Daily Patterns of Accelerometer Activity Predict Changes in Sleep, Cognition, and Mortality in Older Men.
There is growing interest in the area of "wearable tech" and its relationship to health. A common element of many of these devices is a triaxial accelerometer that can yield continuous information on gross motor activity levels; how such data might predict changes in health is less clear.



We examined accelerometry data from 2,976 older men who were part of the Osteoporotic Fractures in Men (MrOS) study. Using a shape-naive technique, functional principal component analysis, we examined the patterns of motor activity over the course of 4-7 days and determined whether these patterns were associated with changes in polysomnographic-determined sleep and cognitive function (Trail Making Test-Part B [Trails B], Modified Mini-Mental State Examination [3MS]), as well as mortality over 6.5-8 years of follow-up.



In comparing baseline to 6.5 years later, multivariate modeling indicated that low daytime activity at baseline was associated with worsening of sleep efficiency (p < .05), more wake after sleep onset (p < .05), and a decrease in cognition (Trails B; p < .001), as well as a 1.6-fold higher rate of all-cause mortality (hazard ratio = 1.64 [1.34-2.00]). Earlier wake and bed times were associated with a decrease in cognition (3MS; p < .05). Having a late afternoon peak in activity was associated with a 1.4-fold higher rate of all-cause mortality (hazard ratio = 1.46 [1.21-1.77]). Those having a longer duration of their daytime activity with a bimodal activity pattern also had over a 1.4-fold higher rate of cardiovascular-related mortality (hazard ratio = 1.42 [1.02-1.98]).



Patterns of daily activity may be useful as predictive biomarkers for changes in clinically relevant outcomes, including mortality and changes in sleep and cognition in older men.
Department of Psychiatry and Behavioral Sciences, Stanford University, California.|Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, California.|Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California.
Jamie M
JM
Zeitzer
California Pacific Medical Center Research Institute, San Francisco.
Terri
T
Blackwell
Department of Medicine, Stanford University, California.
Andrew R
AR
Hoffman
California Pacific Medical Center Research Institute, San Francisco.
Steve
S
Cummings
Department of Psychiatry, University of California, San Diego, La Jolla.|Department of Medicine, University of California, San Diego, La Jolla.
Sonia
S
Ancoli-Israel
California Pacific Medical Center Research Institute, San Francisco.
Katie
K
Stone
D061725:Accelerometry / Q000295:instrumentation*; D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D009483:Neuropsychological Tests; D017286:Polysomnography; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D014481:United States