{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:32:51Z","timestamp":1787160771652,"version":"build-2736575974"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Daily heart rate (HR) and physical activity are biomarkers of cardiovascular disease. A smartwatch\u2010derived metric, daily HR per step (DHRPS), has also been associated with cardiovascular disease. Integrating smartwatch data with neuropsychological assessments in older adults makes it possible to capture subclinical cardiovascular factors relevant to brain health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This cross\u2010sectional study combined the electronic Framingham Heart Study smartwatch data (2021\u20132024) with neuropsychological assessments (2018\u20132023). The primary exposure was DHRPS defined as the average daily HR divided by steps per day. The dependent measure was assessed by composite neuropsychological scores including memory, executive function, language, and visuospatial cognitive domains. Linear mixed\u2010effects models were used to examine the association between each exposure and repeated cognitive measures, adjusting for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 248 older adults (mean age=73\u2009years; median Mini\u2010Mental State Examination score=29; 56% women; 14% multiethnic [including participants of Black, Hispanic, Asian, Indian, Pacific Islander, and Native American origins]) were assessed for a median of 662 smartwatch wear days, during which daily average HR (median 74 bpm [25th\u201375th percentiles: 69\u201378]) and daily steps (median 4810 [25th\u201375th percentiles: 3270\u20136831]) were recorded. Each 1\u2010SD higher DHRPS was associated with 0.06\u2010SD lower composite neuropsychological score (adjusted 95% CI, \u22120.11 to \u22120.01;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01). Every 1000 more steps per day were associated with 0.03\u2010SD higher composite neuropsychological score (adjusted 95% CI, 0.004\u20130.05;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher DHRPS was associated with lower cognitive function in older adults beyond HR or steps alone. Longitudinal evaluation of DHRPS exposures is needed to determine its utility for predicting cognitive decline trajectories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049284","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T03:42:26Z","timestamp":1786160546000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Smartwatch\u2010Derived Measures and Cognitive Function: Findings From the Electronic Framingham Heart Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7962-2758","authenticated-orcid":false,"given":"Jie","family":"He","sequence":"first","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-7539","authenticated-orcid":false,"given":"Yuankai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuzhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0724-8629","authenticated-orcid":false,"given":"Nicole L.","family":"Spartano","sequence":"additional","affiliation":[{"name":"Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center","place":["Boston, USA"]},{"name":"Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study","place":["Framingham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Rong","sequence":"additional","affiliation":[{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]},{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4687-2552","authenticated-orcid":false,"given":"Ting Fang Alvin","family":"Ang","sequence":"additional","affiliation":[{"name":"Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]},{"name":"Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-4491","authenticated-orcid":false,"given":"Rhoda","family":"Au","sequence":"additional","affiliation":[{"name":"Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]},{"name":"Boston University School of Public Health","place":["Boston, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]},{"name":"Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3043-3942","authenticated-orcid":false,"given":"Honghuang","family":"Lin","sequence":"additional","affiliation":[{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9458-4585","authenticated-orcid":false,"given":"Eric","family":"Schramm","sequence":"additional","affiliation":[{"name":"Care Evolution","place":["Ann Arbor, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0859-796X","authenticated-orcid":false,"given":"Belinda","family":"Borrelli","sequence":"additional","affiliation":[{"name":"Boston University Henry M. 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