Remote evaluation of sleep and circadian rhythms in older adults with mild cognitive impairment and dementia: Protocol for a feasibility and acceptability study (Preprint)

Abstract

Sleep disturbances are a potentially modifiable risk factor for neurodegenerative dementia secondary to Alzheimer’s disease (AD) and Lewy body disease (LBD). Therefore, we need to identify the best methods to study sleep and circadian rhythms in this population.

This study will assess the feasibility and acceptability of various wearable devices, smart devices, and remote study tasks in sleep and cognition research for people with AD and LBD.

We will deliver a feasibility and acceptability study alongside a prospective observational cohort study assessing sleep and cognition longitudinally in the home environment. Adults aged >50 years diagnosed with mild to moderate dementia or mild cognitive impairment (MCI) due to probable AD or LBD and age-matched controls will be eligible. Exclusion criteria include lack of capacity to consent to research, other causes of MCI/dementia, and clinically significant sleep disorders. Participants will complete a cognitive assessment and questionnaires with a researcher and receive training and instructions for at-home study tasks across 8 weeks. At-home study tasks include remote sleep assessments using wearable devices (electroencephalography (EEG) headband, actigraphy watch), app-based sleep diaries, online cognitive assessments, and saliva samples for melatonin- and cortisol-derived circadian markers. Feasibility outcomes will be assessed relating to recruitment and retention, data completeness, data quality, and support required. Feedback on acceptability and usability will be collected throughout the study period and during end-of-study interviews analysed using thematic analysis.

Recruitment started in February 2022. Data collection is ongoing, with final data expected in January 2024 and data analysis and publication of findings scheduled for late 2023 and 2024.

This study will allow us to assess if remote testing utilising smart devices and wearable technology is a viable alternative to traditional sleep measurements, such as polysomnography and questionnaires, in older adults with and without MCI/dementia due to AD/LBD. Understanding participant experience and the barriers and facilitators to technology use for research purposes in this population will assist with development of, recruitment to, and retention within future research projects using similar technologies to study sleep and cognition outside of the clinic or laboratory.