Background: Mobile health technologies such as wearable inertial sensors are emerging as complementary clinical assessments and potential to evaluate and analyze postural stability, mobility and gait. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations. We investigated differences in 180° walking turns and 360° turning on the spot among frail, pre-frail, and non-frail older adults utilizing wearable sensors, and determined cutoff points of the turning measures that best discriminated older adults with frailty from those without.Methods: A cross-sectional study was conducted with community-dwelling older adults aged over 65 years. Frailty was assessed using Fried's phenotype method, and turning tasks were measured by wearable sensors. The turn duration (s) and angular velocity (°/s) in 180°and 360° turns were recorded for analysis.Results: In total, 109 participants were enrolled including 50 pre-frail and 12 frail individuals. Frail older adults took significantly longer and had slower angular velocities to complete the 180° and 360° turning than either pre-frail (p=0.002 and p<0.001, respectively) or non-frail (p=0.03 and p<0.001, respectively) older adults after adjustments for gait speed. Cutoff times of 2.45 and 3.46 s were found to best discriminate frail people from those without frailty in both 180° (sensitivity 83.3%, specificity 71.1%, AUC 0.796) and 360° (sensitivity 91.7%, specificity 74.2%, AUC 0.857) turn tasks.Conclusions: Older individuals with frailty syndrome had difficulty turning as evidenced by a longer turning duration and a slower angular velocity. The turn duration could be a potential biomarker of frailty in older populations. This simple and portable wearable technique could improve early detection of the onset of frailty, allowing the clinician to prescribe prevention and rehabilitation interventions for reversing their physical decline.

The authors have withdrawn this preprint due to erroneous posting.