Digital pen technology for conducting cognitive assessments: a cross-over study with older adults

AbstractMany digitalized cognitive assessments exist to increase reliability, standardization, and objectivity. Particularly in older adults, the performance of digitized cognitive assessments can lead to poorer test results if they are unfamiliar with the computer, mouse, keyboard, or touch screen. In a cross-over design study, 40 older adults (age M = 74.4 ± 4.1 years) conducted the Trail Making Test A and B with a digital pen (digital pen tests, DPT) and a regular pencil (pencil tests, PT) to identify differences in performance. Furthermore, the tests conducted with a digital pen were analyzed manually (manual results, MR) and electronically (electronic results, ER) by an automized system algorithm to determine the possibilities of digital pen evaluation. ICC(2,k) showed a good level of agreement for TMT A (ICC(2,k) = 0.668) and TMT B (ICC(2,k) = 0.734) between PT and DPT. When comparing MR and ER, ICC(2,k) showed an excellent level of agreement in TMT A (ICC(2,k) = 0.999) and TMT B (ICC(2,k) = 0.994). The frequency of pen lifting correlates significantly with the execution time in TMT A (r = 0.372, p = 0.030) and TMT B (r = 0.567, p < 0.001). A digital pen can be used to perform the Trail Making Test, as it has been shown that there is no difference in the results due to the type of pen used. With a digital pen, the advantages of digitized testing can be used without having to accept the disadvantages.

Download Full-text

Effects of dance on cognitive function in older adults: a systematic review and meta-analysis

Age and Ageing ◽

10.1093/ageing/afaa270 ◽

2020 ◽

Author(s):

Patricia Hewston ◽

Courtney Clare Kennedy ◽

Sayem Borhan ◽

Dafna Merom ◽

Pasqualina Santaguida ◽

...

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Learning And Memory ◽

Optimal Dose ◽

Future Research ◽

Trail Making Test ◽

Global Cognitive Function ◽

Trail Making ◽

Complex Attention

Abstract Background dance is a mind–body activity that stimulates neuroplasticity. We explored the effect of dance on cognitive function in older adults. Methods we searched MEDLINE, EMBASE, CENTRAL and PsycInfo databases from inception to August 2020 (PROSPERO:CRD42017057138). Inclusion criteria were (i) randomised controlled trials (ii) older adults (aged ≥ 55 years), (iii) intervention—dance and (iv) outcome—cognitive function. Cognitive domains were classified with the Diagnostic and Statistical Manual of Mental Disorders-5 Neurocognitive Framework. Meta-analyses were performed in RevMan5.3 and certainty of evidence with GradePro. Results we reviewed 3,997 records and included 11 studies (N = 1,412 participants). Seven studies included only healthy older adults and four included those with mild cognitive impairment (MCI). Dance interventions varied in frequency (1–3×/week), time (35–60 minutes), duration (3–12 months) and type. We found a mean difference (MD) = 1.58 (95% confidence interval [CI) = 0.21–2.95) on the Mini Mental State Examination for global cognitive function (moderate-certainty evidence), and the Wechsler Memory Test for learning and memory had an MD = 3.02 (95% CI = 1.38–4.65; low-certainty evidence). On the Trail Making Test-A for complex attention, MD = 3.07 (95% CI = −0.81 to 6.95; high-certainty evidence) and on the Trail Making Test-B for executive function, MD = −4.12 (95% CI = −21.28 to 13.03; moderate-certainty evidence). Subgroup analyses did not suggest consistently greater effects in older adults with MCI. Evidence is uncertain for language, and no studies evaluated social cognition or perceptual–motor function. Conclusions dance probably improves global cognitive function and executive function. However, there is little difference in complex attention, and evidence also suggests little effect on learning and memory. Future research is needed to determine the optimal dose and if dance results in greater cognitive benefits than other types of physical activity and exercise.

Download Full-text

ASSOCIATION BETWEEN THE NIH TOOLBOX COGNITION BATTERY AND GAIT IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.3388 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S931-S931

Author(s):

Kate Hamel ◽

Sarah Barber ◽

Carl Ketcham ◽

Kristy Lui

Keyword(s):

Older Adults ◽

Sex Education ◽

Stride Length ◽

Dimensional Change ◽

Community Dwelling ◽

Trail Making Test ◽

Card Sort ◽

Cognitive Predictors ◽

Trail Making ◽

Temporal Measures

Abstract The relationship between older adults’ gait and cognition has been well-studied, however there is little consensus regarding a best set of measures to assess cognition. One option that has not been previously examined is the NIH Toolbox Cognition Battery (NIHT-CB), which was developed to be used across the lifespan and across research disciplines. This study examined the relationships between the seven subtests of the NIHT-CB, Trail-Making Tests A and B, and temporospatial measures of gait. One hundred sixty-seven healthy, community-dwelling older adults (115 females, 73.4 ± 4.5 years) completed these cognitive measures and also walked at their self-selected pace back-and-forth five times along a temporospatial-measuring walkway. The mean and coefficient of variation were calculated for each gait variable (stride length, width, time and velocity; stance/swing time and % of stride). After controlling for potential confounders (height, weight, age, sex, education, self-efficacy, health, exercise and falls history), executive function measures were typically the most significant cognitive predictors. More specifically, the Dimensional Change Card Sort task was the best predictor of temporal measures and stride velocity (all ps < 0.001) and the Trail-Making Test Part B was the best predictor for variability measures (five of eight p-values < 0.001). Interestingly, stride length and also stance and swing % of stride were strongly related to a measure of language - Picture Vocabulary (all ps < 0.006). The NIHT-CB appears to be a useful tool for studies of gait in older adults, particularly when used in conjunction with Trail-Making Test B.

Download Full-text

Language dominance and inhibition abilities in bilingual older adults

Bilingualism Language and Cognition ◽

10.1017/s1366728913000126 ◽

2013 ◽

Vol 18 (1) ◽

pp. 79-89 ◽

Cited By ~ 27

Author(s):

MIRA GORAL ◽

LUCA CAMPANELLI ◽

AVRON SPIRO

Keyword(s):

Older Adults ◽

Working Memory ◽

Language Use ◽

Simon Task ◽

Trail Making Test ◽

Single Test ◽

Cognitive Domains ◽

Bilingual Advantage ◽

Age Related ◽

Trail Making

This study aimed to examine the so-called bilingual advantage in older adults’ performance in three cognitive domains and to identify whether language use and bilingual type (dominant vs. balanced) predicted performance. The participants were 106 Spanish–English bilinguals ranging in age from 50 years to 84 years. Three cognitive domains were examined (each by a single test): inhibition (the Simon task), alternating attention (the Trail Making test), and working memory (Month Ordering). The data revealed that age was negatively correlated to performance in each domain. Bilingual type – balanced vs. dominant – predicted performance and interacted with age only on the inhibition measure (the Simon task). Balanced bilinguals showed age-related inhibition decline (i.e., greater Simon effect with increasing age); in contrast, dominant bilinguals showed little or no age-related change. The findings suggest that bilingualism may offer cognitive advantage in older age only for a subset of bilinguals.

Download Full-text

Clinimetric validity of the Trail Making Test Czech version in Parkinson’s disease and normative data for older adults

The Clinical Neuropsychologist ◽

10.1080/13854046.2017.1324045 ◽

2017 ◽

Vol 31 (sup1) ◽

pp. 42-60 ◽

Cited By ~ 3

Author(s):

Ondrej Bezdicek ◽

Hana Stepankova ◽

Bradley N. Axelrod ◽

Tomas Nikolai ◽

Zdenek Sulc ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Normative Data ◽

Trail Making Test ◽

Trail Making

Download Full-text

Association of Sarcopenia With Performance on Multiple Cognitive Domains: Results From the ELSA-Brasil Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glz118 ◽

2019 ◽

Vol 74 (11) ◽

pp. 1805-1811 ◽

Cited By ~ 2

Author(s):

Claudia Szlejf ◽

Claudia K Suemoto ◽

Paulo A Lotufo ◽

Isabela M Benseñor

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Verbal Fluency ◽

Recall Test ◽

Word Recall ◽

Trail Making Test ◽

Verbal Fluency Test ◽

Trail Making ◽

Fluency Test

Abstract Background Sarcopenia and cognitive impairment share pathophysiological paths and risk factors. Our aim was to investigate the association of sarcopenia and its defining components with cognitive performance in middle-aged and older adults. Methods This cross-sectional analysis included 5,038 participants from the ELSA-Brasil Study, aged ≥ 55 years. Muscle mass was evaluated by bioelectrical impedance analysis and muscle strength by handgrip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health. Cognition was evaluated using delayed word recall test, semantic verbal fluency test, and trail making test version B. Possible confounders included sociodemographic characteristics, lifestyle, and clinical comorbidities. Results The frequencies of sarcopenia, low muscle mass, and low muscle strength were 1.8%, 23.3%, and 4.4%, respectively. After adjustment for possible confounders, poorer performance on the verbal fluency test was associated with sarcopenia (β = −0.20, 95% confidence interval [CI] = −0.38; −0.01, p = .03) and low muscle mass (β = −0.08, 95% CI = −0.14; −0.01, p = .02). Low muscle strength was associated with poorer performance in the delayed word recall test (β = −0.14, 95% CI = −0.27; −0.02, p = .02), verbal fluency test (β = −0.14, 95% CI = −0.26; −0.02, p = .03), and trail making test (β = −0.15, 95% CI = −0.27; −0.03, p = .01). Conclusions Sarcopenia was associated with poorer performance on the verbal fluency test, and low muscle strength was associated with poorer performance in all cognitive tests in middle-aged and older adults.

Download Full-text

B-09Effects of Age, Education, and Gender on Trail Making Test Parts A & B in Non-Demented Older Adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acv047.105 ◽

2015 ◽

Vol 30 (6) ◽

pp. 525.1-525 ◽

Cited By ~ 1

Author(s):

R Zec ◽

S Kohlrus ◽

R Robbs ◽

T Ala

Keyword(s):

Older Adults ◽

Trail Making Test ◽

Trail Making ◽

And Gender

Download Full-text

Processing speed and the relationship between Trail Making Test-B performance, cortical thinning and white matter microstructure in older adults

Cortex ◽

10.1016/j.cortex.2017.07.021 ◽

2017 ◽

Vol 95 ◽

pp. 92-103 ◽

Cited By ~ 29

Author(s):

Sarah E. MacPherson ◽

Simon R. Cox ◽

David A. Dickie ◽

Sherif Karama ◽

John M. Starr ◽

...

Keyword(s):

Older Adults ◽

White Matter ◽

Processing Speed ◽

Trail Making Test ◽

Cortical Thinning ◽

White Matter Microstructure ◽

Trail Making ◽

The Relationship

Download Full-text

A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm9092835 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2835 ◽

Cited By ~ 1

Author(s):

Yosuke Osuka ◽

Hunkyung Kim ◽

Yutaka Watanabe ◽

Yu Taniguchi ◽

Narumi Kojima ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Dual Task ◽

Gait Speed ◽

Concurrent Validity ◽

Trail Making Test ◽

Cognitive Tests ◽

Cross Sectional ◽

Net Reclassification Improvement ◽

Trail Making

This study aimed to examine the concurrent validity of a novel motor-cognitive dual-task test, the Stepping Trail Making Test (S-TMT), as an indicator of cognitive impairment (CI), and compare its screening performance to that of motor or cognitive tests alone. This was a population-based cross-sectional study including 965 Japanese adults aged ≥ 70 years. To measure the time taken to perform the S-TMT, the participants were instructed to step on 16 numbers in sequence as quickly and accurately as possible. Motor and cognitive functions were assessed by gait speed and TMT part A (TMT-A), respectively. Participants were classified into CI (< 24 points), mild CI (MCI, 24–27 points), and intact cognition (> 27 points) categories based on their Mini-Mental State Examination score. Binary logistic regression models showed that the addition of the S-TMT to the covariates model gave the highest discrimination index (c-statistics), and significantly improved reclassification indices (net reclassification improvement and integrated discrimination improvement) for screening both CI and MCI compared to those of gait speed or TMT-A alone. These results show that S-TMT has a concurrent validity as a dual-task test for screening CI and MCI and better discrimination and reclassification performance than motor or cognitive tests alone in older adults.

Download Full-text