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However, adherence to typical 5\u20137\u2009day wear protocols decreases with age, reducing feasibility. Whether accelerometry measures collected over shorter wear periods predict frailty decline is unknown. In cross\u2010section, we have shown that frailty is most strongly differentiated by morning activity patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to determine whether two morning activity measures, mean hourly activity and within activity variance, measured over 72\u2009h predicted 5\u2010year mortality and frailty progression among survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a secondary data analysis of the 2010\u20132011 accelerometry substudy and 2015\u20132016 data of the National Social Life, Health and Aging Project which included\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009584 community\u2010dwelling older adults;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009104 died at 5\u2009years. Wrist accelerometers were worn for 72\u2009h in 2010\u20132011, and an adapted frailty phenotype was measured in both years. We employed a mixed effects location scale model to calculate mean morning (7:00\u201311:59\u2009am) hourly activity (counts per minute z\u2010score) and within\u2010subject morning hourly activity variance (z\u2010score) for each participant, adjusted for day of week and month of wear. Second, 5\u2010year mortality (logistic) and adapted frailty phenotype scores (range 0\u20134, ordinal) were regressed on baseline frailty and both accelerometry z\u2010scores in a 2\u2010stage model, adjusting for covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for baseline frailty, demographics, comorbidities, BMI, and cognition, higher mean morning hourly activity predicted lower 5\u2010year mortality risk (OR\u2009=\u20090.64 for 1 SD increase,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Conversely, higher morning activity WS variance predicted better frailty scores among survivors (OR\u2009=\u20090.67 for 1 SD increase,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher activity levels and higher day\u2010to\u2010day morning activity variance measured over just two to three mornings differentiate those at higher risk of death and frailty decline, increasing the feasibility of using accelerometry as a digital frailty screening tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70690","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:16:33Z","timestamp":1789701393000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Mean and Variability of Morning Hour Activity Over 2\u20133\u2009Days Predict 5\u2010Year Mortality and Frailty Risk in a National Sample of Older Adults"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3997-5791","authenticated-orcid":false,"given":"Megan","family":"Huisingh\u2010Scheetz","sequence":"first","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Brown","sequence":"additional","affiliation":[{"name":"NORC at the University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelangelo","family":"Pagan","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassidy","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Depaul University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rubin","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabiel","family":"Mir","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2950-7230","authenticated-orcid":false,"given":"Maria Lucia","family":"Madariaga","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Philip","family":"Schumm","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Wroblewski","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Hedeker","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in Older Adults: Evidence for a Phenotype","volume":"56","author":"Fried L. 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