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

Your competent? doctor should use this test on you post stroke to determine the extent of your upcoming dementia and then provide EXACT DEMENTIA PREVENTION PROTOCOLS. 

They would have to account for the complete inability to do finger tapping on your affected side.

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

The latest here:

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

Renjie Li, Xinyi Wang, Katherine Lawler, Saurabh Garg, Rebecca J. St George, Aidan D. Bindoff, Larissa Bartlett, Eddy Roccati, Anna E. King, James C. Vickers, Quan Bai, Jane Alty

First published: 25 January 2024

https://doi.org/10.1002/dad2.12520

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Abstract

INTRODUCTION

Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger-tapping were associated with cognitive performance in older adults.

METHODS

A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference.

RESULTS

Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2).

DISCUSSION

This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline.

1 INTRODUCTION

Dementia prevalence is rapidly rising around the world and expected to reach 150 million by 2050.¹ Alzheimer's disease (AD) accounts for more than 70% of cases, and the pathology begins 10–20 years before any overt cognitive symptoms emerge.² Developing simple, low-cost tests to detect this preclinical stage is a research priority for drug development and enriching cohorts for dementia prevention.³ However, we currently lack cost-effective population-level tests to risk stratify asymptomatic community samples; cognitive test performance is highly correlated with intelligence and education, and some people are more resilient to cognitive decline, carrying a higher burden of pathology for longer before cognitive test performance starts to decline.⁴ Positron emission tomography scans, cerebrospinal fluid (CSF) analysis, and blood-based biomarkers are too costly, invasive, or specialist for widespread use.⁵

Emerging evidence indicates that analyzing hand motor function is a sensitive method to detect preclinical AD.⁶ Recent research (n = 72) has demonstrated that speed and rhythm of repetitive hand movements, measured by tapping on a computer keyboard, declined in cognitively healthy adults who had CSF AD biomarkers compared to those with normal biomarker levels.⁷ Relatively few studies have analyzed hand movements in AD and most required specialist wearable sensors or required researcher supervision.^8-10 To harness the potential of hand movement analysis as a low-cost population-level test of preclinical AD, there remains a need to develop more accessible methods for remote administration.

Computer vision techniques can be applied to digital videos recorded through webcams in household computers or mobile phones to precisely measure movements.^11-15 In contrast to using keyboard-tapping tasks, video-based technologies enable analysis of hand movements in 3D space (so additional features such as amplitude and decrement can be extracted), and the non-touch technique minimizes infection risks. Computer vision analysis of finger-tapping has not yet been employed via an online self-test in home settings to aid prediction of cognitive performance in asymptomatic older adults.

In response to the urgent need for simple population-level screening tests for dementia risk, we developed a home-based online test, Tasmanian Test (TAS Test), that uses a computer webcam to record finger-tapping videos, without requiring researcher assistance.¹⁶ Movement features from the videos are automatically extracted using computer vision algorithms that have been validated against wearable sensors.¹⁷ The objective of the study was to determine how well finger-tapping movement features associate with cognitive performance in a community sample of cognitively-asymptomatic older adults. Deficits in episodic memory are considered a proxy measure of preclinical AD as the hippocampus (critical for episodic memory function) is one of the earliest areas affected by AD pathology.^{18, 19} We thus hypothesized that (i) hand movement features predict cognitive performance over a model comprising age, sex, and level of education; (ii) nondominant hand movement features have stronger associations with cognitive performance than the dominant hand due to greater cognitive load required; and (iii) movement features associate more strongly with episodic memory than executive or working memory functions.¹⁸

2 METHODS

2.1 Study participants

Participants were recruited from the Island Study Linking Aging and Neurodegenerative Disease (ISLAND) project, a 10-year public health initiative that launched in 2019 at the University of Tasmania, Australia; the detailed protocol has previously been described.²⁰ In brief, the project recruits people aged 50 years or older who live in the Australian state of Tasmania and aims to reduce their dementia risk through education on modifying lifestyle and medical factors.²¹ ISLAND participants who had completed their annual research surveys were invited to the TAS Test sub-study. TAS Test is an online battery of motor-cognitive tasks, designed to be completed on a desktop or laptop computer without researcher assistance. The detailed TAS Test protocol has been described by Alty et al.¹⁶; in brief, participants log into a website, provide online consent, and are guided through a series of tasks, including video-recorded assessments of finger-tapping.

RESEARCH IN CONTEXT

• Systematic review: The authors reviewed journal articles and abstracts using PubMed and Google Scholar. Emerging evidence suggests hand movement analysis holds strong potential to identify people at risk of Alzheimer's disease. Relevant citations are cited.
• Interpretation: A total of 404 cognitively asymptomatic adults aged 51–84 completed self-administered 10-second-finger-tapping tasks at home via the TAS Test website, recorded via a webcam. Hand motor features improved prediction of episodic memory, executive function and working memory. Dominant hand features were more predictive for cognitive function, than nondominant hand features.
• Future directions: Brief self-administered online hand movement tests using a webcam may aid identification of pre-symptomatic cognitive performance. This provides a low-cost accessible and language-agnostic method for stratification of enriched cohorts for further assessment. Future work should compare finger-tapping webcam tests to other validated biomarkers of preclinical Alzheimer's disease. Prospective longitudinal designs are required to support the association between hand motor performance and cognitive function.