{"doi":"10.1093/gerona/glac013","title":"Free-Living Gait Cadence Measured by Wearable Accelerometer: A Promising Alternative to Traditional Measures of Mobility for Assessing Fall Risk","abstract":"BACKGROUND: Wearable devices have become widespread in research applications, yet evidence on whether they are superior to structured clinic-based assessments is sparse. In this manuscript, we compare traditional, laboratory-based metrics of mobility with a novel accelerometry-based measure of free-living gait cadence for predicting fall rates. METHODS: Using negative binomial regression, we compared traditional in-clinic measures of mobility (6-minute gait cadence, speed, and distance, and 4-m gait speed) with free-living gait cadence from wearable accelerometers in predicting fall rates. Accelerometry data were collected with wrist-worn Actigraphs (GT9X) over 7 days in 432 community-dwelling older adults (aged 77.29 ± 5.46 years, 59.1% men, 80.2% White) participating in the Study to Understand Fall Reduction and Vitamin D in You. Falls were ascertained using monthly calendars, quarterly contacts, and ad hoc telephone reports. Accelerometry-based free-living gait cadence was estimated with the Adaptive Empirical Pattern Transformation algorithm. RESULTS: Across all participants, free-living cadence was significantly related to fall rates; every 10 steps per minute higher cadence was associated with a 13.2% lower fall rate (p = .036). Clinic-based measures of mobility were not related to falls (p > .05). Among higher-functioning participants (cadence ≥100 steps/minute), every 10 steps per minute higher free-living cadence was associated with a 27.7% lower fall rate (p = .01). In participants with slow baseline gait (gait speed <0.8 m/s), all metrics were significantly associated with fall rates. CONCLUSION: Data collected from biosensors in the free-living environment may provide a more sensitive indicator of fall risk than in-clinic tests, especially among higher-functioning older adults who may be more responsive to intervention. CLINICAL TRIAL REGISTRATION: NCT02166333.","journal":"The Journals of Gerontology Series A","year":2022,"id":242218,"datarank":1.3040720801737038,"base_score":3.6635616461296463,"endowment":3.6635616461296463,"self_citation_contribution":0.5495342469194471,"citation_network_contribution":0.7545378332542567,"self_endowment_contribution":0.5495342469194471,"citer_contribution":0.7545378332542567,"corpus_percentile":null,"corpus_rank":null,"citation_count":38,"citer_count":35,"citers_with_citation_signal":23,"citers_with_endowment":23,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9614,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02166333"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":262942,"name":"David L. Roth","orcid":"0000-0003-2105-0536","position":1,"is_corresponding":false},{"id":872552,"name":"Marta Karas","orcid":"0000-0001-5889-3970","position":2,"is_corresponding":false},{"id":409899,"name":"Amal A. Wanigatunga","orcid":"0000-0002-5763-5184","position":3,"is_corresponding":false},{"id":737401,"name":"Christine Mitchell","orcid":"0000-0002-8211-281X","position":4,"is_corresponding":false},{"id":291339,"name":"Stephen P. Juraschek","orcid":"0000-0003-4168-2696","position":5,"is_corresponding":false},{"id":321098,"name":"Yurun Cai","orcid":"0000-0001-8264-8158","position":6,"is_corresponding":false},{"id":277163,"name":"Lawrence J. Appel","orcid":"0000-0002-0673-6823","position":7,"is_corresponding":false},{"id":264188,"name":"Jennifer A. Schrack","orcid":"0000-0001-9244-9267","position":8,"is_corresponding":false},{"id":381541,"name":"Jacek Urbanek","orcid":"0000-0002-1890-8899","position":0,"is_corresponding":true}],"reference_count":48,"raw_metadata":null,"created_at":"2026-07-19T00:23:05.485568Z","pmid":"35029661","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}