Consumer-grade Wearable Device for Predicting Frailty in Canadian Home Care Service Clients: Prospective Observational Proof-of-concept Study
What's the challenge?
Frailty has detrimental health impacts on older home care clients and is associated with increased hospitalization and long-term care admission. The prevalence of frailty among home care clients is poorly understood and ranges from 4.0% to 59.1%. Although frailty screening tools exist, their inconsistent use in practice calls for more innovative and easier-to-use tools. Owing to increases in the capacity of wearable devices, as well as in technology literacy and adoption in Canadian older adults, wearable devices are emerging as a viable tool to assess frailty in this population.
What have we done?
Consumer-level smart activity trackers are a promising tool to continuously monitor physical activity level and sleep quality of community-dwelling older adults. The evidence of medical-grade smart activity trackers as a frailty monitoring tool; consumer-grade smart activity trackers as a valid and acceptable tool to measure physical, sleep quality, and heart rate parameters; and increasing adoption of these smarts wearables by older adults highlight the opportunity to continuously monitor frailty within the community. The objective of this study was to prove that using a wearable device for assessing frailty in older home care clients could be possible.
What have we found?
A total of 37 older home care clients completed the study. The mean age was 82.27 (SD 10.84) years, and 76% (28/37) were female; 13 participants were frail, significantly older (P<.01), utilized more home care service (P=.01), walked less (P=.04), slept longer (P=.01), and had longer deep sleep time (P<.01). Total sleep time (r=0.41, P=.01) and deep sleep time (r=0.53, P<.01) were moderately correlated with frailty. The logistic regression model fitted with deep sleep time, step count, age, and education level yielded the best predictive performance with an area under the receiver operating characteristics curve value of 0.90 (Hosmer-Lemeshow P=.88).
We proved that a wearable device could be used to assess frailty for older home care clients. Wearable data complemented the existing assessments and enhanced predictive power. Wearable technology can be used to identify vulnerable older adults who may benefit from additional home care services.