{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:17:28Z","timestamp":1788362248139,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Wearable devices provide multidimensional measures of cardiometabolic health. We aimed to derive latent physiological dimensions from ECG and motion variables collected by a wearable device and evaluate their associations with the individual health metrics of the Longevity Check-Up 8+ (LC8+) programme. Methods: Community-dwelling adults voluntarily participating in four Longevity Check-Up 8+ (LC8+) events underwent 24-h multiparameter recording using a wearable device. Eight wearable-derived variables were entered into principal component analysis (PCA) to derive latent physiological dimensions. Component scores were subsequently evaluated for associations with overall LC8+ health, while exploratory analyses examined associations with individual health metric domains. Results: Ninety-seven participants (mean age 51.3 \u00b1 13.4 years; 36% female) were enrolled. Among the 96 participants with complete data for the PCA, three latent physiological components were identified, explaining 70.1% of the total variance. PC1, which was characterised by high SDNN, high RMSSD, and low nocturnal heart rate, was independently associated with overall LC8+ health (LM: B = +0.402, 95% CI [+0.103, +0.700], p = 0.009). Among the eight LC8+ domains, only the association between PC1 and glycaemic health remained statistically significant after Benjamini\u2013Hochberg correction in the primary fixed-effects analysis (95% CI [1.32, 4.62], adjusted p = 0.039). Conclusions: A wearable-derived autonomic component was associated with overall cardiometabolic health in community-dwelling adults. Among the individual LC8+ domains, the strongest association was observed for glycaemic health. These preliminary findings support further investigation of wearable device monitoring as a complementary tool for cardiovascular health assessment in preventive medicine.<\/jats:p>","DOI":"10.3390\/medsci14050540","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:35:29Z","timestamp":1788359729000},"page":"540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Wearable-Derived Autonomic Component Is Associated with Cardiovascular Health in Community-Dwelling Adults: A Cross-Sectional Analysis from the Longevity Check-Up 8+ Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-2365","authenticated-orcid":false,"given":"Riccardo","family":"Calvani","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6475-7510","authenticated-orcid":false,"given":"Fabrizio","family":"Sollazzo","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Scuola di Specializzazione in Medicina dello Sport e dell\u2019Esercizio Fisico, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Maria","family":"Sarti","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-7202","authenticated-orcid":false,"given":"Antonella","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-3487","authenticated-orcid":false,"given":"Anna","family":"Picca","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Surgery, Libera Universit\u00e0 Mediterranea (LUM) Giuseppe Degennaro, 70010 Casamassima, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-9514","authenticated-orcid":false,"given":"H\u00e9lio Jos\u00e9","family":"Coelho-J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-0925","authenticated-orcid":false,"given":"Andrea","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9093-4776","authenticated-orcid":false,"given":"Sara","family":"Salini","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-5899","authenticated-orcid":false,"given":"Massimiliano","family":"Bianco","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Scuola di Specializzazione in Medicina dello Sport e dell\u2019Esercizio Fisico, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-6983","authenticated-orcid":false,"given":"Emanuele","family":"Marzetti","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4478-4033","authenticated-orcid":false,"given":"Vincenzo","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Scuola di Specializzazione in Medicina dello Sport e dell\u2019Esercizio Fisico, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Landi","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Tosato","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/s41569-021-00522-7","article-title":"Smart wearable devices in cardiovascular care: Where we are and how to move forward","volume":"18","author":"Bayoumy","year":"2021","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1093\/eurheartj\/ehag189","article-title":"Wearable devices and cardiovascular health: Revolutionizing remote monitoring and disease prevention","volume":"47","author":"Hughes","year":"2026","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Burlacu, A., Brinza, C., Geman, O., Karppa, M., and Hemanth, D.J. (2026). Heart rate variability as a dual-use digital biomarker: Integrating clinical, ai, and operational perspectives on human performance and resilience. BMC Cardiovasc. Disord., 26.","DOI":"10.1186\/s12872-026-05543-z"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Liu, S., Cui, Y., and Chen, M. (2025). Heart rate variability: A multidimensional perspective from physiological marker to brain-heart axis disorders prediction. Front. Cardiovasc. Med., 12.","DOI":"10.3389\/fcvm.2025.1630668"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wang, B.X., Brennand, E., Le Page, P., and Mitchell, A.R.J. (2026). Heart rate variability in cardiovascular disease diagnosis, prognosis and management. Front. Cardiovasc. Med., 12.","DOI":"10.3389\/fcvm.2025.1680783"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11998","DOI":"10.1038\/s41598-022-15824-0","article-title":"Reduced heart rate variability is related to the number of metabolic syndrome components and manifest diabetes in the sixth troms\u00f8 study 2007\u20132008","volume":"12","author":"Azulay","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ortiz-Guzm\u00e1n, J.E., Moll\u00e0-Casanova, S., Serra-A\u00f1\u00f3, P., Arias-Mutis, \u00d3.J., Calvo, C., Bizy, A., Alberola, A., Chorro, F.J., and Zarzoso, M. (2023). Short-term heart rate variability in metabolic syndrome: A systematic review and meta-analysis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12186051"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, W., Qin, X., Xu, J., Zhao, Y., and Ren, H. (2026). Dynamic effects of different exercise modalities on autonomic recovery: A longitudinal study based on heart rate variability. Eur. J. Appl. Physiol.","DOI":"10.1007\/s00421-026-06329-z"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ijcard.2018.08.005","article-title":"Heart rate variability as a marker of healthy ageing","volume":"275","author":"Tan","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s13098-024-01505-7","article-title":"Impact of sleep problems on the cardiometabolic risks: An integrated epidemiological and metabolomics study","volume":"16","author":"Chen","year":"2024","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1093\/eurpub\/cky034","article-title":"Cardiovascular health metrics, muscle mass and function among italian community-dwellers: The Lookup 7+ project","volume":"28","author":"Landi","year":"2018","journal-title":"Eur. J. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Cacciatore, S., Levati, E., Calvani, R., Tosato, M., Ciciarello, F., Galluzzo, V., Salini, S., Russo, A., Marzetti, E., and Landi, F. (2025). Temporal trends in cardiovascular health metrics in italy, 2015\u20132024: A ten-year report from the longevity check-up (Lookup) 8+ study. Med. Sci., 13.","DOI":"10.3390\/medsci13040251"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28882","DOI":"10.1038\/s41598-024-79329-8","article-title":"Waist-to-calf circumference ratio as a potential indicator of diabetes risk: Results from the Longevity Check-Up (Lookup) 8+","volume":"14","author":"Cacciatore","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_14","first-page":"E18","article-title":"Life\u2019s Essential 8: Updating and enhancing the American Heart Association\u2019s construct of cardiovascular health: A presidential advisory from the American Heart Association","volume":"146","author":"Allen","year":"2022","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jelectrocard.2019.02.012","article-title":"The quality of ecg data acquisition, and diagnostic performance of a novel adhesive patch for ambulatory cardiac rhythm monitoring in arrhythmia detection","volume":"54","author":"Yurtseven","year":"2019","journal-title":"J. Electrocardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.5664\/jcsm.8462","article-title":"Screening of Obstructive Sleep Apnea in Patients Who Snore Using a Patch-Type Device with Electrocardiogram and 3-Axis Accelerometer","volume":"16","author":"Hsu","year":"2020","journal-title":"J. Clin. Sleep Med."},{"key":"ref_17","first-page":"141","article-title":"A simple method to assess exercise behavior in the community","volume":"10","author":"Godin","year":"1985","journal-title":"Can. J. Appl. Sport Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"604","DOI":"10.2466\/03.27.PMS.120v19x7","article-title":"The Godin-Shephard leisure-time physical activity questionnaire: Validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories","volume":"120","author":"Amireault","year":"2015","journal-title":"Percept. Mot. Skills"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/1094428104263675","article-title":"Factor retention decisions in exploratory factor analysis: A tutorial on parallel analysis","volume":"7","author":"Hayton","year":"2004","journal-title":"Organ. Res. Methods"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104907","DOI":"10.1016\/j.neubiorev.2022.104907","article-title":"Heart rate variability in the prediction of mortality: A systematic review and meta-analysis of healthy and patient populations","volume":"143","author":"Jarczok","year":"2022","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/eci.12730","article-title":"A Composite autonomic index as unitary metric for heart rate variability: A proof of concept","volume":"47","author":"Sala","year":"2017","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Banerjee, A. (2026). Understanding the shortcomings of heart rate variability as a tool for autonomic analysis. Front. Physiol., 17.","DOI":"10.3389\/fphys.2026.1760160"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/j.ijcard.2012.02.002","article-title":"Heart rate variability is associated with glycemic status after controlling for components of the metabolic syndrome","volume":"167","author":"Jarczok","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"583","DOI":"10.2188\/jea.JE20140254","article-title":"Heart rate variability, insulin resistance, and insulin sensitivity in japanese adults: The toon health study","volume":"25","author":"Saito","year":"2015","journal-title":"J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Benichou, T., Pereira, B., Mermillod, M., Tauveron, I., Pfabigan, D., Maqdasy, S., and Dutheil, F. (2018). Heart rate variability in type 2 diabetes mellitus: A systematic review and meta-analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195166"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1038\/s41569-018-0109-6","article-title":"Short sleep duration and cardiometabolic risk: From pathophysiology to clinical evidence","volume":"16","author":"Tobaldini","year":"2019","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100656","DOI":"10.1016\/j.ijchp.2025.100656","article-title":"What comes first: Heart rate variability changes or insomnia? a causal investigation using mendelian randomization","volume":"25","author":"Yan","year":"2025","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_28","first-page":"e62465","article-title":"Effects of exercise training on heart rate variability in healthy adults: A systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Amekran","year":"2024","journal-title":"Cureus"},{"key":"ref_29","first-page":"303","article-title":"Improvements in Heart Rate Variability with Exercise Therapy","volume":"26","author":"Routledge","year":"2010","journal-title":"Can. J. Cardiol."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/540\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:45:14Z","timestamp":1788360314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["medsci14050540"],"URL":"https:\/\/doi.org\/10.3390\/medsci14050540","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}