Can motor function uncertainty and local instability within upper-extremity dual-tasking predict amnestic mild cognitive impairment and early-stage Alzheimer's disease?
| Autor: | Kathy O’Connor, Christopher S. Wendel, Nima Toosizadeh, Hossein Ehsani, Saman Parvaneh, Jane Mohler, Edward Zamrini |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Health Informatics Disease Neuropsychological Tests Motor function Ordinal regression Article Upper Extremity 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Alzheimer Disease medicine Humans Cognitive Dysfunction Stage (cooking) Cognitive impairment Aged Aged 80 and over Uncertainty Motor control Cognition Computer Science Applications 030104 developmental biology Analysis of variance Psychology 030217 neurology & neurosurgery |
| Zdroj: | Comput Biol Med |
| ISSN: | 1879-0534 |
| Popis: | In this study, we examined the uncertainty and local instability of motor function for cognitive impairment screening using a previously validated upper-extremity function (UEF). This approach was established based upon the fact that elders with an impaired executive function have trouble in the simultaneous execution of a motor and a cognitive task (dual-tasking). Older adults aged 65 years and older were recruited and stratified into 1) cognitive normal (CN), 2) amnestic MCI of the Alzheimer's type (aMCI), and 3) early-stage Alzheimer's Disease (AD). Participants performed normal-paced repetitive elbow flexion without counting and while counting backward by ones and threes. The influence of cognitive task on motor function was measured using uncertainty (measured by Shannon entropy), and local instability (measured by the largest Lyapunov exponent) of elbow flexion and compared between cognitive groups using ANOVAs, while adjusting for age, sex, and BMI. We developed logistic ordinal regression models for predicting cognitive groups based on these nonlinear measures. A total of 81 participants were recruited, including 35 CN (age = 83.8 ± 6.9), 30 aMCI (age = 83.9 ± 6.9), and 16 early AD (age = 83.2 ± 6.6). Uncertainty of motor function demonstrated the strongest associations with cognitive impairment, with an effect size of 0.52, 0.88, and 0.51 for CN vs. aMCI, CN vs. AD, and aMCI vs. AD comparisons, respectively. Ordinal logistic models predicted cognitive impairment (aMCI and AD combined) with a sensitivity and specificity of 0.82. The findings accentuate the potential of employing nonlinear dynamical features of motor functions during dual-tasking, especially uncertainty, in detecting cognitive impairment. |
| Databáze: | OpenAIRE |
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