Association between Continuous Wearable Activity Monitoring and Self-Reported Functioning in Assisted Living Facility...

Physical functioning is a key factor in independent living, and its preclinical state assessment and monitoring during the subject's normal life would be beneficial.

The aim of the study is to analyse associations between ambulatory measured physical activity behaviour and sleep patterns (wrist actigraphy) and self-reported difficulties in performing activities of daily living. Participants, setting and design: 36 residents in assisted living facilities and nursing homes (average age=80.4±9.0 years) without dementia in free living conditions participated. Actigraphic monitoring is integrated with the facilities' social alarm system.

Indices on activity level, activity rhythm, sleep pattern and external stimuli response of sleep-wake behaviours were extracted from the actigraph data and correlated (Spearman rank-order correlation) with activities of daily living measures. Bonferroni correction for multiple comparisons was applied.

Activity level (ρ=-0.49, p<0.05) and night-time activity variance (ρ=-0.69, p<0.01) had correlation with the activities of daily living scores. The similarity of subject-wise activity pattern to facility common activities had a trend with activities of daily living (ρ=-0.44, p<0.1). In longitudinal case analysis, sleep and activity patterns were found to be associated with local weather variables.

Activity patterns as measured by actigraphy may provide objective information on older people's behaviour related to functioning state and its changes in nursing home and assisted living facility settings. However, variance between individuals was large in this dataset which decreases the reliability of the results. Furthermore, external stimuli such as weather and facility-related activities can affect subjects' activity and sleep behaviour and should be considered in the related studies as well.