High frequency of getting out of bed in patients with Alzheimer's disease monitored by non‐wearable actigraphy

Higami, Yoko; Yamakawa, Miyae; Shigenobu, Kazue; Kamide, Kei; Makimoto, Kiyoko

doi:10.1111/ggi.13565

Cited by 17 publications

(16 citation statements)

References 28 publications

(77 reference statements)

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“…Moreover, AD patients showed a higher prevalence of other alterations in actigraphic parameters, thus confirming that the evolution of cognitive impairment is associated with a reduction in sleep quality. The increase in the number of NA in cognitive impairment patients, besides underlining the relevance of actigraphy in detecting and defining the extent of motor hyperactivity [32], further emphasizes that sleep deprivation is a common feature in patients with dementia [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Sleep actigraphic patterns and cognitive status

Buratti¹,

Camilletti²,

Pulcini³

et al. 2021

Journal of Integrative Neuroscience

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We performed an actigraphic assessment of sleep characteristics in healthy subjects and patients with cognitive impairment. Thirty subjects were included and classified into controls (10 subjects), mild cognitive impairment (10 patients) and mild-to-moderate Alzheimer's disease (10 patients). Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Participants had a 7-day actigraphic record. Sleep parameters collected were time in bed, total sleep time, sleep efficiency, sleep latency, wakefulness after sleep onset, number of awakenings, and mean motor activity. Significant differences between mild cognitive impairment and controls patients were found for sleep latency (p = 0.05); Alzheimer's disease patients had significantly worse scores for Pittsburgh Sleep Quality Index (p = 0.01), time in bed (p = 0.001), total sleep time (p = 0.04), sleep latency, sleep efficiency, motor activity (p = 0.0001) and wakefulness after sleep onset (p = 0.001) compared to controls. When comparing Alzheimer's disease and mild cognitive impairment, differences were significant for sleep latency (p = 0.01), wakefulness after sleep onset (p = 0.004), sleep efficiency, number of awakenings and motor activity (p = 0.0001). In addition to showing a high prevalence of sleep alterations in subjects with cognitive impairment, our data suggest that they are evident from the earliest stages of cognitive decline. Further studies are needed to assess whether early correction of sleep alterations can positively influence the evolution of cognitive impairment. The opportunity to provide clinically meaningful information with a simple assessment of sleep characteristics based on actigraphy suggests that wider use of the approach in patients with cognitive decline should be considered.

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Section: Discussionmentioning

confidence: 99%

Sleep actigraphic patterns and cognitive status

Buratti¹,

Camilletti²,

Pulcini³

et al. 2021

Journal of Integrative Neuroscience

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“…To the best of our knowledge, previous studies on STS measurements primarily used video recordings to evaluate postures or motion sequences and no sensor-based studies have ever been conducted in patients with PD. One recent study used non-wearable actigraphy placed under patient mattresses to determine the number of waking events and number of times patients with Alzheimer's disease left their beds ( 31 ). While a high frequency of getting out of bed was demonstrated in this study, it was not possible to capture axial and limb muscle movement patterns with non-wearable devices.…”

Section: Discussionmentioning

confidence: 99%

Technological evaluation of strategies to get out of bed by people with Parkinson's disease: Insights from multisite wearable sensors

Sringean

Thanawattano

Bhidayasiri

2022

Front. Med. Technol.

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BackgroundDifficulty getting out of bed is a common night-time and early morning manifestation of Parkinson's disease (PD), rated by 40% of the patients as their most concerning motor symptoms. However, current assessment methods are based on clinical interviews, video analysis, and clinical scales as objective outcome measures are not yet available.ObjectiveTo study the technical feasibility of multisite wearable sensors in the assessment of the supine-to-stand (STS) task as a determinant of the ability to get out of bed in patients with PD and age-matched control subjects, and develop relevant objective outcome measures.MethodsThe STS task was assessed in 32 patients with PD (mean Hoehn and Yahr; HY = 2.5) in the early morning before their first dopaminergic medication, and in 14 control subjects, using multisite wearable sensors (NIGHT-Recorder®; trunk, both wrists, and both ankles) in a sleep laboratory. Objective getting out of bed parameters included duration, onset, velocity and acceleration of truncal rotation, and angle deviation (a°) from the z-axis when subjects rose from the bed at different angles from the x-axis (10°, 15°, 30°, 45°, and 60°) as measures of truncal lateral flexion. Movement patterns were identified from the first body part or parts that moved. Correlation analysis was performed between these objective outcomes and standard clinical rating scales.ResultsCompared to control subjects, the duration of STS was significantly longer in patients with PD (p = 0.012), which is associated with a significantly slower velocity of truncal rotation (p = 0.003). Moderate and significant correlations were observed between the mean STS duration and age, and the Nocturnal Hypokinesia Questionnaire. The velocity of truncal rotation negatively and significantly correlated with HY staging. Any arm and leg moved together as the first movement significantly correlated with UPDRS-Axial and item #28. Several other correlations were also observed.ConclusionOur study was able to demonstrate the technical feasibility of using multisite wearable sensors to quantitatively assess early objective outcome measures of the ability of patients with PD to get out of bed, which significantly correlated with axial severity scores, suggesting that axial impairment could be a contributing factor in difficulty getting out of bed. Future studies are needed to refine these outcome measures for use in therapeutic trials related to nocturia or early morning akinesia in PD.

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“…Although subjective sleep status might predict nighttime care needs, it is also necessary to objectively clarify CRs' sleep status. 26 Home-based care is becoming increasingly critical in Japan; therefore, it is meaningful to determine how to reduce objective care burden among FCs. 27 Our results indicated that reduced objective total sleep time (as measured by the ActiGraph) is significantly associated with FCs' care burden severity.…”

Section: Discussionmentioning

confidence: 99%

Association between sleep, care burden, and related factors among family caregivers at home

et al. 2020

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Aim Several studies have reported a negative correlation between depressive symptoms and family caregivers' (FCs) subjective sleep status. However, there is a paucity of information on the association between objective/subjective sleep status, care burden, and related factors. Methods Participants were 23 pairs of care receivers (CRs; Mage = 82.7 ± 8.5 years; 69.6% women) receiving long‐term care at home and their FCs (Mage = 66.9 ± 11.0 years; 69.6% women). At baseline, demographic data, subjective sleep status (Pittsburgh Sleep Quality Index; PSQI), WHO‐5 well‐being, depressive mood, and frequency of going outdoors were collected. FCs wore a small, wrist‐worn device with an accelerometer to assess objective sleep status for a consecutive 24‐h 2‐week period, and they answered the Zarit Burden Interview short version (ZBI) every night before sleep. After 3 months, CR status was collected and analysed retrospectively. Results The mean total sleep time over 2 weeks was 349.5 ± 69.6 min. The mean ZBI score over 2 weeks was 8.8 ± 6.8, which was significantly correlated with total sleep time (r = −0.42; P < 0.05), total time in bed (r = −0.44; P < 0.05), PSQI (r = 0.62; P < 0.01), frequency of going outdoors by CRs (r = −0.42; P < 0.05), and WHO‐5 well‐being among CRs (r = −0.50; P < 0.05). Multiple regression analyses revealed that total sleep time (β = −0.51; P < 0.05) was significantly associated with care burden (adjusted R2 = 0.45). At the 3‐month follow‐up, four CRs had been hospitalised or died, and their FCs displayed significantly severe care burden and slept less than at baseline. Conclusions Reduced objective total sleep time is significantly associated with the severity of care burden among FCs. Home‐based care is critical in Japan; therefore, it is meaningful to determine how to reduce care burden.

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High frequency of getting out of bed in patients with Alzheimer's disease monitored by non‐wearable actigraphy

Cited by 17 publications

References 28 publications

Sleep actigraphic patterns and cognitive status

Sleep actigraphic patterns and cognitive status

Technological evaluation of strategies to get out of bed by people with Parkinson's disease: Insights from multisite wearable sensors

Association between sleep, care burden, and related factors among family caregivers at home

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