Digital markers from smartwatch data relate to non-motor clinical examinations of Parkinson’s disease

Monitoring of Parkinson’s disease (PD) has seen substantial improvement over recent years as digital sensors enable a passive and continuous collection of information in the home environment. However, the primary focus of this work has been motor symptoms, with little focus on the non-motor aspects of the disease. To address this, we combined longitudinal clinical non-motor assessment data and digital multi-sensor data from the Verily Study Watch for 85 participants from the Parkinson’s Progression Monitoring Initiative (PPMI) cohort with a diagnosis of PD. We show that digitally collected physical activity and sleep markers do significantly relate to clinical non-motor assessments of cognitive, autonomic, and daily living impairment. The observed poor predictive performance, however, highlights the need for better targeted digital markers to enable a monitoring of non-motor symptoms. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement PPMI (a public-private partnership) is funded by the Michael J. Fox Foundation for Parkinson's Research with funding partners including Abbvie, Acure, Allergan, Amathus, Avid, Biogen, Bial Biotech, Biolegend, Bristol‐Myers Squibb, Calico, Celgene, Covance, Dacapo brain-science, Jenali, 4D Pharma plc, GE Healthcare, Edmond J. Safra philanthropic foundation, Genentech, GlaxoSmithKline, Golub Capital, Handl Therapeutics, Insitro, Janssen Neuroscience, Lilly, Lundbeck, Merck, Meso Scale Discovery, Neurocine, Pfizer, Piramal, Prevail, Roche, Sanofi Genzyme, Servier, Takeda, Teva, UCB, Verily and Voyager therapeutics. A.-K.S. and C.S. are funded by the Moondance Foundation as part of the Moondance Dementia Research Laboratory. A.-K.S. and C.S. are funded by the Moondance Foundation as part of the Moondance Dementia Research Laboratory. A.-K.S. is supported by a PhD studentship funded by the Welsh Government through Health and Care Research Wales (HS-20-11). C.S. is supported by the UK Dementia Research Institute funded by the Medical Research Council (MRC), Alzheimer's Society and Alzheimer's Research UK and by the Ser Cymru II programme (CU187) which is part-funded by Cardiff University and the European Regional Development Fund through the Welsh Government. K.P. is funded by an MRC Clinician-Scientist Fellowship (MR/P008593/1) and a Transition Support Award (MR/V036084/1). N.H. has nothing to declare. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study used publicly available data from . I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data used in this study was accessed from . The Institutional Review Board approved the PPMI program and all participants gave written informed consent. For up-to-date information on the study, visit [www.ppmi-info.org][1]. [1]: http://www.ppmi-info.org