Relationship between measures provided by smartwatches and identification of frailty syndrome in older adults: a scoping review

Ferreira, Amanda Caroline de Andrade; Silva, Betuel Gomes da; Gomes, Cristiano dos Santos; Fittipaldi, Etiene Oliveira da Silva; Andrade, Armele de Fátima Dornelas de; Barbosa, Juliana Fernandes de Souza

doi:10.1590/1981-22562024027.230238.en

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Revista Brasileira de Geriatria e Gerontologia

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Original Articles • Rev. bras. geriatr. gerontol. 27 • 2024 • https://doi.org/10.1590/1981-22562024027.230238.en copy

Relationship between measures provided by smartwatches and identification of frailty syndrome in older adults: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

This scoping review aimed to describe and map the measures provided by smartwatches as a tool for identifying Frailty Syndrome in older adults.

Methods

Studies published in any language, without publication date restrictions, that described the use of measures provided by smartwatches in evaluating or identifying Frailty Syndrome and/or its criteria in older adults were included. English descriptors for smartwatches, smartbands, Frailty Syndrome and Older Adults were used to develop a comprehensive search strategy, which was then applied to search the following databases: COCHRANE LIBRARY, EMBASE, SCOPUS, PUBMED/MEDLINE, LILACS, WEB OF SCIENCE and PEDRO.

Results

The initial search identified a total of 156 articles and 2 articles were identified from the manual search in the references of eligible studies. Next, 4 studies that used daily step count measurements for descriptive synthesis were included, and three of the four also used sleep and heart rate data to assess frailty in older adults. The results obtained in this review indicate that parameters derived from smartwatches have been used to identify stages of frailty in different areas, with the majority of studies being associated with other clinical conditions.

Conclusion

Smartwatches are an excellent frailty monitoring tool through daily measurements of step count, sleep data and heart rate. The results obtained with the use of these devices may suggest a broader evaluation of older adults who face an increased risk of developing Frailty Syndrome.

Keywords
Aging; Frailty Syndrome; Wearable devices

Database	Search strategy
PUBMED/ MEDLINE	(Frailty or Frail or Frailty Syndrome or Frail older adults or Frail Elder* or Functionally-Impaired Elderly or Frail Older Adult) and (smartwatch, smartband or trackers or fitness trackers) and (Older adult or older adults or aged) NOT (randomized controlled trial or clinical trial or Controlled Clinical Trial)
SCOPUS	(TITLE-ABS-KEY (Frailty or Frail or ‘Frailty Syndrome’ or ‘Frail older adults’ or ‘Frail Elder’ or ‘Functionally-Impaired Elderly’ or ‘Frail Older Adult’ ‘Older adult’ or ‘older adults’ or aged) AND TITLE-
EMBASE	('frail syndrome'/exp OR 'frailty syndrome' OR 'frail older adult' OR 'functionally-impaired elderly' OR 'older adult'/exp OR 'older adult' OR 'older adults'/exp OR 'older adults' OR 'aged'/exp OR aged) AND ('smartwatch'/exp OR smartband OR trackers OR 'fitness trackers') AND (observational AND study NOT 'randomized controlled trial'/exp OR 'clinical trial'/exp OR 'controlled clinical trial'/exp)
LILACS	(Frailty or Frail or Frailty Syndrome or Frail older adults or Frail Elder or Functionally-Impaired Elderly or Frail Older Adult) and (smartwatch, smartband or trackers or fitness trackers) and (Older adult or older adults or aged) NOT (randomized controlled trial or clinical trial or Controlled Clinical Trial)
Web Of Science	((ALL=(“frail syndrome” OR “frailty syndrome” OR “frail older adult” OR “functionally-impaired elderly” )) AND ALL=(“smartwatch” OR smartband OR trackers OR “fitness trackers” )) NOT ALL=(“randomized controlled trial” OR “clinical trial” OR “controlled clinical trial”)
PEDro	Frailty Syndrome Smartwatch
COCHRANE LIBRARY	(Frailty or Frail or (Frailty Syndrome) or (Frail older adults) or (Frail Elder) or (Functionally-Impaired Elderly or Frail Older Adult)):ti,ab,kw AND (smartwatch, smartband or trackers or (fitness trackers)):ti,ab,kw NOT ((randomized controlled trial) or (clinical trial) or (Controlled Clinical Trial)):ti,ab,kw" (Word variations have been searched)

Author	Title	Design and study location	Purpose of the study	Sample	Smartwatch used	Parameters derived from the smartwatch that were used to assess frailty criteria
Kim, B. et al., 2020¹⁵15 Kim B, McKay SM, Lee J. Consumer-Grade Wearable Device for Predicting Frailty in Canadian Home Care Service Clients: Prospective Observational Proof-of-Concept Study. J Med Internet Res 2020;22(9):e19732; http://doi.org/10.2196/19732. https://doi.org/10.2196/19732... ,	Consumer-Grade Wearable Device for Predicting Frailty in Canadian Home Care Service Clients: Prospective Observational Proof-of-Concept Study	Prospective Study Conducted in Canada, participants wore a monitoring device for a minimum of 8 days.	To prove that the use of a wearable device to assess frailty in older adults home care clients may be possible.	N = 37 participants Mean age= 82.23 (±10.84) female sex = 76%	Xiaomi Mi Band Pulse 1S	Daily step count, sleep measures (deep sleep time, light sleep time, total sleep time, sleep quality), heart rate measures.
Mach, M. et al., 2020¹⁶16 Mach M, Watzal V, Hasan W, Andreas M, Winkler B, Weiss G, et al. Fitness-Tracker Assisted Frailty-Assessment Before Transcatheter Aortic Valve Implantation: Proof-of-Concept Study. JMIR MHealth UHealth 2020;8(10):e19227; http://doi.org/10.2196/19227. https://doi.org/10.2196/19227... ,	Fitness-Tracker Assisted Frailty-Assessment Before Transcatheter Aortic Valve Implantation: Proof-of-Concept Study	Prospective Study Conducted in Austria in 2017-2018, each patient used a monitoring device for 1 week before the surgical procedure.	To develop a simple, efficient and cost-effective method for assessing pre-procedure frailty of transcatheter aortic valve implantation, based on parameters measured by a wearable health monitoring device	N = 50 patients Mean age= 77.5 (±5.1) years female sex = 44%	Garmin Vivosmart 3	Daily step count, distance covered (in kilometers), calories burned, time spent at different stress levels, hours and depth of sleep, minimum and maximum heart rate, and number of flights of stairs climbed.
Kim, B.; Kim, A., 2021¹⁷17 Kim B, Hunt M, Muscedere J, Maslove DM, Lee J. Using Consumer-Grade Physical Activity Trackers to Measure Frailty Transitions in Older Critical Care Survivors: Exploratory Observational Study. JMIR Aging 2021;4(1):e19859; http://doi.org/10.2196/19859. https://doi.org/10.2196/19859... ,	Using Consumer-Grade Physical Activity Trackers to Measure Frailty Transitions in Older Critical Care Survivors: Exploratory Observational Study	Prospective Study Performed in Canada, patients were followed up for 4 weeks after hospital discharge	Examine data generated from wearable devices for their association with frailty progression after hospital discharge.	N = 12 Mean age= 66.75 (±6.80) years. female sex = 58.3%	Fitbit Charge HR	Daily step count, active and sedentary time, sleep efficiency (obtained from the percentage of sleep time over total sleep time) and heart rate.
Schmidle, S. et al., 2023¹⁸18 Schmidle S, Gulde P, Koster R, Maslove DM, Lee J. The relationship between self-reported physical frailty and sensor-based physical activity measures in older adults – a multicentric cross-sectional study. BMC Geriatr 2023;23(1):43; http://doi.org/10.1186/s12877-022-03711-2. https://doi.org/10.1186/s12877-022-03711... ,	The relationship between self-reported physical frailty and sensor-based physical activity measures in older adults – a multicentric cross-sectional study	Multicenter cross-sectional study Conducted in Germany and France between May and November 2019, the average time of use of the smartwatch was 17.5 (± 5.1) days with ≥8 hours per day	Assess whether and to what extent a self-reported assessment of frailty is associated with daily physical activity patterns.	N = 88 Mean age= 80.6 (±9.1) female = 55%	Huawei 2 (4G)	Measure the intensity of acceleration changes, i.e. the intensity of physical activity, for every five seconds of data and daily step count.

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[1] Correspondence Juliana Fernandes de Souza Barbosa juliana.fsbarbosa@ufpe.br

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Relationship between measures provided by smartwatches and identification of frailty syndrome in older adults: a scoping review

Abstract

﻿Objective

Methods

Results

Conclusion

Objective