Tracking Cognitive Health With Wearables in Telerehabilitation Female Participants: Could Nighttime Sleep Measures Be Used as Sex-Specific Digital Endpoints?

Apr 17, 2026JMIR neurotechnology

Using Wearable Sleep Tracking to Monitor Thinking Health in Women During Remote Rehab: Can Night Sleep Measures Serve as Female-Specific Digital Markers?

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Abstract

Wearables may help track sleep behaviors essential for understanding cognitive health in older women.

Changes in brain structure occur throughout the lifespan, complicating the distinction between normal variations and early signs of disease.
Cognitive decline is often associated with aging, with early detection being crucial for preventive measures, especially in high-risk groups.
Women generally have fewer modifiable risk factors for dementia compared to men, which may impact their cognitive health outcomes.
Wearable technology has potential for establishing new digital measures that could aid in managing brain aging.
Individual differences in sleep patterns, influenced by chronotype, require personalized strategies for effective health management.
Current understanding of sleep measures critical to cognitive health in women, especially those with multiple health issues, is limited.

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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 and dementia, such as 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 chronotype variability necessitates new strategies to personalize care. Though sex-based differences in circadian rhythm are well established, little is understood about which sleep measures and thresholds are uniquely important to cognitive health in women, particularly those with high comorbid burden. In this viewpoint, we discuss recent findings on the use of wearables to track sleep and cognitive health in women, while highlighting challenges and opportunities for health outcomes and clinical trial researchers seeking to implement meaningful digital endpoints in future telerehabilitation programs.

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Tracking Cognitive Health With Wearables in Telerehabilitation Female Participants: Could Nighttime Sleep Measures Be Used as Sex-Specific Digital Endpoints?

Abstract

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