Banca de DEFESA: CAROLINE SOUSA TRUTA RAMALHO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : CAROLINE SOUSA TRUTA RAMALHO
DATE: 18/05/2026
TIME: 09:00
LOCAL: remoto
TITLE:

Relationships between physiological parameters obtained by wearable devices and mental health symptoms in the elderly.

KEY WORDS:

mental health; elderly person; wearable devices; heart rate variability; sleep;
aging.

 

PAGES: 106
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Population aging has intensified the prevalence of mental disorders in older people, conditions that are frequently underdiagnosed and associated with functional and cognitive decline. Changes in heart rate variability (HRV) and objective sleep patterns emerge as potential biomarkers associated with these mental health outcomes. However, the applicability of wearable devices (WDs) in monitoring the mental health of older people still constitutes a gap in the literature. Objective: To investigate the relationships between physiological parameters of heart rate variability and sleep, obtained by wearable devices, and mental health outcomes in older people. Methods: This thesis is composed of two studies. Article 1 – This is a Systematic Review (SR) conducted in six databases (PubMed, Embase, CINAHL, Scopus, Web of Science, and PsycINFO), without time restrictions, following the methodological guidelines of the Joanna Briggs Institute (JBI). The SR investigated studies that evaluated HRV and sleep parameters derived from wearable devices and their associations with mental health outcomes in adults aged 50 or older. The protocol was registered on the PROSPERO platform (CRD42023458573). Article 2 – Cross-sectional, descriptive, and analytical study conducted with 122 elderly people living in the community, recruited at the Jardim Planalto Basic Health Unit in Parnamirim/RN, and at the Open University for Maturity (UAMA) of the State University of Paraíba, in Campina Grande/PB. The participants used the Fitbit Inspire HR/Inspire 3 smartwatch for seven consecutive days to monitor sleep parameters and HRV. Symptoms of depression (CES-D), anxiety (GAI), perceived stress (EEP), sleep quality (PSQI), daytime sleepiness (ESE), and cognitive function (Cognitive Test of 

Leganés). Associations were investigated using binary logistic regression, with calculation of the respective odds ratios (OR). Results: Article 1: The SR included 13 studies, totaling 1,295 participants, aged between 50 and 90 years. The findings indicate that reduced HRV indices, especially RMSSD, SDNN, and high-frequency (HF) power, are associated with greater severity of depressive symptoms, anxiety, and cognitive impairment. Alterations in objective sleep patterns, such as reduced efficiency, circadian fragmentation, and alterations in REM and non-REM phases, were systematically associated with worse mental health outcomes. The most used devices were Holter, actigraphy, Fitbit, and portable ECG sensors. Article 2: The sample was predominantly composed of women (68.9%), with a mean age of 70.7 ± 6.4 years. A high prevalence of psychoemotional symptoms was observed: stress (72.3%), depression (49.6%), and anxiety (31.9%). Logistic regression identified the following as independent predictors of depression: polypharmacy (OR=8.4; p=0.001), maximum heart rate below the 20th percentile (OR=4.5; p=0.01), poorer sleep quality (OR=1.3; p=0.001), and greater daytime sleepiness (OR=1.1; p=0.02). For anxiety, female sex (OR=4.2; p=0.01) and longer time awake during sleep (OR=1.0; p=0.03) were the identified predictors. For stress, the triangular HRV index was the only significant predictor (OR=1.1; p=0.04). Conclusions: The findings of this thesis, taken together, suggest that HRV and sleep parameters obtained by wearable devices are associated with mental health outcomes in elderly people, with emphasis on sleep quality, daytime sleepiness, and cardiac autonomic modulation as risk markers for depression. Polypharmacy emerged as an independent and modifiable risk factor for depressive symptoms. Although the association between classic vagal HRV indices and mental health was not 

Confirmed in the observational study, possibly due to the limitations of the PPG signal and the loss of physiological data in the database, the preliminary results reinforce the potential of wearable devices as viable tools for screening and monitoring mental health in community-dwelling older adults, allowing for the early identification of vulnerabilities and the planning of more individualized interventions.

COMMITTEE MEMBERS:
Presidente - 1460020 - ALVARO CAMPOS CAVALCANTI MACIEL
Externa à Instituição - ANA TEREZA DO NASCIMENTO SALES FIGUEIREDO FERNANDES - UEPB
Interno - 2419223 - GERSON FONSECA DE SOUZA
Externa à Instituição - MARCELA MONTEIRO PIMENTEL - UEPB
Interno - 350637 - RICARDO OLIVEIRA GUERRA