{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T20:45:05Z","timestamp":1763585105165,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Paul-Kuth-Stiftung (Wuppertal)","award":["project \"Chronosense\""],"award-info":[{"award-number":["project \"Chronosense\""]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Disruptions of circadian motor behavior cause a significant burden for older adults as well as their caregivers and often lead to institutionalization. This cross-sectional study investigates the association between mobility-related behavior and subjectively rated circadian chronotypes in healthy older adults. The physical activity of 81 community-dwelling older adults was measured over seven consecutive days and nights using lower-back-worn hybrid motion sensors (MM+) and wrist-worn actigraphs (MW8). A 30-min and 120-min active period for the highest number of steps (MM+) and activity counts (MW8) was derived for each day, respectively. Subjective chronotypes were classified by the Morningness-Eveningness Questionnaire into 40 (50%) morning types, 35 (43%) intermediate and six (7%) evening types. Analysis revealed significantly earlier starts for the 30-min active period (steps) in the morning types compared to the intermediate types (p \u2264 0.01) and the evening types (p \u2264 0.01). The 120-min active period (steps) showed significantly earlier starts in the morning types compared to the intermediate types (p \u2264 0.01) and the evening types (p = 0.02). The starting times of active periods determined from wrist-activity counts (MW8) did not reveal differences between the three chronotypes (p = 0.36 for the 30-min and p = 0.12 for the 120-min active period). The timing of mobility-related activity, i.e., periods with the highest number of steps measured by hybrid motion sensors, is associated to subjectively rated chronotypes in healthy older adults. The analysis of individual active periods may provide an innovative approach for early detecting and individually tailoring the treatment of circadian disruptions in aging and geriatric healthcare.<\/jats:p>","DOI":"10.3390\/s21062121","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T02:42:05Z","timestamp":1616035325000},"page":"2121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quantifying Circadian Aspects of Mobility-Related Behavior in Older Adults by Body-Worn Sensors\u2014An \u201cActive Period Analysis\u201d"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-940X","authenticated-orcid":false,"given":"Tim","family":"Fleiner","sequence":"first","affiliation":[{"name":"Institute of Movement and Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany"},{"name":"Department of Geriatric Psychiatry &amp; Psychotherapy, LVR Hospital Cologne, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7091-4583","authenticated-orcid":false,"given":"Rieke","family":"Trumpf","sequence":"additional","affiliation":[{"name":"Institute of Movement and Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany"},{"name":"Department of Geriatric Psychiatry &amp; Psychotherapy, LVR Hospital Cologne, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Hollinger","sequence":"additional","affiliation":[{"name":"Institute of Movement and Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Haussermann","sequence":"additional","affiliation":[{"name":"Department of Geriatric Psychiatry &amp; Psychotherapy, LVR Hospital Cologne, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wiebren","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Institute of Movement and Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Colwell, C.S. (2015). Circadian Medicine, John Wiley & Sons Inc.","DOI":"10.1002\/9781118467831"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.smrv.2007.07.003","article-title":"Live to the Rhythm, Slave to the Rhythm","volume":"11","year":"2007","journal-title":"Sleep Med. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/S0531-5565(00)00191-1","article-title":"Circadian and Sleep Disturbances in the Elderly","volume":"35","year":"2000","journal-title":"Exp. Gerontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"R432","DOI":"10.1016\/j.cub.2016.04.011","article-title":"The Circadian Clock and Human Health","volume":"26","author":"Roenneberg","year":"2016","journal-title":"Curr. Biol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0031-9384(02)00733-3","article-title":"Age-Associated Difference in Circadian Sleep\u2013Wake and Rest\u2013Activity Rhythms","volume":"76","author":"Huang","year":"2002","journal-title":"Physiol. Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1081\/CBI-100101046","article-title":"Circadian Rhythms and Sleep in Human Aging","volume":"17","year":"2000","journal-title":"Chronobiol. Int."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pandi-Perumal, S.R., Monti, J.M., and Monjan, A.A. (2010). Sleep and Circadian Rhythm Disturbances in Alzheimer\u2019s Disease. Principles and Practice of Geriatric Sleep Medicine, Cambridge University Press.","DOI":"10.1017\/CBO9780511770661"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.biopsych.2012.11.021","article-title":"The Circadian System in Alzheimer\u2019s Disease: Disturbances, Mechanisms, and Opportunities","volume":"74","author":"Coogan","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Boronat, A.C., Ferreira-Maia, A.P., and Wang, Y.P. (2019). Sundown Syndrome in Older Persons: A Scoping Review. J. Am. Med. Dir. Assoc., 664\u2013671.e5.","DOI":"10.1016\/j.jamda.2019.03.001"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"325","DOI":"10.3389\/fnagi.2014.00325","article-title":"Buying Time: A Rationale for Examining the Use of Circadian Rhythm and Sleep Interventions to Delay Progression of Mild Cognitive Impairment to Alzheimer\u2019s Disease","volume":"6","author":"Landry","year":"2014","journal-title":"Front. Aging Neurosci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1159\/000106930","article-title":"Predictors of Mortality and Institutionalization in Alzheimer Disease Patients 1 Year after Discharge from an Alzheimer Dementia Unit","volume":"6","author":"Bianchetti","year":"1995","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.3109\/07420528.2013.817415","article-title":"Reviewing the Psychometric Properties of Contemporary Circadian Typology Measures","volume":"30","author":"Adan","year":"2013","journal-title":"Chronobiol. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1212\/WNL.44.12.2308","article-title":"The Neuropsychiatric Inventory: Comprehensive Assessment of Psychopathology in Dementia","volume":"44","author":"Cummings","year":"1994","journal-title":"Neurology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1093\/sleep\/26.3.342","article-title":"The Role of Actigraphy in the Study of Sleep and Circadian Rhythms","volume":"26","author":"Cole","year":"2003","journal-title":"Sleep"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/sleep\/30.4.519","article-title":"Practice Parameters for the Use of Actigraphy in the Assessment of Sleep and Sleep Disorders: An Update for 2007","volume":"30","author":"Morgenthaler","year":"2007","journal-title":"Sleep"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/B978-0-444-52006-7.00004-6","article-title":"Actigraphic Monitoring of Sleep and Circadian Rhythms","volume":"Volume 98","author":"Montagna","year":"2011","journal-title":"Handbook of Clinical Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/0006-3223(90)90523-5","article-title":"Alterations in the Circadian Rest-Activity Rhythm in Aging and Alzheimer\u2019s Disease","volume":"27","author":"Witting","year":"1990","journal-title":"Biol. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s40520-018-0930-0","article-title":"Physical Activity among Hospitalised Older People: Insights from Upper and Lower Limb Accelerometry","volume":"30","author":"Lim","year":"2018","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Trumpf, R., Zijlstra, W., Haussermann, P., and Fleiner, T. (2020). Quantifying Habitual Physical Activity and Sedentariness in Older Adults\u2014Different Outcomes of Two Simultaneously Body-Worn Motion Sensor Approaches and a Self-Estimation. Sensors, 20.","DOI":"10.3390\/s20071877"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s11332-018-0479-5","article-title":"Exercise-Induced Adaptations in Patients with Alzheimer\u2019s Disease: The Role of Circadian Scheduling","volume":"14","author":"Baldacchino","year":"2018","journal-title":"Sport Sci. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1186\/s13063-015-0758-2","article-title":"Evaluation of a Hospital-Based Day-Structuring Exercise Programme on Exacerbated Behavioural and Psychological Symptoms in Dementia\u2014The Exercise Carrousel: Study Protocol for a Randomised Controlled Trial","volume":"16","author":"Fleiner","year":"2015","journal-title":"Trials"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"R\u00f6cker, C., and Ziefle, M. (2011). Wearable Systems for Monitoring Mobility Related Activities. E-Health, Assistive Technologies and Applications for Assisted Living, IGI Global.","DOI":"10.4018\/978-1-60960-469-1"},{"key":"ref_23","first-page":"16","article-title":"Lazy Sundays: Role of Day of the Week and Reactivity on Objectively Measured Physical Activity in Older People","volume":"1","author":"Klenk","year":"2019","journal-title":"Eur. Rev. Aging Phys. Act."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"103911","DOI":"10.1016\/j.archger.2019.103911","article-title":"Day-to-Day Variability of Multiple Sensor-Based Physical Activity Parameters in Older Persons with Dementia","volume":"85","author":"Abel","year":"2019","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_25","unstructured":"Lukowicz, P., Kr\u00fcger, A., Bulling, A., Lim, Y.-K., and Patel, S.N. (2016). Patterns of Human Activity Behavior. Proceedings of the 2016 ACM International Joint Conference on Pervasive and Ubiquitous Computing Adjunct\u2014UbiComp \u201916, ACM Press."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-Mental State\u201d. A Practical Method for Grading the Cognitive State of Patients for the Clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_27","first-page":"CD011145","article-title":"Mini-Mental State Examination (MMSE) for the Detection of Dementia in Clinically Unevaluated People Aged 65 and over in Community and Primary Care Populations","volume":"2016","author":"Creavin","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jclinepi.2004.10.018","article-title":"The Development of a Comorbidity Index with Physical Function as the Outcome","volume":"58","author":"Groll","year":"2005","journal-title":"J. Clin. Epidemiol."},{"key":"ref_29","first-page":"97","article-title":"A Self-Assessment Questionnaire to Determine Morningness-Eveningness in Human Circadian Rhythms","volume":"4","author":"Horne","year":"1976","journal-title":"Int. J. Chronobiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s11818-997-0019-z","article-title":"Abend-Morgenprotokolle in Schlafforschung Und Schlafmedizin\u2014Ein Standardinstrument F\u00fcr Den Deutschsprachigen Raum","volume":"1","author":"Hoffmann","year":"1997","journal-title":"Somnologie"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1249\/MSS.0b013e3181a0c95c","article-title":"Exercise and Physical Activity for Older Adults","volume":"41","author":"Proctor","year":"2009","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.3233\/JAD-160392","article-title":"Effectiveness of Exercise- and Cognitive-Based Treatments on Salivary Cortisol Levels and Sundowning Syndrome Symptoms in Patients with Alzheimer\u2019s Disease","volume":"53","author":"Venturelli","year":"2016","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/1479-5868-8-80","article-title":"How Many Steps\/Day Are Enough? For Older Adults and Special Populations","volume":"8","author":"Craig","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"165","DOI":"10.3389\/fnagi.2015.00165","article-title":"Measuring Physical Activity in Older Adults: Calibrating Cut-Points for the MotionWatch 8\u00a9","volume":"7","author":"Landry","year":"2015","journal-title":"Front. Aging Neurosci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s11556-019-0213-6","article-title":"Physical Activity Monitors to Enhance Amount of Physical Activity in Older Adults\u2014A Systematic Review and Meta-Analysis","volume":"16","author":"Larsen","year":"2019","journal-title":"Eur. Rev. Aging Phys. 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