Comparison of digital gait characteristics measured by wearable devices in older adults with and without depressive symptoms.

BACKGROUND

As older adults with depression exhibit gait impairments, this study aimed to investigate the association between depressive symptoms in older adults and digital gait parameters derived from wearable devices.

METHODS

862 community-dwelling older adults were recruited. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). A multi-sensor wearable gait analyzer was used to measure periodic, kinetic, and spatiotemporal gait parameters during a 12-m normal walking test. Multivariable logistic regression analyses were conducted to examine the relationship between depressive symptoms and Z-transformed gait parameters, adjusting for demographics, BMI, lifestyles, cognitive function, and comorbidities. Receiver operating characteristic curve analysis was used to evaluate the discriminative performance of gait parameters in identifying depressive symptoms.

RESULTS

The mean age of all participants was 70.24 ± 6.19 years, and 58.35% were female. After adjusting for all covariates, longer double-limb support time (OR = 1.30, 95% CI: 1.05-1.60, P = 0.014) and terminal limb support time (OR = 1.26, 95% CI: 1.03-1.54, P = 0.023) were associated with higher odds of depressive symptoms. Conversely, higher thigh swing work (OR = 0.75, 95% CI: 0.59-0.95, P = 0.016), ground reaction force (OR = 0.79, 95% CI: 0.63-0.99, P = 0.041), landing control force (OR = 0.79, 95% CI: 0.63-0.99, P = 0.045), gait speed (OR = 0.63, 95% CI: 0.49-0.80, P < 0.001), stride frequency (OR = 0.78, 95% CI: 0.63-0.95, P = 0.016), step length (OR = 0.59, 95% CI: 0.46-0.75, P < 0.001), and stride length (OR = 0.59, 95% CI: 0.47-0.76, P < 0.001) were related to lower odds of depressive symptoms. Gait parameters demonstrated acceptable value for identifying depressive symptoms, with an area under the curve (AUC) of 0.707. Spatiotemporal parameters (AUC = 0.675) showed better discriminatory ability than periodic parameters (AUC = 0.585) and kinetic parameters (AUC = 0.609).

CONCLUSION

Older adults with depressive symptoms exhibited poorer kinetic and spatiotemporal gait performance. Gait parameters measured by wearable sensors hold potential value for identifying depression.