC Scopus subject areas

  • Analytical Chemistry
  • Information Systems
  • Atomic and Molecular Physics, and Optics
  • Biochemistry
  • Instrumentation
  • Electrical and Electronic Engineering


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