Multicenter Study on Sleep and Circadian Alterations as Objective Markers of Mild Cognitive Impairment and Alzheimer’s Disease Reveals Sex Differences

Abstract

Background: Circadian and sleep disturbances are associated with increased risk of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Wearable activity trackers could provide a new approach in diagnosis and prevention. Objective: To evaluate sleep and circadian rhythm parameters, through wearable activity trackers, in MCI and AD patients as compared to controls, focusing on sex dissimilarities. Methods: Based on minute level data from consumer wearable devices, we analyzed actigraphic sleep parameters by applying an electromedical type I registered algorithm, and the corresponding circadian variables in 158 subjects: 86 females and 72 males (42 AD, 28 MCI, and 88 controls). Moreover, we used a confusion-matrix chart method to assess accuracy, precision, sensitivity, and specificity of two decision-tree models based on actigraphic data in predicting disease or health status. Results: Wake after sleep onset (WASO) was higher (p < 0.001) and sleep efficiency (SE) lower (p = 0.003) in MCI, and Sleep Regularity Index (SRI) was lower in AD patients compared to controls (p = 0.004). SE was lower in male AD compared to female AD (p = 0.038) and SRI lower in male AD compared to male controls (p = 0.008), male MCI (p = 0.047), but also female AD subjects (p = 0.046). Mesor was significantly lower in males in the overall population. Age reduced the dissimilarities for WASO and SE but demonstrated sex differences for amplitude (p = 0.009) in the overall population, controls (p = 0.005), and AD subjects (p = 0.034). The confusion-matrices showed good predictive power of actigraphic data. Conclusion: Actigraphic data could help identify disease or health status. Sex (possibly gender) differences could impact on neurodegeneration and disease trajectory with potential clinical applications.

2022 Alzheimer's disease facts and figures

“…601 A systematic review of telehealth for dementia care, 639 biomarkers of MCI. 640,641 Similarly, technologies that identify speech patterns 642 and retinal blood vessel changes 643 may help flag the earliest stages of cognitive decline.…”

“…In the future, technology may also have a role in expanding biomarkers and in dementia screening and diagnosis. Studies of remote monitoring techniques, such as activity data from wrist‐worn devices or game‐like assessments on mobile phones, may produce digital biomarkers of MCI 640,641 . Similarly, technologies that identify speech patterns 642 and retinal blood vessel changes 643 may help flag the earliest stages of cognitive decline.…”

Risk-taking behavior and sustained attention after a night shift: an observational study in healthcare professionals

“…Data were sampled in 1-minute epochs and digitally stored for subsequent analysis. The following quantitative sleep parameters derived from the FF2 were estimated through a validated and certified artificial neural network (ANN)-based algorithm:[51,52]…”

“…Data were sampled in 1-minute epochs and digitally stored for subsequent analysis. The following quantitative sleep parameters derived from the FF2 were estimated through a validated and certified artificial neural network (ANN)-based algorithm: [51,52] -Total Sleep Time (TST), defined as the total duration of sleep (in hours and minutes); -Waking After Sleep Onset (WASO), defined as the time spent awake after sleep onset and before sleep offset (in minutes); -Sleep Efficiency (SE), defined as the time spent asleep between sleep onset and offset (in %).…”

Association of rs3027178 polymorphism in the circadian clock gene PER1 with susceptibility to Alzheimer’s disease and longevity in an Italian population

“…In this study, DNA samples from 1101 unrelated northern Italian subjects were analyzed. In the discovery phase, we included 79 AD, 33 MCI and 62 CTRL, recruited at the IRCCS Istituto delle Scienze Neurologiche di Bologna, Bellaria Hospital in the framework of an Italian multi-centric study and as part of a research project funded by the Italian Ministry of Health (GR-2013-02358026 to CLM and AS) [43]. In the validation phase, we analyzed an independent group including 449 AD, 326 age-matched healthy CTRL and 152 centenarians (CENT).…”