InSleep46: Deployment of a remote monitoring device for the detection and monitoring of dementia risk in older adult populations: a feasibility study

Background: Improvements in health technology offer opportunities for remote disease screening, diagnosis and monitoring. The Withings Sleep Analyzer (WSA), an under mattress ballistocardiograph sensor able to detect body movement, breathing, and cardiac ejection is a promising technology for the non-invasive detection and monitoring of neurodegenerative diseases. InSleep46 aims to evaluate whether the WSA is able to detect preclinical Alzheimer's disease in members of the 1946 British Birth cohort, now in their late 70s. Objectives: To assess feasibility of deployment of a remote sleep, circadian and physiological monitoring device in a population of older adults. Participants: 356 participants from the Insight 46 neuroimaging sub-study (1946 British Birth Cohort), all born in one week in March 1946. Methods: We describe remote recruitment, device installation, and troubleshooting protocols. Feasibility analysis examined participant characteristics associated with recruitment and successful device set-up using logistic regression. Troubleshooting events for device installation and maintenance were recorded over a mean 14-month follow-up period. Results: During the feasibility analysis period, 263 (74%) participants, mean (SD) age 77 years (0.47) agreed to take part, of whom 245 (93%) successfully set up the WSA. Recruitment and successful set up of the WSA were not dependent on cognitive ability, socioeconomic position, or educational attainment. 162 (62%) of recruited individuals required ≥1 troubleshooting call (mean 2.3 per participant, range 0-16). 603 calls were required in total. Conclusion: Deployment of a remote sleep and physiological monitoring device in an older adult population is feasible. Most participants required individualised assistance to set up the device. For the technology to be widely implemented, the set up must be accessible, with dedicated support available.