Clinically relevant monitoring of long‐term night‐time behaviour and physiology from the homes of people living with dementia

Background Disturbances of sleep and night-time behaviours are amongst the most disabling symptoms dementia. They often increase carers’ burden risk institutionalization. The causes complex difficult to investigate because a lack acceptable methods for monitoring in home. Here we show that passive under-mattress can be used track changes behaviour physiology, range digital biomarkers produced informative understanding effects medication changes, disease progression intercurrent illness patients living with dementia (PLWD). Method We contactless Withings Sleep Mattress (WSM) monitor bed-occupancy 4 PLWD (age 74-93, 3males) enrolled into CR&T MINDER cohort study. Each participant was tracked over 1000 nights between 2019 2021. Minute-to-minute timeseries were extracted from WSM calculate bed occupancy metrics nocturnal physiology measures (heart breathing rates (HR/BR)). Raw standardized within subjects by comparing each time point mean points preceded it. then investigated relationship these clinical events such as infections medication. Result case studies illustrate potential this technology health PLWD. High levels intraindividual variability behavioural physiological observed. Progressive observed two frontotemporal Alzheimer’s (Cases 1&2). Intercurrent medications influenced measures. For example, Patient 1 showed progressive wandering increasing spent out bed, which improved following initiation risperidone. Case 2 recurrent episodes heart failure accompanied increased HR. Cases 3 urinary tract infections, transient Conclusion Passive is simple cost-effective way change medical Digital derived hold great promise progression, enhance care identifying at individuals novel outcome trials.