Wrist-Worn Actigraphy Feasible For Monitoring Patients With Late-Stage Alzheimer Dementia

Researchers examining patients with late-stage dementia and significant pre-defined agitation at baseline, found that passively wearing a wrist-worn actigraphy could be a feasible behavior-monitoring tool to assess sleep or behavioral symptoms for up to 4 weeks.

“Measuring behavioral rhythmicity and specific patterns of activities using wearable devices such as an actigraphy watch (wrist-worn actigraphy) is receiving more attention in ageing and dementia research because these devices are capable of objectively and longitudinally capturing behavioral changes, certain circadian rhythmicity changes are potential markers of aging or progression of dementia, and linked to the development of behavioral and psychological symptoms of dementia,” Guu and colleagues wrote in their study.

Between October 2021 and July 2022, patients who participated in the Sativex for the Treatment of the Agitation & Aggression in Alzheimer's Dementia (STAND) trial were recruited to take part in the current study, which included care home residents with late-stage Alzheimer dementia between 55 and 95 years of age (n = 29). Patients from the STAND trial were recruited to wear an actigraphy watch for 4 weeks, and they were evaluated for compliance as well as the factors influencing compliance.

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The results showed high watch-acceptance (96.6%) and compliance rates (88.0%). Additionally, the type of symptoms or severity associated with late-stage dementia did not significantly influence compliance. Guu and colleagues noted that an instruction document that reminded the participants and communicated the study needs with caregivers may have helped improve overall compliance.

The researchers found that the participants were less compliant if they had better cognitive function (p = 0.022), and the care staff found that participants were less compliant during the night shift compared to other shifts. Further, women were also marginally less compliant (p = 0.062) compared to men.

This study had limitations. For example, the participants only had to wear the device passively. If the device involved remembering to press buttons or to record data, the results may have been different or not generalizable.

“We found wearing a wrist-worn actigraphy watch is acceptable for late-stage dementia patients living with significant agitation in care homes and demonstrates the feasibility of using such devices for behavioral monitoring in this population,” Guu and colleagues concluded. “Caregivers felt more comfortable assisting and encouraging participants to keep wearing the device when clear and clinically relevant instructions were easily accessible.”

Reference:
Guu TW, Brem AK, Albertyn CP, Kandangwa P, Aarsland D, ffytche D. Wrist-worn actigraphy in agitated late-stage dementia patients: a feasibility study on digital inclusion. Alzheimers Dement. 2024 May;20(5):3211-3218. doi:10.1002/alz.13772.