A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Design and Setting
2.2. Participants
2.3. Measurements
2.3.1. CI and MCI
2.3.2. Motor-Cognitive Dual-Task
2.3.3. Single Motor Task
2.3.4. Single Cognitive Task
2.3.5. Covariates
2.4. Statistical Analysis
3. Results
3.1. Characteristics of Study Participants
3.2. Associations between MMSE Score and the S-TMT Time, Gait Speed, or TMT-A Time
3.3. Discrimination Performance of the S-TMT, Gait Speed, and TMT-A for Screening CI and MCI
3.4. Comparison of the Reclassification Performance of Gait Speed, TMT-A, and S-TMT for Screening CI and MCI
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Age, years | 77 (74–81) |
Sex, men/women | 402/563 |
Body mass index, kg/m2 | 22.9 (21.1–25.0) |
Years of education | 12 (12–15) |
Living alone, yes | 383 (39.7%) |
Hypertension, yes | 507 (52.5%) |
Stroke, yes | 79 (8.2%) |
Heart disease, yes | 194 (20.1%) |
Diabetes mellitus, yes | 139 (14.4%) |
Hyperlipidemia, yes | 383 (39.7%) |
Osteoporosis, yes | 240 (24.9%) |
Handgrip strength, kg | 26.0 (21.0–31.0) |
GDS score, point | 3.0 (1.0–5.0) |
Smoker, yes | 61 (6.3%) |
Drinker, yes | 422 (43.7%) |
AUC (95% CI) | Cut-off Values | Sensitivity (%) | Specificity (%) | |
---|---|---|---|---|
Discrimination of cognitive impairment in participants with MMSE scores < 27 points (n = 406) | ||||
S-TMT, s | 0.75 (0.68–0.82) | 18.4/18.5 | 80.3 | 63.2 |
Gait speed, m/s | 0.61 (0.54–0.69) | 1.07/1.08 | 41.0 | 76.5 |
TMT-A, s | 0.72 (0.65–0.79) | 46.0/47.0 | 82.0 | 60.0 |
Discrimination of mild cognitive impairment in participants with MMSE scores > 24 points (n = 904) | ||||
S-TMT, s | 0.60 (0.56–0.64) | 15.6/15.7 | 61.4 | 55.1 |
Gait speed, m/s | 0.55 (0.51–0.58) | 1.17/1.18 | 36.8 | 73.3 |
TMT-A, s | 0.57 (0.54–0.61) | 44.0/45.0 | 46.7 | 63.7 |
Adjusted ORs (95% CI) | C-statistics (95% CI) | |
---|---|---|
Discrimination of cognitive impairment in participants with MMSE scores < 27 points (n = 406) | ||
Covariates model | 0.66 (0.58–0.73) | |
+ S-TMT, s | 1.12 (1.07–1.17) | 0.77 (0.71–0.83) |
+ Gait speed, m/s | 0.25 (0.07–0.95) | 0.67 (0.59–0.74) |
+ TMT-A, s | 1.02 (1.01–1.04) | 0.73 (0.66–0.80) |
Discrimination of mild cognitive impairment in participants with MMSE scores > 24 points (n = 904) | ||
Covariates model | 0.64 (0.60–0.67) | |
+ S-TMT, s | 1.03 (1.01–1.06) | 0.65 (0.61–0.69) |
+ Gait speed, m/s | 1.02 (0.52–1.99) | 0.64 (0.60–0.67) |
+ TMT-A, s | 1.00 (1.00–1.01) | 0.64 (0.60–0.68) |
cNRI (95% CI) | p | IDI (95% CI) | p | |
---|---|---|---|---|
Reclassification of the cognitive impairment in the participants with MMSE scores < 27 points (n = 406) | ||||
Covariates + Gait speed model | Reference | Reference | ||
vs. covariates + S-TMT model | 0.54 (0.28–0.81) | <0.01 | 0.08 (0.04–0.12) | <0.01 |
Covariates + TMT-A model | Reference | Reference | ||
vs. covariates + S-TMT model | 0.30 (0.03–0.57) | 0.03 | 0.05 (0.01–0.09) | 0.02 |
Reclassification of the mild cognitive impairment in the participants with MMSE scores > 24 points (n = 904) | ||||
Covariates + Gait speed model | Reference | Reference | ||
vs. covariates + S-TMT model | 0.18 (0.05–0.31) | <0.01 | 0.01 (0.00–0.01) | 0.02 |
Covariates + TMT-A model | Reference | Reference | ||
vs. covariates + S-TMT model | 0.21 (0.08–0.34) | <0.01 | 0.01 (0.00–0.01) | 0.04 |
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Osuka, Y.; Kim, H.; Watanabe, Y.; Taniguchi, Y.; Kojima, N.; Seino, S.; Kawai, H.; Sakurai, R.; Inagaki, H.; Awata, S.; et al. A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults. J. Clin. Med. 2020, 9, 2835. https://doi.org/10.3390/jcm9092835
Osuka Y, Kim H, Watanabe Y, Taniguchi Y, Kojima N, Seino S, Kawai H, Sakurai R, Inagaki H, Awata S, et al. A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults. Journal of Clinical Medicine. 2020; 9(9):2835. https://doi.org/10.3390/jcm9092835
Chicago/Turabian StyleOsuka, Yosuke, Hunkyung Kim, Yutaka Watanabe, Yu Taniguchi, Narumi Kojima, Satoshi Seino, Hisashi Kawai, Ryota Sakurai, Hiroki Inagaki, Shuichi Awata, and et al. 2020. "A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults" Journal of Clinical Medicine 9, no. 9: 2835. https://doi.org/10.3390/jcm9092835