Daijiworld Media Network - New Delhi

New Delhi, Jan 17: Real-time location data captured through wearable devices can effectively reveal rest-activity rhythm patterns in people with advanced dementia, closely tracking sleep disruption and agitation, a new study has found.

Disrupted sleep and circadian rhythms are common in dementia and often affect patient safety, quality of life and caregiver burden. In the study, researchers assessed whether a wrist-worn real-time location system (RTLS), typically used for nurse call alerts and elopement prevention, could be used to objectively quantify rest-activity rhythms in residents with advanced dementia.

The research involved continuous monitoring of participants living in a specialised dementia care unit for up to 16 weeks. Data from 47 residents, including 21 women with a mean age of 80.1 years, were analysed. Distance moved within 15-minute intervals was converted into digital markers representing activity intensity and rhythmicity, using both parametric and non-parametric measures. These markers were then compared with repeated clinical assessments using panel and mixed-effects models.

The findings showed that higher activity intensity was linked to increased clinical motor agitation. Indicators of disrupted rhythmicity and reduced nighttime time in bed were associated with difficulty in falling asleep and higher levels of nighttime agitation, suggesting that objective rest-activity data can reflect clinically significant sleep disturbances.

Using unsupervised machine learning techniques, researchers identified six distinct rest-activity phenotypes over one-week periods. These included patterns described as high time in bed, well-regulated, low stability, severe rhythm disturbance, nighttime active and a highly active individual. The phenotypes varied significantly by age, cognitive status, mood disturbances and functional ability, highlighting considerable diversity in rest-activity rhythms even among individuals with advanced dementia.

Across the analysis, increased activity intensity, reduced rhythmic stability and less time spent in bed at night consistently correlated with greater agitation and sleep disruption. Researchers said the findings indicate that RTLS-derived rest-activity rhythms could serve as scalable digital markers to monitor behavioural and psychological symptoms of dementia in residential care settings, supporting more data-driven and evidence-based dementia care.