68 | Chapter 4 Our analysis includes baseline data from a selected group of non- and pre-frail participants with an increased fall risk, recruited for a fall prevention program. This sample may not be representative of the broader community-dwelling older adult population, as it excludes individuals without an increased fall risk and consists of those over 65 years old. While this selection criterion may affect the generalizability of the findings, the SPPB scores remain high within this sample. It is important to note that including a more diverse population, including younger and lower fall-risk individuals, might not necessarily lower SPPB scores but could potentially affect the range and strength of correlations. Moreover, there may have been ceiling effects in our study population, which may limit the sensitivity of the SPPB in detecting subtle changes or differences in functional status among individuals with relatively higher baseline capabilities. Furthermore, the tasks included in the SPPB may not adequately reflect the dynamic and varied demands encountered in daily life, potentially influencing the correlations observed with wearable sensor data focused on continuous monitoring of gait quality and quantity. Future research could explore more comprehensive assessments that better align with the multifaceted nature of functional capacity in real-world environments. Last, further research could look into combining the SPPB and daily life gait to determine functional status. However, because the SPPB and gait quality and quantity are not interchangeable, objective daily life gait quality and quantity may have added value besides using the SPPB. Since inertial sensors are being incorporated in modern electronics like smartphones and smartwatches, these devices could potentially be used to determine performance in a clinical setting. This could increase awareness of functional status for older adults and may provide both health professionals and older adults more insight into their patients’ or own functional status. Moreover, depending on the level of capacity and the gap between capacity and performance, health professionals can advise interventions or encourage people to become more physically active in daily life to potentially increase capacity. CONCLUSION Weak correlations between the SPPB and sensor-based daily life gait quality and quantity indicate that the SPPB reflects the maximal capacity, while the gait quality and quantity reflect the submaximal performance in daily life. This is likely given by the large interindividual variation in daily life gait quality and quantity data in combination with the small interindividual variation in the SPPB score in our study population of older adults. The SPPB and gait quality and quantity seem distinct constructs with complementary value, rather than being interchangeable. A more comprehensive understanding of functional status might be achieved when the SPPB assessment of standardized activities is combined with the evaluation of
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