Objectives: To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people.
Design: Longitudinal cohort study.
Setting and participants: A total of 72,359 participants recruited in the United Kingdom.
Methods: Participants were assessed at baseline on gait quantity, speed, intensity, quality, walk length distribution, and walk-related arm movement proportions using wrist-worn accelerometers for up to 7 days. Univariable and multivariable Cox proportional-hazard regression models were used to analyze the associations between these parameters and diagnosed incident depressive episodes for up to 9 years.
Results: A total of 1332 participants (1.8%) had incident depressive episodes over a mean of 7.4 ± 1.1 years. All gait variables, except some walk-related arm movement proportions, were significantly associated with the incidence of depressive episodes (P < .05). After adjusting for sociodemographic, lifestyle, and comorbidity covariates; daily running duration, steps per day, and step regularity were identified as independent and significant predictors (P < .001). These associations held consistent in subgroup analysis of older people and individuals with serious medical conditions.
Conclusions and implications: The study findings indicate digital gait quality and quantity biomarkers derived from wrist-worn sensors are important predictors of incident depression in middle-aged and older people. These gait biomarkers may facilitate screening programs for at-risk individuals and the early implementation of preventive measures.
Keywords: Smartwatch; free-living daily walking; gait analysis; walking; wearable electronic device.
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