Feasibility of implementing wearable technologies for in‐home assessment of behavioral and event‐related potential responses after sleep and wakefulness in Alzheimer disease

Background Alzheimer’s disease (AD) is associated with impaired sleep that worsens over disease progression. To explore the circadian effects on memory consolidation and underlying neurophysiology in young versus old healthy volunteers versus patients with AD, we used two wearables in a repeated/longitudinal at‐home clinical paradigm that captured key behavioral and electrophysiologic responses after sleep and after daytime activity. Method A participant home‐administered, behavioral, and event‐related potential (ERP) through electroencephalogram (EEG) platform (Cumulus Neuroscience) is administered over a two‐week period to healthy younger adults, healthy older adults, and older adult patients with AD. Participants engaged in behavioral (image recognition) testing coupled with EEG/ERP recordings twice daily ‐ once in the morning following approx. 12 hrs of sleep/rest and once after at end of day before retiring activity. Two‐minutes of resting state EEG/ERPs began each session, for twenty‐two total sessions. Reports of sleep, together with smart watch actigraphy (Empatica, Inc), are used to estimate the duration and intensity of the rest/sleep period versus daytime activity. This novel protocol explores whether each wearable generates data that is sufficiently reproducible and sensitive to track and interpret changes in episodic memory consistent with known changes expected based on age and AD status. Result We report on feasibility of implementation of the experimental paradigm and whether the sensors employed reliably yield interpretable data. We share data on recruitment rates and subject feedback regarding tolerability of Cumulus Headset and Empatica watch. Conclusion The home‐based experimental paradigm is well‐tolerated with excellent adherence to the study design. Both sensors yielded experimental datasets of similar quality to those obtained in in‐house studies. Planned analyses focus on establishing whether this experimental paradigm yields data with sufficient sensitivity and reproducibility to confirm past observations regarding the effect of age and AD on memory consolidation.