Tracking cognitive function with wearables during telerehabilitation: can nighttime sleep regularity and respiratory measures be used as sex-specific digital endpoints? (Preprint)

UNSTRUCTURED While changes in brain structure are common across the lifespan, it is difficult to differentiate benign variations from early disease pathogenesis, especially in patients participating in home-based rehabilitation. Cognitive decline is frequently linked with normative aging, but its early detection can facilitate preventative interventions, particularly in patients at high risk of cognitive impairment, like older women. Although women have fewer modifiable risk factors for dementia than men, wearables have the potential to establish new digital endpoints that facilitate the management and/or prevention of abnormal brain aging. Sleep, which is necessary for maintaining overall brain health, is one behavior tracked via wearables, for which an ever-growing body of pilot and validation phase studies exists; yet, endpoints defining optimal sleep are not one-size-fits-all, as individual differences in chronotype necessitate new strategies to personalize care. Though sex-based differences in circadian rhythm are well established, little is understood about which sleep features and thresholds are uniquely important to cognitive function in women. In this editorial, we discuss recent findings on the use of wearables to track sleep and cognitive health in women, while highlighting the challenges and opportunities for implementing meaningful digital endpoints for future work.