Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan.
Psychogeriatrics. 2024 Mar;24(2):404-414. doi: 10.1111/psyg.13086. Epub 2024 Jan 30.
Gesture imitation, a simple tool for assessing visuospatial/visuoconstructive functions, is reportedly useful for screening and diagnosing dementia. However, gesture imitation performance in healthy older adults is largely unknown, as are the factors associated with lower performance. To address these unknowns, we examined the gesture imitation performance of a large number of community-dwelling older adults aged ≥65 years in Arao City, Kumamoto Prefecture (southern Japan).
The examiner presented the participants with eight gesture patterns and considered it a success if they could imitate them within 10 s. The success rate of each gesture imitation was calculated for three diagnostic groups: cognitively normal (CN) (n = 1184), mild cognitive impairment (MCI) (n = 237), and dementia (n = 47). Next, we reorganised the original gesture imitation battery by combining six selected gestures with the following scoring method: if the participants successfully imitated the gestures, immediately or within 5 s, two points were assigned. If they succeeded within 5-10 s, one point was assigned. The sensitivity and specificity of the battery were investigated to detect the dementia and MCI groups. Factors associated with gesture imitation battery scores were examined.
Except one complex gesture, the success rate of imitation in the CN group was high, approximately 90%. The sensitivity and specificity of the gesture imitation battery for discriminating between the dementia and CN groups and between the MCI and CN groups were 70%/88%, and 45%/75%, respectively. Ageing, male sex, and a diagnosis of dementia or MCI were associated with lower scores on the gesture imitation battery.
Gesture imitation tasks alone may not be sufficient to detect MCI. However, by combining gestures with set time limits, gesture imitation tasks can be a low-burden and effective method for detecting dementia, even in community medicine, such as during health check-ups.
手势模仿作为一种评估视空间/视构建功能的简单工具，据报道对痴呆症的筛查和诊断很有用。然而，健康老年人的手势模仿表现很大程度上是未知的，与较低表现相关的因素也是未知的。为了解决这些未知问题，我们在日本熊本县有明市（南部）检查了大量年龄在 65 岁以上的社区居住老年人的手势模仿表现。
检查者向参与者展示了 8 种手势模式，如果他们能在 10 秒内模仿成功，则认为成功。计算每个手势模仿的成功率，分为三个诊断组：认知正常（CN）（n=1184）、轻度认知障碍（MCI）（n=237）和痴呆（n=47）。然后，我们通过将六个选定的手势与以下评分方法相结合，对原始的手势模仿电池进行了重新组织：如果参与者立即或在 5 秒内成功模仿手势，则得 2 分。如果他们在 5-10 秒内成功，则得 1 分。研究了电池的敏感性和特异性，以检测痴呆和 MCI 组。检查了与手势模仿电池评分相关的因素。
除了一个复杂的手势外，CN 组的模仿成功率很高，约为 90%。手势模仿电池对区分痴呆和 CN 组以及 MCI 和 CN 组的敏感性和特异性分别为 70%/88%和 45%/75%。年龄增长、男性、痴呆或 MCI 的诊断与手势模仿电池评分较低有关。
单独的手势模仿任务可能不足以检测 MCI。然而，通过结合有时间限制的手势，手势模仿任务可以成为一种低负担且有效的检测痴呆的方法，即使在社区医学中，例如在健康检查期间。
