Wearable monitoring of physical functioning and disability changes, circadian rhythms and sleep patterns in nursing home residents

Juho Merilahti, Petteri Viramo, Ilkka Korhonen

    Research output: Contribution to journalArticleScientificpeer-review

    34 Citations (Scopus)


    Sleep problems and disrupted circadian rhythms are common among older adults and may be associated with several health issues and physical functioning status. Wearable continuous monitoring of physical activity enables unobtrusive monitoring of circadian activity and sleep patterns. The objective of this retrospective study was to analyze whether physical functioning status (Activities of Daily Living assessment of Resident Assessment Instrument) is associated with diurnal activity rhythm and sleep patterns measured with wearable activity sensor in nursing home residents during their normal daily life. Continuous activity data were collected by the wearable sensor from 16 nursing home residents (average age of 90.7 years, seven demented subjects, one female) in their daily life over several months (12-18 months). The subjects' physical activity and sleep were quantified by several parameters from the activity data. In the cross-sectional analysis, physical functioning status was associated with the strength (RHO = 0.78,P <0.05) and the stability (RHO = 0.72,P <0.05) of the activity rhythm when the level of dementia was not controlled. In the longitudinal analysis (12-18 months), at an individual level the activity rhythm indices and activity level had the strongest correlations with changes in physical functioning but the associations were to some extent individual. In these long-term case recordings, decrease in the physical functioning was most strongly associated with decreasing levels of activity, stability, and strength of the activity rhythm, and with increasing fragmentation of rhythm and daytime passivity. Daily wearable monitoring of physical activity may hence reveal information about functioning state and health of older adults. However, since the changes in activity patterns implying changes in physical functioning statusmay not be consistent between the individuals, a multivariate approach is recommended for monitoring of these changes by continuous physical activity measurement.
    Original languageEnglish
    Pages (from-to)856 - 864
    JournalIEEE Journal of Biomedical and Health Informatics
    Issue number3
    Publication statusPublished - 2016
    MoE publication typeA1 Journal article-refereed


    • activities of daily living
    • ambulatory monitoring
    • dementia
    • long-term
    • physical activity


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