Investigating the associations between upper limb motor function and cognitive impairment: a scoping review

Abstract

Upper limb motor function is a potential new biomarker of cognitive impairment and may aid discrimination from healthy ageing. However, it remains unclear which assessments to use. This study aimed to explore what methods have been used and to describe associations between upper limb function and cognitive impairment. A scoping review was conducted using PubMed, CINAHL and Web of Science. A systematic search was undertaken, including synonyms for key concepts ‘upper limb’, ‘motor function’ and ‘cognitive impairment’. Selection criteria included tests of upper limb motor function and impaired cognition in adults. Analysis was by narrative synthesis. Sixty papers published between 1998 and 2022, comprising 41,800 participants, were included. The most common assessment tasks were finger tapping, Purdue Pegboard Test and functional tasks such as writing. Protocols were diverse in terms of equipment used and recording duration. Most participants were recruited from clinical settings. Alzheimer’s Disease was the most common cause of cognitive impairment. Results were mixed but, generally, slower speed, more errors, and greater variability in upper limb movement variables was associated with cognitive impairment. This review maps the upper limb motor function assessments used and summarises the available evidence on how these associate with cognitive impairment. It identifies research gaps and may help guide protocols for future research. There is potential for upper limb motor function to be used in assessments of cognitive impairment.

Brief webcam test of hand movements predicts episodic memory, executive function, and working memory in a community sample of cognitively asymptomatic older adults

“…The present study's finger‐tapping results generally align with previous finger‐ and key‐tapping studies that report reduced frequency and increased variability characterize cognitive impairment across the dementia continuum 7,31,34–37 …”

“…The present study's finger‐tapping results generally align with previous finger‐ and key‐tapping studies that report reduced frequency and increased variability characterize cognitive impairment across the dementia continuum. 7 , 31 , 34 , 35 , 36 , 37 Together, these studies suggest that the ability to maintain a fast‐ and regular‐paced hand motor rhythm is associated with cognition, especially episodic memory and executive function. They also align with gait studies that report walking speed, and step variability, associate most strongly with memory and executive function.…”

“…This is the largest study examining finger‐tapping and cognitive function ( n = 404), the first to evaluate finger‐tapping with individual cognitive domains, and the first to use a webcam‐based self‐test. Only five previous studies (total n = 310 participants, including largest study n = 102) 30 examined finger‐tapping in dementia or mild cognitive impairment (MCI); these generally reported slower speed and impaired rhythm, with 4 using wearable sensors and one a subjective clinical rating 31 …”

“…Only five previous studies (total n = 310 participants, including largest study n = 102) 30 examined finger‐tapping in dementia or mild cognitive impairment (MCI); these generally reported slower speed and impaired rhythm, with 4 using wearable sensors and one a subjective clinical rating. 31 …”