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Background: Wrist-worn actigraphy can be an objective tool to assess sleep and other behavioral and psychological symptoms in dementia (BPSD). We investigated the feasibility of using wearable actigraphy in agitated late-stage dementia patients., Methods: Agitated, late-stage Alzheimer's dementia care home residents in Greater London area (n = 29; 14 females, mean age ± SD: 80.8 ± 8.2; 93.1% White) were recruited to wear an actigraphy watch for 4 weeks. Wearing time was extracted to evaluate compliance, and factors influencing compliance were explored., Results: A high watch-acceptance (96.6%) and compliance rate (88.0%) was noted. Non-compliance was not associated with age or BPSD symptomatology. However, participants with "better" cognitive function (R = 0.42, p = 0.022) and during nightshift (F 1.240, 33.475  = 8.075, p = 0.005) were less compliant. Female participants were also marginally less compliant (F 1, 26  = 3.790, p = 0.062)., Discussions: Wrist-worn actigraphy appears acceptable and feasible in late-stage agitated dementia patients. Accommodating the needs of both the patients and their carers may further improve compliance., (© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

The prevalence of dementia is increasing and poses a health challenge for individuals and society. Despite the desire to know their risks and the importance of initiating early therapeutic options, large parts of the population do not get access to memory clinic-based assessments. Remote memory clinics facilitate low-level access to cognitive assessments by eschewing the need for face-to-face meetings. At the same time, patients with detected impairment or increased risk can receive non-pharmacological treatment remotely. Sensor technology can evaluate the efficiency of this remote treatment and identify cognitive decline. With remote and (partly) automatized technology the process of cognitive decline can be monitored but more importantly also modified by guiding early interventions and a dementia preventative lifestyle. We highlight how sensor technology aids the expansion of assessments beyond cognition and to other domains, e.g., depression. We also illustrate applications for aiding remote treatment and describe how remote tools can facilitate health education which is the cornerstone for long-lasting lifestyle changes. Tools such as transcranial electric stimulation or sleep-based interventions have currently mostly been used in a face-to-face context but have the potential of remote deployment-a step already taken with memory training apps. Many of the presented methods are readily scalable and of low costs and there is a range of target populations, from the worried well to late-stage dementia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Owens, Krebs, Kuruppu, Brem, Kowatsch, Aarsland and Klöppel.)

Background: Sleep disturbance is suggested to contribute to the development of dementia. However, prospective longitudinal data from middle-aged populations are scarce., Methods: We investigated a population-based sample of 2386 men aged 42-62 years at baseline during 1984-1989. Participants having a history of mental illnesses, psychiatric medication, Parkinson's disease or dementia within 2 years after baseline (n=296) were excluded. Difficulty falling asleep or maintaining sleep, sleep duration and daytime tiredness were enquired. Dementia diagnoses (n=287) between 1984 and 2014 were obtained through linkage with hospital discharge, national death and special reimbursement registers. Cox proportional hazards analyses were performed for all dementias, and separately for Alzheimer's disease (n=234) and other phenotypes (n=53). Additional analyses were performed on a subsample of an apolipoprotein E ( APOE ) genotype-tested population (n=1199)., Results: The risk ratio for dementia was 1.58 (95% CI 1.10 to 2.27) in men with frequent sleep disturbance after adjustments for age, examination year, elevated depressive symptoms, physical activity, alcohol consumption, cumulative smoking history, systolic blood pressure, body mass index, low-density lipoprotein and high-density lipoprotein cholesterol, high-sensitivity C reactive protein, cardiovascular disease history, education years and living alone. Daytime tiredness and sleep duration were not associated with dementia in adjusted analysis. In the APOE subsample, both APOE ε4 genotype and frequent sleep disturbance were associated with increased dementia risk, but in the interaction analysis they had no joint effect., Conclusions: Self-reported frequent sleep disturbance in middle-aged men may relate to the development of dementia in later life. Having an APOE ε4 genotype did not affect the relationship., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)