Objective: To assess the feasibility of using wearable sensors in Parkinson’s disease (PD) inpatients with/without delirium and to quantify clinically relevant digital outcomes to facilitate understanding of sleep and activity patterns in this cohort

Background: Delirium is an acute neuropsychiatric syndrome associated with altered levels of consciousness, confusion and impaired attention. Sleep-wake cycle disruptions and motor activity alterations are core domains affected. People with PD may be at a higher risk of developing delirium[1]; however, a diagnosis may be missed due to an overlap in symptoms. Most tools only provide information for a snapshot of time which fails to show the fluctuating nature of delirium. Wearable sensors (WS) provide an objective, non-invasive opportunity to continuously monitor activity and sleep patterns in inpatients with PD

Method: The study is nested within DELIRIUM-PD, a prospective study of inpatients with PD, aiming to establish optimal criteria to identify delirium. In parallel to longitudinal delirium assessments, all eligible inpatients from DELIRIUM-PD, had the option to wear sensors on their lower back and wrist for 7 days to monitor movement and sleep patterns. The location/duration the sensor was worn and the reasons for removal was recorded. A participant compliance rating was collated representing 0–non-compliant to 10–fully compliant. Walking activity outcomes will be quantified using a validated analytical pipeline[2].Sleep metrics including sleep episodes/night awakenings will be derived using GGIR analytical package[3]

Results: Data analysis is ongoing. Forty-six patients (39%-female) were recruited comprising 68 separate admissions(figure 1). Delirium was identified during 69% of admissions. Mean age was 76.31±10.1 years. Mean duration for wearing the sensors was 3.7±2.2 days. 63.2% wore the wrist-sensor only, 1.5% lumbar-sensor only and 35.3% wore both. Participants with delirium had a higher compliance rating for the lumbar-sensor 9.0±2.2 with respect to the wrist-sensor 8.2±2.9. Participants without delirium had a mean compliance rating of 9.1 for both sensors

Conclusion: In inpatients with PD with/without delirium, wearable sensors are feasible to use and well-tolerated. Future work will determine if digital outcomes of activity and sleep may be useful as complementary tools for diagnosis of delirium in people with PD.

References: [1] Lawson RA et al, 2020, Int J Geriatr Psychiatry 35(5):547-52
[2] Del Din et al, 2016, IEEE SSP;1-5
[3] van Hees VT, 2015, PLOS ONE, 10(11), p. e0142533.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/feasibility-of-using-wearable-sensors-to-monitor-activity-and-sleep-patterns-in-inpatients-with-delirium-and-parkinsons-disease/