UMass Chan Medical School Faculty Publications

UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Geriatrics | Health Services Administration | Telemedicine



Geriatric conditions (eg, cognitive impairment, frailty) are increasingly recognized for their impact on clinical and quality-of-life outcomes in older patients with cardiovascular disease, but are not systematically assessed in the context of clinical visits owing to time constraints.


To examine feasibility of remote monitoring of the physical, cognitive, and psychosocial status of older adults with atrial fibrillation (AF) via a novel smartphone app over 6 months.


Forty participants with AF and eligible for anticoagulation therapy (CHA2DS2VASc ≥2) enrolled in an ongoing cohort study participated in a mobile health pilot study. A 6-component geriatric assessment, including validated measures of frailty, cognitive function, social support, depressive symptoms, vision, and hearing, was deployed via a smartphone app and 6-minute walk test was completed using a Fitbit. Adherence to mobile assessments was examined over 6 months.


Participants were an average of 71 years old (range 65–86 years) and 38% were women. At 1 month, 75% (30/40) of participants completed the app-based geriatric assessment and 63% (25/40) completed the 6-minute walk test. At 6 months, 52% (15/29) completed the geriatric assessment and 28% (8/29) completed the walk test. There were no differences in demographic, clinical, or psychosocial factors between participants who completed the surveys at 6 months and those who did not. Participants, on average, required less than 10 minutes of telephone support over the 6-month period.


It is feasible, among smartphone users, to use a mobile health app and wearable activity monitor to conduct serial geriatric assessments in older patients with AF for up to 6 months.


Atrial fibrillation, Geriatric assessment, Mobile health application, Older adults

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© 2020 Heart Rhythm Society. This is an open access article under the CC BY-NC-ND license (

DOI of Published Version



Trymbulak K, Ding E, Marino F, Wang Z, Saczynski JS. Mobile health assessments of geriatric elements in older patients with atrial fibrillation: The Mobile SAGE-AF Study (M-SAGE). Cardiovascular Digital Health Journal. 2020 Nov 12;1(3)123-129.

Journal/Book/Conference Title

Cardiovascular Digital Health Journal

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.