Use of Digital Biomarkers from Sensing Technologies to Explore the Relationship Between Daytime Activity Levels and Sleep Quality in Nursing Home Residents with Dementia: A Proof-of-Concept Study

Inactivity and increases in psychological and behavioral symptoms are common for people with dementia and current assessment relies on proxy-rated tools. We investigate the feasibility and adherence of the use of sensor technology by exploring the relationship between daytime activity and sleep quality. For a total of 40 day-night data pairs in nursing home residents with dementia (N=11), Garmin Vivoactive5 and Somnofy monitored continuous physical activity levels, Sleep Efficiency (SE), Sleep Score, Sleep Regularity Index (SRI), and Wake After Sleep Onset (WASO). Using Spearman coefficient, we explored correlations between digital and proxy-rated tools (Personal Self Maintenance Scale (PSMS), and Neuropsychiatric Inventory-Nursing Home version (NPI-NH)) and the relationships between the digital biomarkers (SE, SRI, WASO, Sleep Score, physical activity). Participants (mean age 84 years, 8 female) had moderate to severe degrees of dementia. Daytime activity levels correlated to sleep quality parameters SE (0.43, p=0.05), WASO (-0.35, p=0.02), and SRI (0.46, p=0.007), and traditional sleep measures were associated with digital biomarkers (WASO/NPI-NH-K, p=0.04). We find a relationship between daytime activity and sleep quality; however, the bidirectional relationship remains ambiguous and should be further investigated. Sensing technologies have the potential to more accurately identity subtle changes, improving clinical assessment and corresponding care recommendations.