摘要
BACKGROUND Older adults with mild cognitive impairment(MCI)often show motor dysfunction,including slower gait and impaired handwriting.While gait and handwriting parameters are promising for MCI screening,their combined potential to distinguish MCI from cognitively normal adults is unclear.AIM To assess gait and handwriting differences and their potential for screening MCI in older adults.METHODS Ninety-five participants,including 34 with MCI and 61 cognitively normal controls,were assessed for gait using the GAITRite^(R)system and handwriting with a dot-matrix pen.Five machine learning models were developed to assess the discriminative power of gait and handwriting data for MCI screening.RESULTS Compared to the cognitively normal group,the MCI group had slower gait velocity(Z=-2.911,P=0.004),shorter stride and step lengths(t=-3.005,P=0.003;t=2.863,P=0.005),and longer cycle,standing,and double support times(t=-2.274,P=0.025;t=-2.376,P=0.018;t=-2.717,P=0.007).They also had reduced cadence(t=2.060,P=0.042)and increased double support time variability(Z=-2.614,P=0.009).In handwriting,the MCI group showed lower average pressure(all tasks:Z=-2.135,P=0.033)and decreased accuracy(graphic task:Z=-2.447,P=0.014;Chinese character task:Z=-3.078,P=0.002).In the graphic task,they demonstrated longer time in air(Z=-2.865,P=0.004),reduced X-axis maximum velocities(Z=-3.237,P=0.001),and lower accelerations(X-axis:Z=-2.880,P=0.004;Y-axis:Z=-1.987,P=0.047)and maximum accelerations(X-axis:Z=-3.998,P<0.001;Y-axis:Z=-2.050,P=0.040).The multimodal analysis achieved the highest accuracy(74.4%)with the Gradient Boosting Classifier.CONCLUSION Integrating gait and handwriting kinematics parameters provides a viable method for distinguishing MCI,potentially supporting large-scale screening,especially in resource-limited settings.
基金
Supported by National Natural Science Foundation of China,No.72174061 and No.71704053
Key Research and Development Program of Zhejiang Province,No.2025C02106
China Scholarship Council Foundation,No.202308330251
Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2022KY370。
