Digital health technology combining wearable gait sensors and machine learning improve the accuracy in prediction of frailty

Abstract

BackgroundFrailty is a dynamic and complex geriatric condition characterized by multi-domain declines in physiological, gait and cognitive function. This study examined whether digital health technology can facilitate frailty identification and improve the efficiency of diagnosis by optimizing analytical and machine learning approaches using select factors from comprehensive geriatric assessment and gait characteristics.MethodsAs part of an ongoing study on observational study of Aging, we prospectively recruited 214 individuals living independently in the community of Southern China. Clinical information and fragility were assessed using comprehensive geriatric assessment (CGA). Digital tool box consisted of wearable sensor-enabled 6-min walk test (6MWT) and five machine learning algorithms allowing feature selections and frailty classifications.ResultsIt was found that a model combining CGA and gait parameters was successful in predicting frailty. The combination of these features in a machine learning model performed better than using either CGA or gait parameters alone, with an area under the curve of 0.93. The performance of the machine learning models improved by 4.3–11.4% after further feature selection using a smaller subset of 16 variables. SHapley Additive exPlanation (SHAP) dependence plot analysis revealed that the most important features for predicting frailty were large-step walking speed, average step size, age, total step walking distance, and Mini Mental State Examination score.ConclusionThis study provides evidence that digital health technology can be used for predicting frailty and identifying the key gait parameters in targeted health assessments.

What If the Clinical and Older Adults’ Perspectives about Frailty Converge? A Call for a Mixed Conceptual Model of Frailty: A Traditional Literature Review

“…This illustration comes in accordance with some studies on the factors affecting the fluctuation in frailty status [62][63][64][65][66][67]. Subsequently, possible patterns could be discovered, and perhaps machine learning is an appropriate way to model and initiate that [68][69][70]. Again, such fluctuation would be within the older adult's perception and experience, as these could differ across frailty severity.…”

How can precision health care contribute to healthy aging?

“…18 However, the most advanced technology using machine learning seems able to identify frailty based on 5 criteria namely age, cognition, large step distance, large step walking time and speed. 19 Moreover, technology combining machine learning and virtual reality makes it possible to facilitate frailty rehabilitation of populations at moderate or high risk. 20 …”

“…18 However, the most advanced technology using machine learning seems able to identify frailty based on 5 criteria namely age, cognition, large step distance, large step walking time and speed. 19 …”