Validation of an Armband to Measure Daily Energy Expenditure in Older Adults

Background. Objective methods to measure daily energy expenditure in studies of aging are needed. We sought to determine the accuracy of total energy expenditure (TEE) and activity energy expenditure (AEE) estimates from the SenseWear Pro armband (SWA) using software versions 6.1 (SWA 6.1) and 5.1 (SWA 5.1) relative to criterion methods in free-living older adults. Methods. Participants (n = 19, mean age 82.0 years) wore a SWA for a mean +/- SD 12.5 +/- 1.1 days, including while sleeping. During this same period, criterion values for TEE were assessed with doubly labeled water and for resting metabolic rate (RMR) with indirect calorimetry. AEE was calculated as 0.9 TEE - RMR. Results. For TEE, there was no difference in mean +/- SD values from doubly labeled water (2,040 +/- 472 kcal/day) versus SWA 6.1 (2,012 +/- 497 kcal/day, p = .593) or SWA 5.1 (2,066 +/- 474 kcal/day, p = .606); individual values were highly correlated between methods (SWA 6.1 r = .893, p <.001; SWA 5.1 r = .901, p <.001) and demonstrated strong agreement (SWA 6.1 intraclass correlation coefficient = .896; SWA 5.1 intraclass correlation coefficient = .904). For AEE, mean values from SWA 6.1 (427 +/- 304 kcal/day) were lower by 26.8% than criterion values (583 +/- 242 kcal/day, p = .003), and mean values from SWA 5.1 (475 +/- 299 kcal/day) were lower by 18.5% than criterion values (p = .021); however, individual values were highly correlated between methods (SWA 6.1 r = .760, p <.001; SWA 5.1 r = .786, p <.001) and demonstrated moderate agreement (SWA 6.1 intraclass correlation coefficient = .645; SWA 5.1 intraclass correlation coefficient = .720). Bland-Altman plots identified no systematic bias for TEE or AEE. Conclusions. Acceptable levels of agreement were observed between SWA and criterion measurements of TEE and AEE in older adults.