Motor signs in Alzheimer's disease and vascular dementia: Detection through natural language processing, co-morbid features and relationship to adverse outcomes

Al-Harrasi, Ahmed; Iqbal, Ehtesham; Tsamakis, Konstantinos; Lasek, Judista; Gadelrab, Romayne; Soysal, Pınar; Kohlhoff, Enno; Tsiptsios, Dimitrios; Rizos, Emmanouil; Perera, Gayan; Aarsland, Dag; Stewart, Robert; Mueller, Christoph

doi:10.1016/j.exger.2020.111223

Cited by 11 publications

(9 citation statements)

References 32 publications

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“…Individuals diagnosed with dementia often present neurologic signs and cognitive symptoms years before the diagnosis of the syndrome [ 1 , 2 ]. Motor signs are common clinical features of dementia syndromes [ 3 , 4 ]. The presence of motor signs in patients with Alzheimer’s disease (AD) has been associated with worse cognitive decline and faster disease progression [ 5 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Of note, motor signs may be useful clinical markers for better differentiation between dementia subtypes [ 19 ]. However, motor signs are under-recorded in clinical practice [ 3 ]. Deeper knowledge regarding associations between motor signs and cognitive performance could shed more light onto the underlying implicated mechanisms, and further increase awareness of the importance of their identification and clinical recording [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between Motor Signs and Cognitive Performance in Cognitively Unimpaired Older Adults: A Cross-Sectional Study Using the NACC Database

2022

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Aiming to examine whether specific motor signs are associated with worse performance in specific cognitive domains among cognitively unimpaired (CU) individuals, we performed a cross-sectional analysis of data from the baseline evaluations of older, CU participants from the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set. In total, 8149 CU (≥60 years) participants were included. Of these, 905 individuals scored ≥ 2 on at least one of the motor domains of the Unified Parkinson’s Disease Rating Scale part III (UPDRSIII). Cognitively impaired individuals, participants with psychiatric disorders and/or under treatment with antipsychotic, anxiolytic, sedative or hypnotic agents were excluded. Nine motor signs were examined: hypophonia, masked facies, resting tremor, action/postural tremor, rigidity, bradykinesia, impaired chair rise, impaired posture/gait and postural instability. Their association with performance on episodic memory, semantic memory, language, attention, processing speed or executive function was assessed using crude and adjusted linear regression models. Individuals with impaired chair rise had worse episodic memory, semantic memory, processing speed and executive function, while those with bradykinesia had worse language, processing speed and executive function. Sensitivity analyses, by excluding participants with cerebrovascular disease or PD, or other Parkinsonism, produced similar results with the exception of the relationship between bradykinesia and language performance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between Motor Signs and Cognitive Performance in Cognitively Unimpaired Older Adults: A Cross-Sectional Study Using the NACC Database

2022

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“…A total of 8 publications addressed acute care settings [ 31 - 38 ], 6 looked at nursing homes [ 39 - 44 ], and 3 examined community care [ 45 - 47 ]. The majority described prospective observational studies published in journals covering geriatrics and psychogeriatrics [ 31 , 33 , 34 , 36 , 46 - 48 ] ( Multimedia Appendix 2 ) [ 31 - 55 ].…”

Section: Resultsmentioning

confidence: 99%

Using AI-Based Technologies to Help Nurses Detect Behavioral Disorders: Narrative Literature Review

Fernandes,

von Gunten,

Verloo

2024

JMIR Nursing

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Background The behavioral and psychological symptoms of dementia (BPSD) are common among people with dementia and have multiple negative consequences. Artificial intelligence–based technologies (AITs) have the potential to help nurses in the early prodromal detection of BPSD. Despite significant recent interest in the topic and the increasing number of available appropriate devices, little information is available on using AITs to help nurses striving to detect BPSD early. Objective The aim of this study is to identify the number and characteristics of existing publications on introducing AITs to support nursing interventions to detect and manage BPSD early. Methods A literature review of publications in the PubMed database referring to AITs and dementia was conducted in September 2023. A detailed analysis sought to identify the characteristics of these publications. The results were reported using a narrative approach. Results A total of 25 publications from 14 countries were identified, with most describing prospective observational studies. We identified three categories of publications on using AITs and they are (1) predicting behaviors and the stages and progression of dementia, (2) screening and assessing clinical symptoms, and (3) managing dementia and BPSD. Most of the publications referred to managing dementia and BPSD. Conclusions Despite growing interest, most AITs currently in use are designed to support psychosocial approaches to treating and caring for existing clinical signs of BPSD. AITs thus remain undertested and underused for the early and real-time detection of BPSD. They could, nevertheless, provide nurses with accurate, reliable systems for assessing, monitoring, planning, and supporting safe therapeutic interventions.

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“…This is not difficult to accept, as some researchers refer to AD as “diabetes of the brain” or “type-3 diabetes” [ 97 ]. In addition, movement disorders, often accompanied by functional defects, were discovered as a strong predictor of mortality and were associated with adverse outcomes [ 10 , 98 – 100 ]. In our work, EPS influenced not only the survival of AD patients but also the quality of life since diagnosis, which is not hard to interpret because EPS, such as rigidity, tremor, and postural instability, means a loss of self-care to a certain extent.…”

Section: Discussionmentioning

confidence: 99%

Predictors for survival in patients with Alzheimer’s disease: a large comprehensive meta-analysis

Zheng,

Wang,

Huang

et al. 2024

Transl Psychiatry

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The prevalence of Alzheimer’s disease (AD) is increasing as the population ages, and patients with AD have a poor prognosis. However, knowledge on factors for predicting the survival of AD remains sparse. Here, we aimed to systematically explore predictors of AD survival. We searched the PubMed, Embase and Cochrane databases for relevant literature from inception to December 2022. Cohort and case-control studies were selected, and multivariable adjusted relative risks (RRs) were pooled by random-effects models. A total of 40,784 reports were identified, among which 64 studies involving 297,279 AD patients were included in the meta-analysis after filtering based on predetermined criteria. Four aspects, including demographic features (n = 7), clinical features or comorbidities (n = 13), rating scales (n = 3) and biomarkers (n = 3), were explored and 26 probable prognostic factors were finally investigated for AD survival. We observed that AD patients who had hyperlipidaemia (RR: 0.69) were at a lower risk of death. In contrast, male sex (RR: 1.53), movement disorders (including extrapyramidal signs) (RR: 1.60) and cancer (RR: 2.07) were detrimental to AD patient survival. However, our results did not support the involvement of education, hypertension, APOE genotype, Aβ42 and t-tau in AD survival. Our study comprehensively summarized risk factors affecting survival in patients with AD, provided a better understanding on the role of different factors in the survival of AD from four dimensions, and paved the way for further research.

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Motor signs in Alzheimer's disease and vascular dementia: Detection through natural language processing, co-morbid features and relationship to adverse outcomes

Cited by 11 publications

References 32 publications

Association between Motor Signs and Cognitive Performance in Cognitively Unimpaired Older Adults: A Cross-Sectional Study Using the NACC Database

Association between Motor Signs and Cognitive Performance in Cognitively Unimpaired Older Adults: A Cross-Sectional Study Using the NACC Database

Using AI-Based Technologies to Help Nurses Detect Behavioral Disorders: Narrative Literature Review

Predictors for survival in patients with Alzheimer’s disease: a large comprehensive meta-analysis

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