Wearable Accelerometers Prove Highly Feasible in AKG Longevity Trial
A 120-person AKG supplementation trial shows accelerometers are practical in aging research, and reveals who is most likely to drop out.
Summary
The ABLE trial tested whether wearable accelerometers could reliably track physical activity in 120 middle-aged adults taking alpha-ketoglutarate (AKG) supplements for six months. Participants wore ActiGraph devices for seven days at four study visits. Adherence was remarkably high — median wear time was 24 hours per day, over 80% achieved the minimum valid data threshold, and supplement compliance exceeded 90%. Overall dropout was 17%. Importantly, longer daily wear time and being male were both significantly linked to lower dropout risk. These findings validate accelerometers as practical digital phenotyping tools in gerotherapeutic trials and highlight that engagement with wearable devices may itself predict who stays committed to a longevity study — a critical operational insight for designing future interventions aimed at extending healthspan.
Detailed Summary
As longevity science moves toward longer, more complex clinical trials, the question of how to reliably measure physical behavior in aging participants becomes critical. Wearable accelerometers offer continuous, objective data, but their real-world feasibility in gerotherapeutic trials — particularly among middle-aged adults — had not been well established. The ABLE trial provides important operational clarity.
This exploratory analysis drew on data from 120 generally healthy middle-aged adults (mean age 50.6 years, 50% female) enrolled in a six-month, double-blind, randomized, placebo-controlled trial of 1 g/day oral alpha-ketoglutarate (AKG) supplementation, with a three-month follow-up. Participants wore an ActiGraph wGT3X-BT accelerometer for seven days at each of four study visits. Researchers evaluated device wear behavior, adherence to both the accelerometer protocol and the supplement regimen, and study dropout patterns.
Results were encouraging. Median accelerometer wear time reached 24 hours per day, more than 80% of participants accumulated at least four valid wear days per visit, and supplement adherence exceeded 90%. Device-related operational issues were minimal across all visits. Overall study dropout stood at 17%.
Cox proportional hazards modeling revealed two significant predictors of dropout. Each additional minute of daily accelerometer wear was associated with a 0.2% reduction in dropout hazard. Being male was associated with a dramatically lower dropout risk (hazard ratio 0.21), suggesting that female participants were considerably more likely to withdraw from the trial.
These findings carry practical implications for trial design. First, they validate accelerometry as a feasible digital phenotyping tool in middle-aged longevity trials. Second, they suggest that wearable engagement is a proxy for overall trial commitment. Third, the sex-based dropout disparity warrants targeted retention strategies for female participants. Limitations include the abstract-only basis of this summary and the exploratory nature of the analysis.
Key Findings
- Median accelerometer wear time was 24 hours/day; over 80% of participants met valid data thresholds at every visit.
- AKG supplement adherence exceeded 90% across the six-month intervention period.
- Each additional minute of daily device wear was associated with a 0.2% lower dropout hazard.
- Male participants had an 80% lower dropout risk than female participants (HR 0.21).
- Overall trial dropout was 17%, with dropout risk linked to both wearable engagement and sex.
Methodology
Exploratory analysis within a double-blind, randomized, placebo-controlled trial (NCT05706389) of 120 middle-aged adults receiving 1 g/day AKG or placebo for six months plus three-month follow-up. ActiGraph wGT3X-BT accelerometers were worn for seven days at four study visits. Cox proportional hazards models used study visit as the time scale to assess dropout predictors.
Study Limitations
This summary is based on the abstract only, as the full paper was not available. The analysis is exploratory and drawn from a single trial, limiting generalizability. The sex-based dropout finding, while statistically significant, requires replication in larger and more diverse cohorts.
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