KTU researcher: how can smartwatches prevent serious health problems?

Smartwatches are one of the most striking outcomes of the information technology revolution. Wearable devices not only help to monitor health but can also identify asymptomatic sub-clinical cases, thus preventing serious complications such as stroke.

“Nowadays, smartwatches have become much more than physical activity monitoring devices – they have acquired the function of a personal health consultant,” says Prof. Vaidotas Marozas, Director of the Biomedical Engineering Institute of Kaunas University of Technology.

His team, in cooperation with scientists from other Lithuanian universities, have created a prototype for a smartwatch, which is currently known as the TeltoHeart multifunctional smart wristband system, a product of Lithuanian company Teltonika.

Recognises heart rhythm disorders

One of the conditions, which requires monitoring is abnormal heart rhythm (arrhythmia), or atrial fibrillation (AF). The KTU researcher says that in the recent Clinical Practice Guidelines for the diagnosis and management of AF, published in the journal Circulation, wearable devices are mentioned as many as 10 times. The medical experts who drafted these guidelines acknowledged that the advances in the monitoring and recognition of arrhythmias made it worth considering dropping the term “clinical AF” altogether.

“In the future, it is hoped that wearable devices will not only be used for early diagnosis and warning, but also for assessing the effectiveness of treatment. Large global research studies show that wearable devices have a 92-97 per cent reliability in detecting arrhythmias. Early diagnosis and treatment can reduce the risk of stroke by as much as 70 per cent,” he notes.

KTU Prof. Marozas says that some countries are already taking active steps to integrate digital health monitoring into the healthcare system. In Germany, for example, the digital health device initiative DiGA (Digitale Gesundheitsanwendungen) is developing rapidly. This programme certifies devices and apps for diagnosing, monitoring or treating various diseases or disabilities.

“Patients can buy these devices with a doctor’s prescription and the cost is reimbursed by insurance companies. A similar initiative is being developed in France, according to recent reports. These programmes are a testament to the growing confidence in the ability of smart technologies to improve healthcare and people’s quality of life,” he says.

Can prevent disease

The KTU researcher explains that the main health indicators that smartwatches can monitor are physical activity (measured in steps’ count), pulse rate (in heartbeats per minute), blood oxygen saturation (in percentage) and sleep quality (including sleep duration and REM, light and deep sleep stages).

In addition to monitoring physical fitness, smartwatches analyse the wearer’s emotional and psychological health. For example, some watches can monitor psychophysiological stress levels by assessing breathing rate and autonomic nervous system balance. This enables them to recognise increased stress levels and take timely action to reduce tension, for example by taking deep and slow breaths.

Marozas notes that there are already commercial wearables that assess body composition (fat, fluid and muscle mass), stress levels, blood pressure, heart arrhythmias and sleep apnoea (temporary stoppage of breathing during sleep). “The number of functions is growing as this is a very active area of research. For example, research is being carried out in Lithuania and the Netherlands on how to use a smartwatch to recognise and encourage a patient to seek immediate medical attention if a myocardial infarction is suspected,” says a KTU researcher.

The most useful functions of smartwatches depend on the wearer, he says. These can include monitoring physical activity, cardiac arrhythmias, vascular stiffness or women’s fertility cycle: “For example, currently in Lithuania, if you suspect that your breathing stops intermittently at night, you could have to wait up to three years for a test at a clinic. The latest wearable devices can not only warn of suspected apnoea but also assess its intensity index.”

Particularly useful in dementia

According to the KTU researcher, many older people suffer from chronic diseases, especially neurodegenerative ones. Smartwatches that can track a person’s location, have a help button and two-way communication are particularly useful if your loved one has Alzheimer’s or advanced dementia.

“This is borne out by personal experience: a close relative with symptoms of dementia found a mobile phone impractical and had to call the emergency services several times because of disappearances and searches. Now, the relative wears a smartwatch with GPS, cellular and some vital signs monitoring functions all the time. This allows us to always know where our relative is, to monitor their vital signs, and if they get lost, to contact them and, if necessary, to help return home,” shares Marozas.

The best way to prevent dementia, he says, is to make healthy lifestyle choices and reduce risk factors. This includes physical activity, a healthy diet, blood pressure and weight control, stress management and quality sleep. Older age increases the risk of sleep disorders such as sleep apnoea, as well as the likelihood of cardiovascular disease, especially arrhythmias and hypertension. Modern technological solutions already exist to monitor these parameters.

“Elderly parents can be helped by giving them smart devices, by offering active support in adopting new health monitoring technologies, and by remotely monitoring and discussing their health data – just as their parents once analysed their grade books,” says Marozas.

The evolution of precision in smart devices

Some blood pressure monitors systematically read 4 mmHg too high for systolic blood pressure, others 7 mmHg too low. Calorie monitoring was the most difficult, he said, with even the most accurate devices showing an error of up to 30 per cent.

KTU Prof. Marozas notes that the situation has now changed, with significant improvements in instrumentation. For example, steps will no longer be counted when driving on a potholed road. Also, there are fewer errors in pulse monitoring during rest and sleep.

New standards have been developed for blood pressure and oxygenation monitoring, and device manufacturers are required to undergo a clinical validation and certification process to offer devices with blood oxygenation, electrocardiogram and cardiac arrhythmia monitoring capabilities. “In Europe, these functions are certified as Class IIa medical devices that patients and doctors can trust. Unfortunately, standards for monitoring stress, pain and sleep quality have not yet been developed, so we can expect a wide variation of results between different devices,” he says.

Smart devices for analysing sweat

The KTU professor shares that one of the most important technological breakthroughs is the development of new sensors and non-invasive diagnostic methods, such as sweat analysis, and long-term monitoring of body temperature, blood pressure and blood glucose levels.

“New methods for analysing long-term data will allow us to offer digital biomarkers that will, for example, help us to identify individual arrhythmia triggers or to tailor drugs to treat hypertension. Although these features are still in development, their potential is undeniable, especially for patients with chronic diseases,” he notes.

It is important that people use smartwatches as a complementary tool rather than a final solution for health diagnosis.

There is a strong focus on the use of artificial intelligence: algorithms can analyse the data collected, detect health anomalies and provide insights into possible risk factors. This not only allows real-time health monitoring but also proactive disease prevention, reinforcing the importance of preventive medicine.

“In the future, smartwatches could become an important link between patients and doctors, enabling remote monitoring of patient’s condition, their response to treatment and rapid response to potential health problems. In addition, the integration of smartwatches and genetic information could provide even more accurate personalised health recommendations,” says Prof. Marozas.

This merging of technology and medicine will have a significant impact on improving both individual and public health, he says. Wearable devices will be able to include currently under-represented populations such as older adults, people with disabilities, those with rare chronic or genetic diseases.

How do I choose a smartwatch?

A KTU researcher advises that it is important to consider your needs when choosing a smartwatch. According to him, there are a few key points to consider. First, you need to assess what health monitoring functions the watch offers. The more features, the better the benefits, but it is also important to assess their accuracy and reliability.

“Another important aspect is the battery life, which depends on the intensity of use and the functions of the watch. Longer battery life allows the device to be used without frequent charging, which is particularly important for everyday use. It is also important to consider how the watch integrates with a mobile phone and other technologies, such as smart scales, to monitor and analyse the data collected,” he says.

Finally, it’s worth noting whether your smartwatch has alerts and reminders. These functions not only help you to take care of your health but also encourage you to achieve your health goals. Smart devices can alert you to important changes in health indicators, encouraging you to take timely action.

“Apple and Samsung watches have the most features, but shorter battery life. One possible solution is to charge your watch every morning, for example during your morning shower,” shares Marozas, the Director of the KTU Biomedical Engineering Institute.

According to him, Garmin and Polar devices are designed for athletes and sportspeople who want to prepare their bodies for athletic performance optimally. Meanwhile, Fitbit and Withings focus on health monitoring features and longer battery life. For example, Withings devices can last up to 30 days on a single charge.

“However, while these devices can provide many useful insights and help identify health problems early, they are not a substitute for professional medical advice. It is important that people use smartwatches as a complementary tool rather than a final solution for health diagnosis,” the KTU researcher stresses.