Cobo Antonio, Rodríguez-Laso Ángel, Villalba-Mora Elena, Pérez-Rodríguez Rodrigo, Rodríguez-Mañas Leocadio
Centre for Biomedical Technology, Universidad Politécnica de Madrid, Autopista M-40 km. 38, 28223 Pozuelo de Alarcón, Madrid Spain.
CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Avda. Monforte de Lemos, 28029 Madrid, Madrid Spain.
Health Inf Sci Syst. 2023 Jun 27;11(1):29. doi: 10.1007/s13755-023-00229-8. eCollection 2023 Dec.
Frailty is a reversible multidimensional syndrome that puts older people at a high risk of adverse health outcomes. It has been proposed to emerge from the dysregulation of the complex system dynamics of physiologic control systems. We propose the analysis of the fractal complexity of hand movements as a new method to detect frailty in older adults.
FRAIL scale and Fried's phenotype scores were calculated for 1209 subjects-72.4 (5.2) y.o. 569 women-and 1279 subjects-72.6 (5.3) y.o. 604 women-in the pubicly available NHANES 2011-2014 data set, respectively. The fractal complexity of their hand movements was assessed with a detrended fluctuation analysis (DFA) of their accelerometry records and a logistic regression model for frailty detection was fit.
Goodness-of-fit to a power law was excellent (R). The association between complexity loss and frailty level was significant, Kruskal-Wallis test (df = 2, Chisq = 27.545, p-value ). The AUC of the logistic classifier was moderate (AUC with complexity = 0.69 vs. AUC without complexity = 0.67).
Frailty can be characterized in this data set with the Fried phenotype. Non-dominant hand movements in free-living conditions are fractal processes regardless of age or frailty level and its complexity can be quantified with the exponent of a power law. Higher levels of complexity loss are associated with higher levels of frailty. This association is not strong enough to justify the use of complexity loss after adjusting for sex, age, and multimorbidity.
衰弱是一种可逆的多维度综合征，使老年人面临不良健康结局的高风险。有人提出，它源于生理控制系统复杂系统动力学的失调。我们提出将手部动作的分形复杂性分析作为一种检测老年人衰弱的新方法。
分别在公开可用的2011 - 2014年美国国家健康与营养检查调查（NHANES）数据集中，对1209名受试者（年龄72.4[5.2]岁，569名女性）和1279名受试者（年龄72.6[5.3]岁，604名女性）计算衰弱量表和弗里德表型评分。通过对其加速度计记录进行去趋势波动分析（DFA）来评估他们手部动作的分形复杂性，并拟合一个用于衰弱检测的逻辑回归模型。
与幂律的拟合优度极佳（R）。复杂性丧失与衰弱水平之间的关联显著，Kruskal - Wallis检验（自由度 = 2，卡方 = 27.545，p值）。逻辑分类器的曲线下面积（AUC）中等（有复杂性时的AUC = 0.69，无复杂性时的AUC = 0.67）。
在该数据集中，衰弱可以用弗里德表型来表征。在自由生活条件下，非优势手的动作是分形过程，无论年龄或衰弱水平如何，其复杂性都可以用幂律的指数来量化。更高水平的复杂性丧失与更高水平的衰弱相关。在调整性别、年龄和多种疾病后，这种关联强度不足以证明使用复杂性丧失是合理的。
