Document Type

Article

Publication Date

2019

DOI

10.1093/gerona/glz193

Publication Title

The Journals of Gerontology: Series A

Volume

GLZ193

Pages

27 pp.

Abstract

Background: Declining physical activity (PA) is a hallmark of aging. Wearable technology provides reliable measures of the frequency, duration, intensity, and timing of PA. Accelerometry-derived measures of PA are compared to established predictors of 5-year all-cause mortality in older adults in terms of individual, relative, and combined predictive performance.

Methods: Participants between 50 and 85 years old from the 2003-2006 National Health and Nutritional Examination Survey (NHANES, n = 2978) wore a hip-worn accelerometer in the free-living environment for up to 7 days. A total of 33 predictors of 5-year all-cause mortality (number of events = 297), including 20 measures of objective PA, were compared using univariate and multivariate logistic regression.

Results: In univariate logistic regression, the total activity count was the best predictor of 5-year mortality (AUC = 0.771) followed by age (AUC = 0.758). Overall, 9 of the top 10 predictors were objective PA measures (AUC from 0.771 to 0.692). In multivariate regression, the 10-fold cross-validated AUC was 0.798 for the model without objective PA variables (9 predictors) and 0.838 for the forward selection model with objective PA variables (13 predictors). The Net Reclassification Index (NRI) was substantially improved by adding objective PA variables (p < .001).

Conclusions: Objective accelerometry-derived PA measures outperform traditional predictors of five-year mortality, including age. This highlights the importance of wearable technology for providing reproducible, unbiased, and prognostic biomarkers of health.

Comments

This is a pre-copyedited, author-produced version of an article accepted for publication in The Journals of Gerontology: Series A following peer review. The version of record,

Smirnova, E., Leroux, A., Cao, Q., Tabacu, L., Zipunnikov, V., Crainiceanu, C., & Urbanek, J. (2019). The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data For 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003-2006. The Journals of Gerontology: Series A, GLZ193. doi:10.1093/gerona/glz193,

is available online at: https://doi.org/10.1093/gerona/glz193

Original Publication Citation

Smirnova, E., Leroux, A., Cao, Q., Tabacu, L., Zipunnikov, V., Crainiceanu, C., & Urbanek, J. (2019). The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data For 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003-2006. The Journals of Gerontology: Series A, GLZ193. doi:10.1093/gerona/glz193

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