JMIR Publications

ABSTRACT

Background:

Delirium is a serious condition characterised by an acute change in attention, arousal, and sleep disturbance. It is common in inpatients with Parkinson’s disease (PD) but frequently missed or misidentified due to overlapping symptoms, such as cognitive impairment, hallucinations and sleep disturbances. Whilst clinical tools often measure only a snapshot of delirium, wearable devices could facilitate the identification and ongoing monitoring of delirium.

Objective:

This study Participants were recruited as part of a nested study and comprised inpatients with PD..

Methods:

Participants were recruited as part of a nested study and comprised inpatients with PD. Delirium was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria, assessed daily. Participants were invited to wear Axivity AX6 devices attached to their lower back and/or wrist for up to seven days. Feasibility was assessed in terms of recruitment, device placement, non-securements, wear-time and compliance. Patient acceptance and clinical constraints were recorded and compared between groups.

Results:

The wearable devices recruitment rate was 75.4% (n=46/61) comprising 68 admissions. Delirium was identified in 64.7% of admissions. The wrist-worn device showed greater participant acceptability with 98.5% of participants wearing a device at the wrist compared to 38.2% of participants wearing a lumbar device (36.8% wore both). Wrist attachment had greater practicality for placement, rated as somewhat or very easy to secure in 95.5% (n=64/67) of cases compared to 69.2% (n=18/26) for lumbar securement (p<.001). Clinical constraints such as injury/pain and low level of arousal were associated with lumbar non-securement. Wear time compliance for both placements tended to be lower in delirium cases but comparable overall (>83% for each location, p>.05).

Conclusions:

This is the first study to evaluate the feasibility of using wearable devices in inpatients with PD, with and without delirium. Wearable devices were shown to be feasible, with the wrist-worn device having greater participant acceptability, practicality and with fewer clinical constraints. These findings will support clinical teams in utilising wearable devices in PD inpatients, with and without delirium, to help evaluate and monitor altered patterns of sleep and rest-activity.