Actigraphy as a proxy biomarker for motoric agitation in Alzheimer disease: Neuropsychiatric symptoms as a treatment target: Recent advances by the ISTAART neuropsychiatric symptoms professional interest area. (7th December 2020) - Burhan, Amer M.
Abstract: Background: Agitation is an important symptom of dementia and is commonly assessed using clinician and/or caregiver rated scales. These scales are useful but they rely on a mixture of direct and indirect observations and therefore are subject to limited reliability and validity depending of factors such as staffing. Actigraphy is a tool to assess motoric activity, a core feature of agitation. There is a growing interest in using Actigraphy as a tool to diagnose and monitor agitation of dementia. We previously published a report demonstrating feasibility and a correlation between Actigraphy and informant‐based rating of physical agitation in a sample of hospital and nursing home patients with Alzheimer in moderate level of cognitive impairment from Kingston Ontario, Canada. Method: This is an extension to our previous observational, cohort study now involving a sample of older adults with Alzheimer disease and agitation from London Ontario, Canada in hospital and nursing home with severe level of cognitive impairment. Measurements: Baseline characteristics included demographics, severity of cognitive impairment, medical comorbidity, and agitation symptoms assessed using CMAI and NPI. Actigraphy was measured over several continuous days. Results: Twenty participants were enrolled (mean age=81.3/years, SD=7.97; Male=12; mean MMSE=6.3, SD=5.7; mean CMAI score=66.83, SD=10.79). Pearson correlation coefficient was explored between agitation and Actigraphy measures. We found that total CMAI scores correlated with 24‐hours Actigraphy data (r(18)= 51, p= .02), further analysis showed that only physical non‐aggressive agitation correlated with 24‐hours actigraphy measures (r(18)= 0.49, p=.03), this was mainly related to day‐time and evening‐time Actigraphy but not overnight. Conclusions: Actigraphy was correlated significantly and moderately with informant‐based methods for measuring physical agitation in individuals with dementia and showed a temporal pattern of activity. Further studies are required to understand the application of Actigraphy as a biomarker for motoric agitation in this population.