Early acute illness detection in delirium and dementia

Project Accomplishments: This ALERT study looked at whether family caregivers could help detect early signs of illness in people with dementia by using simple weekly mental status checks and home health monitoring devices. Researchers trained caregivers to use a short screening tool to spot changes in attention and orientation, and provided reminders to help them stay on track. Most caregivers (75%) were able to notice changes in mental status, showing that they can play an important role in early detection. However, some found it difficult to keep up with the screenings, suggesting that extra support from healthcare teams may be needed. 

The study also tested how well caregivers and patients could use devices like sleep mats, blood pressure monitors, and wearables to track health at home. While many found the setup overwhelming, the sleep mat was the easiest to use and provided the most consistent data. This device tracked heart rate, breathing, and sleep patterns, and researchers found that changes in these readings often matched up with hospital visits or shifts in mental status. These findings suggest that simple, passive devices like sleep mats could help spot health problems early, but future studies should make setup easier and offer more support to families. 

Initial Project Abstract: Acute illness presents in the most vulnerable organ in the body, among patients with dementia that organ is the brain and acute illness often presents first as delirium, an acute confusional state. This project will evaluate home monitoring devices as early indicators of acute illness in persons with dementia. The study will be conducted in collaboration with the Program for All Inclusive Care of the Elderly (PACE) program, a healthcare provider for patients who are nursing home eligible but live at home with family.

Each home will be outfitted with the Withings Big Health Bundle (bed mat, body composition scale, thermometer and blood pressure monitor) and patients will receive a Garmin wearable. These monitoring devices will collect data on changes in health associated with acute illness and that lead to delirium (e.g., sleep disruption, infection, dehydration) over an 8-month follow-up. Caregivers will screen for delirium using a validated measure during follow- up. We hypothesize that changes identified by the remote monitoring devices will precede clinical manifestation of illness as measured by delirium in the patient.