{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:09:03Z","timestamp":1770991743283,"version":"3.50.1"},"reference-count":69,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["2R42AG032748"],"award-info":[{"award-number":["2R42AG032748"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Physical frailty together with cognitive impairment (Cog), known as cognitive frailty, is emerging as a strong and independent predictor of cognitive decline over time. We examined whether remote physical activity (PA) monitoring could be used to identify those with cognitive frailty. A validated algorithm was used to quantify PA behaviors, PA patterns, and nocturnal sleep using accelerometer data collected by a chest-worn sensor for 48-h. Participants (N = 163, 75 \u00b1 10 years, 79% female) were classified into four groups based on presence or absence of physical frailty and Cog: PR-Cog-, PR+Cog-, PR-Cog+, and PR+Cog+. Presence of physical frailty (PR-) was defined as underperformance in any of the five frailty phenotype criteria based on Fried criteria. Presence of Cog (Cog-) was defined as a Mini-Mental State Examination (MMSE) score of less than 27. A decision tree classifier was used to identify the PR-Cog- individuals. In a univariate model, sleep (time-in-bed, total sleep time, percentage of sleeping on prone, supine, or sides), PA behavior (sedentary and light activities), and PA pattern (percentage of walk and step counts) were significant metrics for identifying PR-Cog- (p &lt; 0.050). The decision tree classifier reached an area under the curve of 0.75 to identify PR-Cog-. Results support remote patient monitoring using wearables to determine cognitive frailty.<\/jats:p>","DOI":"10.3390\/s20082218","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T04:01:46Z","timestamp":1586923306000},"page":"2218","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Toward Using Wearables to Remotely Monitor Cognitive Frailty in Community-Living Older Adults: An Observational Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1157-159X","authenticated-orcid":false,"given":"Javad","family":"Razjouyan","sequence":"first","affiliation":[{"name":"VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77004, USA"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, TX 77004, USA"},{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-8101","authenticated-orcid":false,"given":"Bijan","family":"Najafi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"given":"Molly","family":"Horstman","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77004, USA"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"given":"Amir","family":"Sharafkhaneh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"given":"Mona","family":"Amirmazaheri","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-2891","authenticated-orcid":false,"given":"He","family":"Zhou","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77004, USA"}]},{"given":"Mark E.","family":"Kunik","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77004, USA"},{"name":"VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX 77004, USA"}]},{"given":"Aanand","family":"Naik","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77004, USA"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, TX 77004, USA"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1532-5415.2008.02136.x","article-title":"Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: The three-city study","volume":"57","author":"Amieva","year":"2009","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jamda.2016.09.015","article-title":"Cognitive frailty and adverse health outcomes: Findings from the Singapore Longitudinal Ageing Studies (SLAS)","volume":"18","author":"Feng","year":"2017","journal-title":"J. Am. Med Dir. 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