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Wearable-Derived Digital Biomarkers for Mobility Assessment and Risk Stratification in Older Adults: A Scoping Review
Gerontology
|July 30, 2026
Summary
Wearable sensors offer promising digital biomarkers for assessing older adults' mobility and fall risk. While evidence shows validity, more longitudinal studies are needed to detect decline and ensure equitable implementation.
Area of Science:
- Gerontology and Digital Health
- Biomedical Engineering
- Wearable Technology Applications
Background:
- The global population aged 60+ will reach 2.1 billion by 2050, with mobility decline a key precursor to adverse health outcomes.
- Clinic-based mobility assessments lack ecological validity, missing subtle changes detectable in free-living conditions.
- Wearable technology provides continuous, objective monitoring via digital biomarkers for early intervention in older adults.
Purpose of the Study:
- To systematically map evidence on digital biomarkers from wearable technology for mobility assessment in older adults (≥60 years).
- To examine biomarker types, sensor devices, validation, clinical applications, and evidence gaps.
- To stratify evidence across mobility impairment, fall/frailty risk, and longitudinal decline.
Main Methods:
- Systematic scoping review following Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.
- Searched four major databases (Scopus, PubMed/MEDLINE, Web of Science, IEEE Xplore) from January 2019 to March 2026.
- Narrative synthesis of 97 primary empirical studies, with dual reviewer screening and third-reviewer resolution.
Main Results:
- Seven digital biomarker categories identified, including gait parameters (38.1%) and daily-life mobility metrics (24.7%).
- Validation showed promising reliability (ICC 0.70-0.98) and discriminative ability (AUC 0.73-0.94) for fall/frailty risk.
- Circadian rhythm biomarkers indicated increased all-cause mortality risk (HR 1.58/year), requiring prospective validation.
Conclusions:
- Wearable-derived digital biomarkers demonstrate promising validity for mobility assessment and risk stratification in older adults.
- Limited and heterogeneous longitudinal evidence exists for detecting mobility decline.
- Critical gaps remain in longitudinal validation, standardization, implementation science, and equity.
