Background: Wearable sensor technology shows promise for neuropsychiatric symptoms (NPS) identification/monitoring in persons living with dementia (PLWD). Accelerometry measures acceleration of body segments and physical activity. This study explores the diagnostic test accuracy (DTA) of accelerometry to identify the following 6 NPS associated with motor activity: aberrant motor behavior (AMB), aggression, agitation, anxiety, apathy, and wandering.
Methods: As part of a larger systematic review, we conducted an extensive literature search in nine health science and engineering databases. Meta-analysis involved converting correlations to Fisher's Z scores, calculating 95% confidence intervals using the R Studio Metacor package, and assessing fixed effects, DerSimonian and Laird's random effects models, and heterogeneity.
Results: Out of 12,853 identified records, 84 reports were retained for analysis. Eight reports that provided 12 datasets assessed the DTA of accelerometry data for identifying/monitoring apathy (n=4), AMB (n=1), anxiety (n=2) agitation (n=5), aggression (n=2), and wandering (n=2). Studies included one single-blinded trial, one non-randomized trial, and ten observational studies. A random-effect meta-analysis yielded a pooled correlation across studies of r=0.61 (0.50; 0.70), heterogeneity I2=68%. When the wandering NPS subgroup was eliminated from analysis, heterogeneity fell considerably to I2=36%, with a pooled correlation of r=0.55 (0.47; 0.62).
Conclusions: These findings suggest that accelerometry consistently provides good to moderate DTA for identifying/ monitoring NPS associated with motor behavior in PLWD. Future research should prioritize standardizing the reporting of measurement procedures, signal thresholds, outcome measures, devices, and reference standards.
© 2024 The Alzheimer's Association. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.