Fractal Complexity of Daily Physical Activity Patterns Differs With Age Over the Life Span and Is Associated With Mortality in Older Adults

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BACKGROUND: Accelerometers are included in a wide range of devices that monitor and track physical activity for health-related applications. However, the clinical utility of the information embedded in their rich time-series data has been greatly understudied and has yet to be fully realized. Here, we examine the potential for fractal complexity of actigraphy data to serve as a clinical biomarker for mortality risk. METHODS: We use detrended fluctuation analysis (DFA) to analyze actigraphy data from the National Health and Nutrition Examination Survey (NHANES; n = 11,694). The DFA method measures fractal complexity (signal self-affinity across time-scales) as correlations between the amplitude of signal fluctuations in time-series data across a range of time-scales. The slope, α, relating the fluctuation amplitudes to the time-scales over which they were measured describes the complexity of the signal. RESULTS: Fractal complexity of physical activity (α) decreased significantly with age (p = 1.29E-6) and was lower in women compared with men (p = 1.79E-4). Higher levels of moderate-to-vigorous physical activity in older adults and in women were associated with greater fractal complexity. In adults aged 50-79 years, lower fractal complexity of activity (α) was associated with greater mortality (hazard ratio = 0.64; 95% confidence interval = 0.49-0.82) after adjusting for age, exercise engagement, chronic diseases, and other covariates associated with mortality. CONCLUSIONS: Wearable accelerometers can provide a noninvasive biomarker of physiological aging and mortality risk after adjusting for other factors strongly associated with mortality. Thus, this fractal analysis of accelerometer signals provides a novel clinical application for wearable accelerometers, advancing efforts for remote monitoring of physiological health by clinicians.

Original languageEnglish (US)
Pages (from-to)1461-1467
Number of pages7
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Issue number9
StatePublished - Aug 16 2019



  • Actigraphy
  • Detrended fluctuation analysis
  • Wearables

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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