Difficulties with Fine Motor Skills and Cognitive Impairment in an Elderly Population: The Progetto Veneto Anziani

Curreri, Chiara; Trevisan, Caterina; Carrer, Pamela; Facchini, Silvia; Giantin, Valter; Maggi, Stefania; Noale, Marianna; Rui, Marina De; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

doi:10.1111/jgs.15209

Cited by 29 publications

(24 citation statements)

References 26 publications

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“…Sensorimotor performances have been investigated by several methods available in clinical settings like gait, postural equilibrium ( 5 – 7 ) or neuropsychological tests ( 8 , 9 ). Markers of impaired manual dexterity have also been used ( 3 ), and a recent longitudinal 4-year cohort study found that prolonged time taken in two simple manual dexterity tasks (including putting on and buttoning a shirt) was related to higher risk of developing cognitive decline [according to MMSE; ( 10 )]. Sensorimotor markers are considered independent of educational level ( 11 ), which is an advantage for clinical use.…”

Section: Introductionmentioning

confidence: 99%

“…First, as a potential marker, what type of manual dexterity task and which type of performance variable is optimal? Performance measures previously used were most often global task-based measures, i.e., time taken to complete task ( 5 , 6 , 10 ). Thus, it remained unclear what aspect of sensorimotor control was being measured, making the rationale for detecting cognitive decline uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Manual Dexterity and Aging: A Pilot Study Disentangling Sensorimotor From Cognitive Decline

et al. 2018

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Manual dexterity measures can be useful for early detection of age-related functional decline and for prediction of cognitive decline. However, what aspects of sensorimotor function to assess remains unclear. Manual dexterity markers should be able to separate impairments related to cognitive decline from those related to healthy aging. In this pilot study, we aimed to compare manual dexterity components in patients diagnosed with cognitive decline (mean age: 84 years, N = 11) and in age comparable cognitively intact elderly subjects (mean age: 78 years, N = 11). In order to separate impairments due to healthy aging from deficits due to cognitive decline we also included two groups of healthy young adults (mean age: 26 years, N = 10) and middle-aged adults (mean age: 41 years, N = 8). A comprehensive quantitative evaluation of manual dexterity was performed using three tasks: (i) visuomotor force tracking, (ii) isochronous single finger tapping with auditory cues, and (iii) visuomotor multi-finger tapping. Results showed a highly significant increase in force tracking error with increasing age. Subjects with cognitive decline had increased finger tapping variability and reduced ability to select the correct tapping fingers in the multi-finger tapping task compared to cognitively intact elderly subjects. Cognitively intact elderly subjects and those with cognitive decline had prolonged force release and reduced independence of finger movements compared to young adults and middle-aged adults. The findings suggest two different patterns of impaired manual dexterity: one related to cognitive decline and another related to healthy aging. Manual dexterity tasks requiring updating of performance, in accordance with (temporal or spatial) task rules maintained in short-term memory, are particularly affected in cognitive decline. Conversely, tasks requiring online matching of motor output to sensory cues were affected by age, not by cognitive status. Remarkably, no motor impairments were detected in patients with cognitive decline using clinical scales of hand function. The findings may have consequences for the development of manual dexterity markers of cognitive decline.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Manual Dexterity and Aging: A Pilot Study Disentangling Sensorimotor From Cognitive Decline

et al. 2018

View full text Add to dashboard Cite

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“…Although numerous studies have demonstrated that coordination and stability are primarily associated with basal ganglia, the cortical connections and functions are critical [ 20 , 21 , 22 , 23 ]. In a population-based longitudinal study of 2361 older patients, the time required to wear a shirt or complete a manual dexterity task was significantly longer in the preclinical phase of dementia [ 18 ]. In the Parkinsonism pathophysiology, early changes start from the medulla and pontine tegmentum and then slowly progress to the substantia nigra dopaminergic system during the mid-stage and finally to cortical deposition of Lewy bodies [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…PD patients with mild cognitive impairment (MCI) perform significantly worse in subtests of precision dexterity and velocity of arm-hand movements than PD patients without MCI [ 10 , 18 ]. In addition, in a study comparing the finger tapping patterns among patients with AD, PD, and MCI and healthy older adults, higher finger tapping variability was negatively associated with cognition; moreover, patients with PD demonstrated more taps with shorter intertap intervals [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Hand Fine Motor Skill Disability Correlates with Cognition in Patients with Moderate-to-Advanced Parkinson’s Disease

et al. 2020

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In older individuals, hand fine motor skill disability is associated with cognitive levels. Similarly, patients with moderate-to-advanced Parkinson’s disease (PD) often have cognitive dysfunction. Here, we investigated the association between hand fine motor skill and cognitive dysfunction in patients with moderate-to-advanced PD. Moderate and advanced PD patients with and without dementia were identified from the Taiwan Data Bank of Persons with Disability. Hand fine motor capacities, namely pen holding, buttoning, and knotting, were assessed with the World Health Organization Disability Assessment Schedule 2.0. Statistical analyses were performed on Statistical Analysis System (SAS) and a p value of <0.05 was considered significant. In total, 3440 patients with PD were enrolled, of which 612 had dementia, exhibiting significant disability in all three tasks. After adjustments for age, sex, and PD severity, pen holding and knotting were significantly associated with PD dementia. The presence of any disability in either task was not only sensitive to the presence of dementia but also associated with cognitive disability in moderate and advanced PD patients without dementia. In conclusion, hand fine motor skill disability was associated with cognitive disability in patients with moderate-to-advanced PD. These simple hand fine motor skills may thus be applicable in screening tests for the early identification of cognitive dysfunction in patients with moderate-to-advanced PD.

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Deficits in rate of force production during multifinger tasks are associated with cognitive status

Carson

Holton

2022

Int J Geriat Psychiatry

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Objectives The multifinger force deficit (MFFD) is the decline in force generated by an individual finger as the number of fingers contributing to the action is increased. It has been proposed that as a measure of neural sufficiency rather than muscle status, it provides a means of detecting individuals at risk of cognitive decline. Age‐related deficits in central neural drive exert a disproportionate impact on the rate at which force can be generated. We examined whether a MFFD derived from the maximum rate at which force is generated, is more sensitive to individual differences in cognitive status, than one calculated using the maximum level of force. Methods Monotonic associations between each of two variants of the MFFD, and cognition (measured with the Montreal Cognitive Assessment), were estimated cross sectionally using generalized partial rank correlations, in which age, level of education and degree of handedness were included as covariates. The participants (n=26) were community dwelling adults aged 66‐87. Results The MFFD derived using the maximum rate of force development was negatively associated with cognitive status. The association for the MFFD based on the maximum level of force, was not statistically reliable. The associations with cognitive status obtained for both variants of the MFFD were of greater magnitude than those reported previously for standard grip strength dynamometry. Conclusion The sensitivity with which the MFFD detects risk of cognitive decline may be enhanced by using the maximum rate of force developed by each finger, rather than the maximum force generated by each finger.

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Difficulties with Fine Motor Skills and Cognitive Impairment in an Elderly Population: The Progetto Veneto Anziani

Abstract: Difficulties with fine motor skills are common in older adults, and assessing them may help to identify early signs of dementia, subjects at high risk to develop cognitive decline, and individuals who can be referred to specialists.

Cited by 29 publications

References 26 publications

Manual Dexterity and Aging: A Pilot Study Disentangling Sensorimotor From Cognitive Decline

Manual Dexterity and Aging: A Pilot Study Disentangling Sensorimotor From Cognitive Decline

Hand Fine Motor Skill Disability Correlates with Cognition in Patients with Moderate-to-Advanced Parkinson’s Disease

Deficits in rate of force production during multifinger tasks are associated with cognitive status

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