Abstract
Background: Gait is an essential manifestation of depression. However, the gait characteristics of daily walking and their relationships with depression have yet to be fully explored. Objective: The aim of this study was to explore associations between depression symptom severity and daily-life gait characteristics derived from acceleration signals in real-world settings. Methods: We used two ambulatory data sets (N=71 and N=215) with acceleration signals collected by wearable devices and mobile phones, respectively. We extracted 12 daily-life gait features to describe the distribution and variance of gait cadence and force over a long-term period. Spearman coefficients and linear mixed-effects models were used to explore the associations between daily-life gait features and depression symptom severity measured by the 15-item Geriatric Depression Scale (GDS-15) and 8-item Patient Health Questionnaire (PHQ-8) self-reported questionnaires. The likelihood-ratio (LR) test was used to test whether daily-life gait features could provide additional information relative to the laboratory gait features. Results: Higher depression symptom severity was significantly associated with lower gait cadence of high-performance walking (segments with faster walking speed) over a long-term period in both data sets. The linear regression model with long-term daily-life gait features (R2=0.30) fitted depression scores significantly better (LR test P=.001) than the model with only laboratory gait features (R2=0.06). Conclusions: This study indicated that the significant links between daily-life walking characteristics and depression symptom severity could be captured by both wearable devices and mobile phones. The daily-life gait patterns could provide additional information for predicting depression symptom severity relative to laboratory walking. These findings may contribute to developing clinical tools to remotely monitor mental health in real-world settings.
| Original language | English (US) |
|---|---|
| Article number | e40667 |
| Journal | JMIR mHealth and uHealth |
| Volume | 10 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2022 |
Funding
RJBD is supported by the following: (1) NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King\u2019s College London, United Kingdom; (2) Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust; (3) The BigData@Heart consortium, funded by the IMI-2 Joint Undertaking under grant agreement number 116074. This Joint Undertaking receives support from the European Union\u2019s Horizon 2020 Research and Innovation Program and EFPIA; it is chaired by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and ESC; (4) the NIHR University College London Hospitals Biomedical Research Centre; (5) the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King\u2019s College London; (6) the UK Research and Innovation London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare; and (7) the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King\u2019s College Hospital NHS Foundation Trust. The Remote Assessment of Disease and Relapse\u2013Central Nervous System (RADAR-CNS) project has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union\u2019s Horizon 2020 Research and Innovation Program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding bodies have not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. This study represents independent research partly funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London, and Maudsley NHS Foundation Trust and King\u2019s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience of mental health problems and their careers, who have been specially trained to advise on research proposals and documentation through Feasibility and Acceptability Support Team for Researchers (FAST-R), a free, confidential service in England provided by the NIHR Maudsley Biomedical Research Centre via King\u2019s College London and South London and Maudsley NHS Foundation Trust. We thank all GLAD Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centers, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King\u2019s College London, South London and Maudsley NHS Trust and King\u2019s Health Partners. We thank the NIHR, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Program. CO is supported by the UK Medical Research Council (MR/N013700/1) and King\u2019s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences.
Keywords
- acceleration signals
- depression
- gait
- mHealth
- mental health
- mobile health
- mobile phones
- monitoring
- wearable devices
ASJC Scopus subject areas
- Health Informatics