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June 25, 2026GeroScience0 citationsOpen Access

Associations of daily step counts with cognitive, clinical, and resting-state electroencephalographic measures in patients with cognitive decline due to Alzheimer’s disease

MCMatteo CarpiMBMina De BartoloVIVerónica Henao Isaza

Key Result

Patients with Alzheimer's disease dementia had significantly lower mean daily steps compared to cognitively unimpaired older adults (3544.0 vs 6506.2 steps, p=0.002).

Key Points

  • This study aims to explore the association between daily step counts and various cognitive and EEG measures in individuals with Alzheimer’s disease.
  • Participants included 19 with dementia due to Alzheimer’s, 28 with mild cognitive impairment, and 23 cognitively unimpaired older adults, totaling 70 individuals.
  • Home-based monitoring utilized Samsung Galaxy Watch to record step counts and activity intensity for approximately one week.
  • Clinical assessments included neuropsychological testing and resting-state EEG measurements.
  • Participants with dementia exhibited reduced daily step counts and lower peak cadence compared to those with mild cognitive impairment and cognitively unimpaired individuals.
  • Strong associations found between step metrics and cognitive performance assessed by neuropsychological tests, particularly the MMSE.
  • Limited associations were observed between step counts and resting-state EEG rhythms, with abnormal EEG measures noted predominantly in the dementia group.

Study Design

Type

Cross-Sectional (n=70)

Multicenter

Yes

Structured PICO

P
Population
70 older adults (mean age 72.5 years, 47% female) including patients with Alzheimer's disease dementia, mild cognitive impairment, and cognitively unimpaired controls, monitored for 1 week.
E
Exposure
One-week home telemonitoring using Samsung Galaxy Watch 4-6 smartwatches to record step counts and activity intensity, combined with unsupervised SmartMe&You-TELEMAIA serious videogame battery for cognitive assessment.
O
Outcome
Association of daily step counts with cognitive functioning (neuropsychological testing and serious videogame performance) and resting-state EEG measures.surrogate

Smartwatch-derived step volume and intensity are associated with cognitive status in patients with Alzheimer's disease, suggesting their utility as feasible markers of everyday functioning.

Main Result

Standardized Mean Difference: 1.13

Absolute Event Rate: 3544% vs 6506.2%

p-value: p=0.002

Limitations

  • Moderate sample size
  • Exploratory nature of partial correlation analyses
  • Exclusion of 21.3% of initial sample due to insufficient valid monitoring days

Abstract

Abstract Sedentary behavior is a recognized and modifiable risk factor for cognitive decline and dementia across neurodegenerative conditions. This study used a smartwatch-based telemonitoring procedure combined with ecological cognitive assessment to examine whether step counts can capture sedentary behavior and its association with cognitive functioning in patients with mild cognitive impairment (ADMCI) and dementia (ADD) due to Alzheimer’s disease. Then, 19 ADD, 28 ADMCI, and 23 cognitively unimpaired older adults (Nold) were consecutively recruited. Participants underwent clinical assessment, resting-state electroencephalography (rsEEG), and neuropsychological testing. They were then monitored at home for approximately one week using Samsung Galaxy Watch 4–6 devices recording step counts (total, purposeful, and incidental) and activity intensity (peak 30-min cadence), together with the unsupervised SmartMe N = 19), Alzheimer’s disease with mild cognitive impairment (ADMCI; N = 28), and cognitively unimpaired older adults (Nold; N = 23), indicating reduced daily step volume and peak cadence mainly in ADD. c Representative significant associations within the AD clinical sample (ADD + ADMCI; up to N = 47), showing that step metrics were more closely related to cognition (MMSE) and depressive symptom severity (BDI-II) than to resting-state EEG activity, for which only limited associations emerged.

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Cite This Study

Carpi et al. (2026) conducted a cross-sectional in Alzheimer's disease (n=70). Alzheimer's disease dementia (ADD) vs. Cognitively unimpaired older adults (Nold) was evaluated on Mean daily steps (Cohen's d 1.13, p=0.002). Patients with Alzheimer's disease dementia had significantly lower mean daily steps compared to cognitively unimpaired older adults (3544.0 vs 6506.2 steps, p=0.002).

synapsesocial.com/papers/6a3d91bf408ebb922448b14ahttps://doi.org/10.1007/s11357-026-02367-9
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