Higher-Level Hand Motor Function in Aging and (Preclinical) Dementia: Its Relationship with (Instrumental) Activities of Daily Life – A Mini-Review

Abstract

A causal relationship between physical activity such as walking and cognitive functions – particularly executive functions and memory – has been observed in elderly people with and without dementia. Executive functions play an important role in the (instrumental) activities of daily life [(I)ADL]. However, a close relationship has also been found between motor activity of the upper limb, particularly the hand, and (I)ADL. Indeed, in aging, a decline in hand motor function is related to a decrease in (I)ADL, an increase in functional dependency, admission to a nursing home, and even mortality. This review begins by addressing clinical studies on the effect of age on higher-level hand motor activity. It then discusses higher-level hand motor function in age-related neurodegenerative diseases such as mild cognitive impairment, Alzheimer’s disease and vascular dementia. It concludes by discussing the contribution of higher-level hand motor function assessment to the diagnosis of the various subtypes of (preclinical) dementia and by addressing the clinical relevance of studying higher-level hand motor function, procedural learning, and (I)ADL in aging and (preclinical) dementia.

Neurochemical and Structural Organization of the Principal Nucleus of the Inferior Olive in the Human

“…It has also been proposed that climbing fiber input is essential for cerebellar plasticity and learning (Gilbert and Thach, 1977;Gibson et al, 2004). The changes of IOpr neurons might then contribute to the age-related decline in executing known motor skills or learning new ones (Spirduso et al, 1988;Woollacott and Shumway-Cook, 2002;Scherder et al, 2008;Fraser et al, 2009) or to a decline in cognitive or language functions mediated by the cerebellum.…”

Age-related Differences in Pre- and Post-synaptic Motor Cortex Inhibition are Task Dependent

“…Subsequently, age-related deficits in motor function may lead to reduced independence, decreased quality of life and institutionalisation [1]. Despite this, our understanding of how the ageing process affects function within core components of the motor system, such as the motor areas of the brain, is somewhat rudimentary.…”

Slowing of Alternating Forearm Movements Is Associated with Cognitive Impairment in Community-Dwelling Older People

“…Less research has stressed the relationship between cognition and upper extremity hand motor function. Motor control is related to higher-level cognitive functioning, in particular executive function [6,7] .…”

“…However, older people may become less able to walk [19][20][21] , which is why an assessment of motor characteristics of the upper extremities could be useful when gait assessments are not applicable due to frailty. The relationship between gait and cognition [19] has also been observed between hand motor function and cognitive functioning [7] . Complex motor functions, like alternating hand movements, are affected earlier than gross motor function, such as grip strength, in the process of cognitive decline and precede the development of the clinical state of dementia [22] .…”

“…The influence of mild cognitive impairment (MCI) and AD on hand motor function has been studied [7] , but sample sizes and data on the oldest old are limited. To our knowledge, no study has described the association of memory impairment, assessed by the 3-word delayed recall item from the Mini-Mental State Examination (MMSE), with complex and gross hand motor function controlled for sociodemographic, health-related and functional factors and comorbidity.…”