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Updated: Aug 9, 2026
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Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
Published on: February 21, 2025
Associations Between Smartwatch-Derived Measures and Cognitive Function: Findings From the Electronic Framingham
Jie He1, Yuankai Zhang1, Xuzhi Wang1
1Department of Biostatistics Boston University School of Public Health Boston MA USA.
Journal of the American Heart Association
|August 8, 2026
Summary
Higher daily heart rate per step (DHRPS) in older adults is linked to poorer cognitive function. Increased daily steps, however, are associated with better cognitive performance, highlighting the importance of physical activity for brain health.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- Daily heart rate (HR) and physical activity are key cardiovascular disease biomarkers.
- A smartwatch-derived metric, daily HR per step (DHRPS), also indicates cardiovascular risk.
- Integrating smartwatch data with neuropsychological assessments in older adults can reveal subclinical cardiovascular factors impacting brain health.
Purpose of the Study:
- To investigate the association between DHRPS and cognitive function in older adults.
- To determine if DHRPS is a better predictor of cognitive function than HR or physical activity alone.
- To explore the relationship between smartwatch-derived cardiovascular metrics and cognitive domains.
Main Methods:
- Cross-sectional study combining Framingham Heart Study smartwatch data (2021-2024) with neuropsychological assessments (2018-2023).
- Primary exposure: DHRPS (average daily HR divided by steps per day).
- Dependent measure: Composite neuropsychological scores (memory, executive function, language, visuospatial); analyzed using linear mixed-effects models.
Main Results:
- 248 older adults (mean age 73 years) with a median of 662 smartwatch wear days.
- Each 1-SD higher DHRPS was associated with a 0.06-SD lower composite neuropsychological score (P=0.01).
- Every 1000 more steps per day correlated with a 0.03-SD higher composite neuropsychological score (P=0.02).
Conclusions:
- Higher DHRPS is independently associated with lower cognitive function in older adults.
- DHRPS may serve as a novel biomarker for cognitive decline.
- Longitudinal studies are needed to confirm DHRPS utility in predicting cognitive decline trajectories.
