Digital mobility assessment using wearable devices in people with Parkinson's disease: a feasibility and implementation study in Ghana (TraPCAf) compared with a UK cohort.

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IntroductionLife expectancy is rising in Africa, increasing Parkinson's disease (PD) prevalence. PD in Africa is often underdiagnosed/undertreated due to limited specialists, awareness and medication access. Gait impairments are among the earliest and most disabling PD symptoms, yet their presentation in African populations is poorly understood. This study aimed to (1) compare real-world mobility between PD and older controls in a population from Ghana (GHA-PD and GHA-CL), (2) examine associations between digital mobility outcomes (DMOs) and clinical/demographic factors between GHA-PD and a PD cohort from a high-income European country (UK-PD), and (3) assess the acceptability of the measurement method in GHA-PD and GHA-CL.MethodsPD (n = 50) and controls (n = 30) in Ghana wore a wearable device (Axivity AX6) for seven days. Raw data were used to derive 24 DMOs using the Mobilise-D pipeline. An age-gender-matched PD and control cohort (UK-CL), based in United Kingdom, from another study was included for comparison. Differences were also analysed by controlling confounding factors.ResultsSixteen of 24 DMOs differed significantly (p DiscussionReduced mobility and gait quality in GHA-PD highlight risks of functional decline and loss of independence. Further research should investigate lifestyle, cultural, environmental and healthcare factors that might contribute to these disparities.

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