Association between mild cognitive impairment and trajectory-based spatial parameters during timed up and go test using a laser range sensor

BackgroundThe Timed Up and Go (TUG) test may be a useful tool to detect not only mobility impairment but also possible cognitive impairment. In this cross-sectional study, we used the TUG test to investigate the associations between trajectory-based spatial parameters measured by laser range sensor (LRS) and cognitive impairment in community-dwelling older adults.MethodsThe participants were 63 community-dwelling older adults (mean age, 73.0 ± 6.3 years). The trajectory-based spatial parameters during the TUG test were measured using an LRS. In each forward and backward phase, we calculated the minimum distance from the marker, the maximum distance from the x-axis (center line), the length of the trajectories, and the area of region surrounded by the trajectory of the center of gravity and the x-axis (center line). We measured mild cognitive impairment using the Mini-Mental State Examination score (26/27 was the cut-off score for defining mild cognitive impairment).ResultsCompared with participants with normal cognitive function, those with mild cognitive impairment exhibited the following trajectory-based spatial parameters: short minimum distance from the marker (p = 0.044), narrow area of center of gravity in the forward phase (p = 0.012), and a large forward/whole phase ratio of the area of the center of gravity (p = 0.026) during the TUG test. In multivariate logistic regression analyses, a short minimum distance from the marker (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.69–0.98), narrow area of the center of gravity in the forward phase (OR: 0.01, 95% CI: 0.00–0.36), and large forward/whole phase ratio of the area of the center of gravity (OR: 0.94, 95% CI: 0.88–0.99) were independently associated with mild cognitive impairment.ConclusionsIn conclusion, our results indicate that some of the trajectory-based spatial parameters measured by LRS during the TUG test were independently associated with cognitive impairment in older adults. In particular, older adults with cognitive impairment exhibit shorter minimum distances from the marker and asymmetrical trajectories during the TUG test.

[1]  Timed Up and Go Test Predicts Cognitive Decline in Healthy Adults Aged 80 and Older in Okinawa: Keys to Optimal Cognitive Aging (KOCOA) Project , 2011, Journal of the American Geriatrics Society.

[2]  Kathryn Ziegler-Graham,et al.  Forecasting the global burden of Alzheimer’s disease , 2007, Alzheimer's & Dementia.

[3]  Cédric Annweiler,et al.  Motor Phenotype of Decline in Cognitive Performance among Community-Dwellers without Dementia: Population-Based Study and Meta-Analysis , 2014, PloS one.

[4]  Masaki Takahashi,et al.  Gait Measurement System for the Multi-Target Stepping Task Using a Laser Range Sensor , 2015, Sensors.

[5]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[6]  C. Mathers,et al.  Global prevalence of dementia: a Delphi consensus study , 2005, The Lancet.

[7]  C. Lyketsos,et al.  Vascular dementia and Alzheimer's disease: is there a difference? A comparison of symptoms by disease duration. , 2000, The Journal of neuropsychiatry and clinical neurosciences.

[8]  Masaki Takahashi,et al.  Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests , 2015, Sensors.

[9]  O. Donoghue,et al.  Association Between Timed Up‐and‐Go and Memory, Executive Function, and Processing Speed , 2012, Journal of the American Geriatrics Society.

[10]  K. Sekiyama,et al.  Visually encoded working memory is closely associated with mobility in older adults , 2014, Experimental Brain Research.

[11]  Masaki Takahashi,et al.  Development of measurement system for task oriented step tracking using laser range finder , 2012, Journal of NeuroEngineering and Rehabilitation.

[12]  D. Berg,et al.  Quantitative Timed-Up-and-Go Parameters in Relation to Cognitive Parameters and Health-Related Quality of Life in Mild-to-Moderate Parkinson's Disease , 2016, PloS one.

[13]  Jeffrey M. Hausdorff,et al.  Properties of the ‘Timed Up and Go’ Test: More than Meets the Eye , 2010, Gerontology.

[14]  Barry R. Greene,et al.  Assessment of Cognitive Decline Through Quantitative Analysis of the Timed Up and Go Test , 2012, IEEE Transactions on Biomedical Engineering.

[15]  R. Green,et al.  Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. , 2010, Archives of physical medicine and rehabilitation.

[16]  J. Lucas,et al.  Diagnostic accuracy of the MMSE in detecting probable and possible Alzheimer's disease in ethnically diverse highly educated individuals: an analysis of the NACC database. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  Stephen Todd,et al.  Survival in dementia and predictors of mortality: a review , 2013, International journal of geriatric psychiatry.

[18]  Xingda Qu,et al.  Age-related cognitive task effects on gait characteristics: do different working memory components make a difference? , 2014, Journal of NeuroEngineering and Rehabilitation.

[19]  M. Yamada,et al.  Arterial stiffness determined according to the cardio-ankle vascular index(CAVI) is associated with mild cognitive decline in community-dwelling elderly subjects. , 2014, Journal of atherosclerosis and thrombosis.

[20]  S. Yoshikawa,et al.  Brain activation during visual working memory correlates with behavioral mobility performance in older adults , 2015, Front. Aging Neurosci..

[21]  D Maquet,et al.  The value of instrumental gait analysis in elderly healthy, MCI or Alzheimer's disease subjects and a comparison with other clinical tests used in single and dual-task conditions. , 2009, Annals of physical and rehabilitation medicine.

[22]  V. E. Kelly,et al.  Associations Between Physical Performance and Executive Function in Older Adults With Mild Cognitive Impairment: Gait Speed and the Timed “Up & Go” Test , 2011, Physical Therapy.

[23]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.