Differences among patients with Alzheimer's disease, older adults with mild cognitive impairment and healthy older adults in finger dexterity

Background and ObjectivesThe number of people diagnosed with dementia is rising appreciably as the population ages. In an effort to improve outcomes, many have called for facilitating early detection of cognitive decline. Increased use of mobile technology by older adults provides the opportunity to deliver convenient, cost-effective assessments for earlier detection of cognitive impairment. This article presents a review of the literature on how mobile platforms—smartphones and tablets—are being used for cognitive assessment of older adults along with benefits and opportunities associated with using mobile platforms for cognitive assessment.Research Design and MethodsWe searched MEDLINE, Web of Science, PsycInfo, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials in October 2018. This search returned 7,024 articles. After removing 1,464 duplicates, we screened titles and abstracts then screened full-text for those articles meeting inclusion and exclusion criteria.ResultsTwenty-nine articles met our inclusion criteria and were categorized into 3 groups as follows: (a) mobile versions of existing article or computerized neuropsychological tests; (b) new cognitive tests developed specifically for mobile platforms; and (c) the use of new types of data for cognitive assessment. This scoping review confirms the considerable potential of mobile assessment.Discussion and ImplicationsMobile technologies facilitate repeated and continuous assessment and support unobtrusive collection of auxiliary behavioral markers of cognitive impairment, thus allowing users to view trends and detect acute changes that have traditionally been difficult to identify. Opportunities include using new mobile sensors and wearable devices, improving reliability and validity of mobile assessments, determining appropriate clinical use of mobile assessment information, and incorporating person-centered assessment principles and digital phenotyping.

Aim The objective of this study was to estimate the predictive accuracy of simple cognitive and motor performance tests to detect cognitive decline (CD) in community‐dwelling older adults. Methods In total, 102 community‐dwelling older adults participated in this study. Cognitive function, gait performance and coordinated finger movements were assessed using the Montreal Cognitive Assessment, the 10‐m walking test and the finger‐tapping test, respectively. We classified the participants into either a CD (n = 60) or a healthy control (n = 42) group. Results Significant group differences were found in the visuospatial/executive function subscale score on the Montreal Cognitive Assessment, stride length and total finger tap count. The results of multivariate logistic regression analysis showed that visuospatial/executive function subscale score, stride length and total tap count were the significant predictors for the presence of CD (sensitivity 83.3%, specificity 82.9%, predictive accuracy 83.2%). We also constructed a decision tree model with these three variables to increase the usefulness of our model as a screening tool by assigning a cut‐off value for each assessment. The sensitivity and specificity of the model were 88.1% and 85.2%, respectively, with an overall predictive accuracy of 86.4%. Conclusions The results of the present study suggest that simple cognitive and motor performance tests have moderate‐to‐high discriminant validity for the presence of CD in community‐dwelling older adults. Addition of such tests might lead to the more accurate detection of early cognitive decline. Geriatr Gerontol Int 2020; ••: ••–••.

Mild cognitive impairment (MCI) is becoming a serious problem for developing countries as the lifespan of populations increases. Exercise is known to be clinically beneficial for MCI patients. Somatosensory-evoked potentials (SEPs) may be a potential diagnostic and prognostic marker for this population. The objective of this study was to determine the acute effects of aerobic exercise on SEPs in patients with MCI, to test whether SEPs are sensitive enough to detect improvements in early somatosensory processing. The study had a randomized parallel-group design and included 28 MCI subjects (14 in the experimental group and 14 in the control group). The experimental intervention was 20 min of aerobic exercise using a stationary bicycle. The control intervention involved 20 min of movements and stretches. Subjects were assessed before and after a single intervention session. SEPs were recorded by stimulating the median nerve of the dominant hand. Analysis of normalized SEP peak amplitudes showed that a single session of aerobic activity significantly reduced the N30 peak at the F3 channel (p = 0.03). There were no significant effects of aerobic exercise on SEP peak latencies. The results indicate that 20 min of aerobic exercise has a significant effect on the N30 SEP peak amplitude in MCI patients. The results suggest that aerobic exercise is likely to provide sensory-enriching inputs that enhance sensorimotor integration. Future studies should assess the effects of aerobic exercise on somatosensory processing in progressive stages of Alzheimer’s disease, longer exercise durations, and multiple exercise sessions.