Mapping sedentary behaviour (MAPS-B) in winter and spring using wearable sensors, indoor positioning systems, and diaries in older adults who are pre-frail and frail: A feasibility longitudinal study

Abstract

Older adults who are frail are likely to be sedentary. Prior interventions to reduce sedentary time in older adults have not been effective as there is little research about the context of sedentary behaviour (posture, location, purpose, social environment). Moreover, there is limited evidence on feasible measures to assess context of sedentary behaviour in older adults. The aim of our study was to determine the feasibility of measuring context of sedentary behaviour in older adults with pre-frailty or frailty using a combination of objective and self-report measures. We defined “feasibility process” using recruitment (20 participants within two-months), retention (85%), and refusal (20%) rates and “feasibility resource” if the measures capture context and can be linked (e.g., sitting-kitchen-eating-alone) and are all participants willing to use the measures. Context was assessed using a wearable sensor to assess posture, a smart home monitoring system for location, and an electronic or hard-copy diary for purpose and social context over three days in winter and spring. We approached 80 potential individuals, and 58 expressed interest; of the 58 individuals, 37 did not enroll due to lack of interest or medical mistrust (64% refusal). We recruited 21 older adults (72±7.3 years, 13 females, 13 frail) within two months and experienced two dropouts due to medical mistrust or worsening health (90% retention). The wearable sensor, indoor positioning system, and electronic diary accurately captured one domain of context, but the hard copy was often not completed with enough detail, so it was challenging to link it to the other devices. Although not all participants were willing to use the wearable sensor, indoor positioning system, or electronic diary, we were able to triage the measures of those who did. The use of wearable sensors and electronic diaries may be a feasible method to assess context of sedentary behaviour, but more research is needed with device-based measures in diverse groups.

Exploring the perspectives of older adults who are pre-frail and frail to identify interventions to reduce sedentary behaviour and improve mobility: a thematic content analysis

“…This study is part of a larger research project, the MAPS-B (Mapping Sedentary Behaviour) study, which aims to understand the feasibility of measuring the context of sedentary behaviour among older adults who are pre-frail and frail [ 19 ]. To map the context of sedentary behaviour we used objective (wearable sensor and indoor positioning system), and self-report (daily diary) measures [ 19 ]. We used a valid thigh-worn sensor, activPAL4™, to distinguish between sedentary and standing postures [ 20 ].…”

“…The system was designed and validated to be used by older adults in their own homes without the need for a floor plan and only minimal initial setup and calibration; the system can also be used in homes with multiple stories with multiple residents [ 21 ]. Participants were equipped with the wearable sensor (activPAL4™) and an indoor positioning system, and completed a 24-hour diary of activities over three days (one weekend and two weekdays) in the winter (February 1, 2023 to March 21st, 2023) and spring (April 10th, 2023 to May 27th, 2023) [ 19 ]. The three measures were linked using date and time (an example of linking the data: sitting-living room-watching TV-alone weekend, Winter 3:30 pm to 5:15 pm).…”