Screening older adults for amnestic mild cognitive impairment and early-stage Alzheimer's disease using upper-extremity dual-tasking
Screening older adults for amnestic mild cognitive impairment and early-stage Alzheimer's disease using upper-extremity dual-tasking
复制标题
DOI：
10.1038/s41598-019-46925-y
复制
发表时间：
2019-07-29
影响因子：
4.6
通讯作者：
Mohler, Jane
中科院分区：
文献类型：
--
作者：
Toosizadeh, Nima;Ehsanil, Hossein;Mohler, Jane
本研究的目的是开发一种基于双任务表现的客观工具，用于筛查早期阿尔茨海默病（AD）和轻度认知障碍（阿尔茨海默病类型的MCI）。双任务包括同时执行基于传感器的上肢功能（UEF）运动任务（正常或快速速度）和向后计数（1或3）的认知任务。记录运动功能速度和变异性，并使用方差分析比较认知组之间的差异，调整年龄、性别和体重指数。采用多变量有序逻辑模型建立认知指标，利用UEF参数预测认知状态。招募了91名参与者；认知正常35例（CN，年龄83.8 +/- 6.9），轻度认知障碍34例（年龄83.9 +/- 6.6），AD 22例（年龄84.1 +/- 6.1）。屈曲次数和基于传感器的运动变异性参数，在正常肘关节屈曲范围内，组间差异显著（CN与MCI的最大效应值为1.10，CN与AD的最大效应值为1.39,p < 0.0001）。使用这些参数预测认知状态（MCI和AD），受试者工作特征曲线下面积为0.83（敏感性= 0.82，特异性= 0.72）。研究结果表明，在更实用的上肢测试（而不是步行）中测量运动功能的速度和准确性可能为认知障碍评估提供足够的复杂性。
The purpose of the current study was to develop an objective tool based on dual-task performance for screening early-stage Alzheimer's disease (AD) and mild cognitive impairment (MCI of the Alzheimer's type). Dual-task involved a simultaneous execution of a sensor-based upper-extremity function (UEF) motor task (normal or rapid speed) and a cognitive task of counting numbers backward (by ones or threes). Motor function speed and variability were recorded and compared between cognitive groups using ANOVAs, adjusted for age, gender, and body mass index. Cognitive indexes were developed using multivariable ordinal logistic models to predict the cognitive status using UEF parameters. Ninety-one participants were recruited; 35 cognitive normal (CN, age = 83.8 +/- 6.9), 34 MCI (age = 83.9 +/- 6.6), and 22 AD (age = 84.1 +/- 6.1). Flexion number and sensor-based motion variability parameters, within the normal pace elbow flexion, showed significant between-group differences (maximum effect size of 1.10 for CN versus MCI and 1.39 for CN versus AD, p < 0.0001). Using these parameters, the cognitive status (both MCI and AD) was predicted with a receiver operating characteristic area under curve of 0.83 (sensitivity = 0.82 and specificity = 0.72). Findings suggest that measures of motor function speed and accuracy within a more practical upper-extremity test (instead of walking) may provide enough complexity for cognitive impairment assessment.