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Facilitating the Measurement and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) and Understanding Caregiver Burden Using Wearable Devices in Rural Taiwan – Protocol for a Dyadic Feasibility Pilot Study
Guu T, Li W, Lee S, Hsu C, Chou C, Lack L, Ma W.. medRxiv, 2026-01-22
Topic: Health services, long-term care and technology
Plain-language summary
Introduction Alzheimer’s disease (AD) prevalence rises with societal ageing. In clinical care, behavioral and psychological symptoms of dementia (BPSD)—including depression, agitation/aggression, apathy, and sleep disturbance—worsen patients’ quality of life and substantially increase caregiver burden, more significantly than the cognitive symptoms. Standard BPSD assessments rely on caregiver-rated questionnaires that are cross-sectional and may be biased when caregivers are themselves older adults. Device-based measures (e.g., research-grade wrist actigraphy) can provide objective longitudinal data and novel features. In parallel, therapeutic wearables may improve sleep and mood in adults, and might improve BPSD if accepted by people living with dementia. This study aims to assess the feasibility and acceptability of two wearables (Geneactiv actigraphy and Re-Timer circadian regulator) among AD patients with significant BPSD and their caregivers in Taiwan. Methods This dyadic pilot study will recruit 20 participants (n=10 AD patients; n=10 caregivers) from outpatient services and affiliated day-care/dementia hubs in rural Taiwan. Participants will wear Geneactiv continuously for 8 weeks and Re-Timer ≥30 min/day for 4 weeks. Device-based data will be processed with GGIR, a well validated R-package designed for processing accelerometer data. Questionnaire assessments include Pittsburgh Sleep Quality Index, PSQI (PSQI), Neuropsychiatry Inventory Questionnaire (NPI-Q), Caregiver Burden Inventory (CBI), and a semi-structured interview based on the Taiwanese version of Quebec User Evaluation of Satisfaction with Assistive Technology (T-QUEST) at prespecified timepoints. Discussion Wearable devices may facilitate the measurement and treatment of specific BPSD, as well as reduce caregiver burden. If proven feasible even in rural Taiwan where both digital and health literacy and resources are limited, this model will inform how device-based dementia care model can be considered and applied in the context of global ageing. Ethics & registration This protocol has been approved by the China Medical University and Hospital Research Ethics Committee (CMUH114-REC3-072), and pre-registered in ClinicalTrials.gov ( NCT07249918 ).
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APA 7th
Guu, T., Li, W., Lee, S., Hsu, C., Chou, C., Lack, L., et al. (2026). Facilitating the Measurement and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) and Understanding Caregiver Burden Using Wearable Devices in Rural Taiwan – Protocol for a Dyadic Feasibility Pilot Study. medRxiv. https://doi.org/10.64898/2026.01.20.26344458
Vancouver
Guu T, Li W, Lee S, Hsu C, Chou C, Lack L, et al. Facilitating the Measurement and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) and Understanding Caregiver Burden Using Wearable Devices in Rural Taiwan – Protocol for a Dyadic Feasibility Pilot Study. medRxiv. 2026. doi:10.64898/2026.01.20.26344458.
BibTeX
@article{guu2026-a51e0079,
author = {Guu, T. and Li, W. and Lee, S. and Hsu, C. and Chou, C. and Lack, L. and Ma, W.},
title = {{Facilitating the Measurement and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) and Understanding Caregiver Burden Using Wearable Devices in Rural Taiwan – Protocol for a Dyadic Feasibility Pilot Study}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.01.20.26344458},
url = {https://doi.org/10.64898/2026.01.20.26344458}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- In clinical care, behavioral and psychological symptoms of dementia (BPSD)—including depression, agitation/aggression, apathy, and sleep disturbance—worsen patients’ quality of life and substantially increase caregiver burden, more significantly than the cognitive symptoms.
- This study aims to assess the feasibility and acceptability of two wearables (Geneactiv actigraphy and Re-Timer circadian regulator) among AD patients with significant BPSD and their caregivers in Taiwan.
Study details
- Study designcross-sectional
- Participants20
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 37 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for effect reported and randomized / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 23 of the 62 points we could judge it on, which is 37 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 20 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 23 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 23 of the 62 points we could judge it on is 37 out of 100. |
| Total | 37 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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