Combining 24-Hour Continuous Monitoring of Time-Locked Heart Rate, Physical Activity and Gait in Older Adults:...

Hemodynamic homeostasis is essential for adapting the heart rate (HR) to postural and physiological changes during daily activities. Traditional HR monitoring, such as 24 hour (h) Holter monitoring, provides important information on homeostasis during daily living. However, this approach lacks concurrent activity recording, limiting insights into hemodynamic adaptation and our ability to interpret changes in HR. To address this, we utilized a novel wearable sensor system (ANNE^@Sibel) to capture time-locked HR and daily activity (i.e., lying, sitting, standing, walking) data in 105 community-dwelling older adults. We developed custom tools to extract 24 h time-locked measurements and introduced a "heart rate response score" (HRRS), based on root Jensen-Shannon divergence, to quantify HR changes relative to activity. As expected, we found a progressive HR increase with more vigorous activities, though individual responses varied widely, highlighting heterogeneous HR adaptations. The HRRS (mean: 0.38 ± 0.14; min: -0.11; max: 0.74) summarized person-specific HR changes and was correlated with several clinical measures, including systolic blood pressure changes during postural transitions (r = 0.325, p = 0.003), orthostatic hypotension status, and calcium channel blocker medication use. These findings demonstrate the potential of unobtrusive sensors in remote phenotyping as a means of providing valuable physiological and behavioral data to enhance the quantitative description of aging phenotypes. This approach could enhance personalized medicine by informing targeted interventions based on hemodynamic adaptations during everyday activities.