Towards Automated Assessment of Frailty Status Using a Wrist-Worn Device

Wearable sensors potentially enable monitoring the user's physical activity in daily life. Therefore, they are particularly appealing for the evaluation of older subjects in their environment, to capture early signs of frailty and mobility-related problems. This study explores the use of body-worn accelerometers for automated assessment of frailty during walking activity. Experiments involved 34 volunteers aged 70+, who were initially screened by geriatricians for the presence of frailty according to Fried's criteria. After screening, the volunteers were asked to walk 60 m at preferred speed, while wearing two accelerometers, one positioned on the lower back and the other on the wrist. Sensor-derived signals were analyzed independently to compare the ability of the two signals (wrist vs. lower back) in frailty status assessment. A gait detection technique was applied to identify segments made of four gait cycles. These segments were then used as input to compute 25 features in time and time-frequency domains, the latter by means of the Wavelet Transform. Finally, five machine learning models were trained and evaluated to classify subjects as robust or non-robust (i.e., pre-frail or frail). Gaussian naive Bayes applied to the features derived from the wrist sensor signal identified non-robust subjects with 91% sensitivity and 82% specificity, compared to 87% sensitivity and 64% specificity achieved with the lower back sensor. Results demonstrate that a wrist-worn accelerometer provides valuable information for the recognition of frailty in older adults, and could represent an effective tool to enable automated and unobtrusive assessment of frailty.