A new early warning method for mild cognitive impairment due to Alzheimer's disease based on dynamic evaluation of the "spatial executive process"

Kai Li; Xiaowen Ma; Tong Chen; Junyi Xin; Chen Wang; Bo Wu; Atsushi Ogihara; Siyu Zhou; Jiakang Liu; Shouqiang Huang; Yujia Wang; Shuwu Li; Zeyuan Chen; Runlong Xu

doi:10.1177/20552076231194938

A new early warning method for mild cognitive impairment due to Alzheimer's disease based on dynamic evaluation of the "spatial executive process"

Digit Health. 2023 Aug 24:9:20552076231194938. doi: 10.1177/20552076231194938. eCollection 2023 Jan-Dec.

Authors

Kai Li^{1

2

3}, Xiaowen Ma^{1

2}, Tong Chen⁴, Junyi Xin⁵, Chen Wang^{1

2}, Bo Wu^{1

6}, Atsushi Ogihara^{1

7}, Siyu Zhou^{1

8}, Jiakang Liu^{1

2}, Shouqiang Huang^{1

2}, Yujia Wang^{1

2}, Shuwu Li^{1

2}, Zeyuan Chen^{3

9}, Runlong Xu⁵

Affiliations

¹ Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China.
² School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China.
³ Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou, China.
⁴ Department of Neurology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
⁵ School of Information Engineering, Hangzhou Medical College, Hangzhou, China.
⁶ School of Computer Science, Tokyo University of Technology, Hachioji City, Tokyo, Japan.
⁷ Department of Health Sciences and Social Welfare, Faculty of Human Sciences, Waseda University, Tokorozawa, Japan.
⁸ School of Public health, Hangzhou Normal University, Hangzhou, China.
⁹ School of International Studies and Cooperation, Zhejiang Police College, Hangzhou, China.

Abstract

Objective: Mild cognitive impairment (MCI) due to Alzheimer's disease (AD), as an early stage of AD, is an important point for early warning of AD. Neuropathological studies have shown that AD pathology in pre-dementia patients involves the hippocampus and caudate nucleus, which are responsible for controlling cognitive mechanisms such as the spatial executive process (SEP). The aim of this study is to design a new method for early warning of MCI due to AD by dynamically evaluating SEP.

Methods: We designed fingertip interaction handwriting digital evaluation paradigms and analyzed the dynamic trajectory of fingertip interaction and image data during "clock drawing" and "repetitive writing" tasks. Extracted fingertip interaction digital biomarkers were used to assess participants' SEP disorders, ultimately enabling intelligent diagnosis of MCI due to AD. A cross-sectional study demonstrated the predictive performance of this new method.

Results: We enrolled 30 normal cognitive (NC) elderly and 30 MCI due to AD patients, and clinical research results showed that there may be neurobehavioral differences between the two groups in digital biomarkers captured during SEP. The early warning performance for MCI due to AD of this new method (areas under the curve (AUC) = 0.880) is better than that of the Minimum Mental State Examination (MMSE) neuropsychological scale (AUC = 0.856) assessed by physicians.

Conclusion: Patients with MCI due to AD may have SEP disorders, and this new method based on dynamic evaluation of SEP will provide a novel human-computer interaction and intelligent early warning method for home and community screening of MCI due to AD.

Keywords: Alzheimer's disease; alerting in the community; fingertip human–computer interaction; intelligent analysis algorithm; mild cognitive impairment; spatial executive process.