Real-time automated detection of older adults' hand gestures in home and clinical settings

Feasibility of computerized motor, cognitive and speech tests in the home: Analysis of TAS Test in 2,300 older adults

BACKGROUND

Early detection of Alzheimer's disease (AD) risk is crucial for dementia prevention. Tasmanian Test (TAS Test) is a novel, unsupervised, computerized assessment of motor, cognitive, and speech function designed to detect AD risk.

OBJECTIVES

To evaluate the feasibility, usability, and acceptability of TAS Test.

DESIGN AND SETTING

TAS Test was administered remotely at home and/or in a research facility, using personal computers.

PARTICIPANTS

2,351 adults aged 50-89 years (mean 65.35), 71.76 % female, from Tasmania, Australia.

MEASUREMENTS

Completion rates, ease-of-use, distraction, test duration, and enjoyment scores. Demographics, computer literacy, cognition, and mood were analyzed.

RESULTS

Over 80 % completed motor and cognitive components with 92.8 % completing speech tests. 89.81 % found the duration acceptable. 80.90 % of remote and 83.46 % of onsite participants enjoyed the procedure. High usability and acceptability were reported, with age, gender, education, computer literacy, cognition and mood having minimal or no impact.

CONCLUSIONS

TAS Test demonstrated high completion rates and user satisfaction across a large community sample, supporting its feasibility as an unsupervised computerized assessment tool. Future research should address demographic representation and technical refinements.

Comparative Study of sEMG Feature Evaluation Methods Based on the Hand Gesture Classification Performance

Effective feature extraction and selection are crucial for the accurate classification and prediction of hand gestures based on electromyographic signals. In this paper, we systematically compare six filter and wrapper feature evaluation methods and investigate their respective impacts on the accuracy of gesture recognition. The investigation is based on several benchmark datasets and one real hand gesture dataset, including 15 hand force exercises collected from 14 healthy subjects using eight commercial sEMG sensors. A total of 37 time- and frequency-domain features were extracted from each sEMG channel. The benchmark dataset revealed that the minimum Redundancy Maximum Relevance (mRMR) feature evaluation method had the poorest performance, resulting in a decrease in classification accuracy. However, the RFE method demonstrated the potential to enhance classification accuracy across most of the datasets. It selected a feature subset comprising 65 features, which led to an accuracy of 97.14%. The Mutual Information (MI) method selected 200 features to reach an accuracy of 97.38%. The Feature Importance (FI) method reached a higher accuracy of 97.62% but selected 140 features. Further investigations have shown that selecting 65 and 75 features with the RFE methods led to an identical accuracy of 97.14%. A thorough examination of the selected features revealed the potential for three additional features from three specific sensors to enhance the classification accuracy to 97.38%. These results highlight the significance of employing an appropriate feature selection method to significantly reduce the number of necessary features while maintaining classification accuracy. They also underscore the necessity for further analysis and refinement to achieve optimal solutions.

Development of a smartphone screening test for preclinical Alzheimer's disease and validation across the dementia continuum

BACKGROUND

Dementia prevalence is predicted to triple to 152 million globally by 2050. Alzheimer's disease (AD) constitutes 70% of cases. There is an urgent need to identify individuals with preclinical AD, a 10-20-year period of progressive brain pathology without noticeable cognitive symptoms, for targeted risk reduction. Current tests of AD pathology are either too invasive, specialised or expensive for population-level assessments. Cognitive tests are normal in preclinical AD. Emerging evidence demonstrates that movement analysis is sensitive to AD across the disease continuum, including preclinical AD. Our new smartphone test, TapTalk, combines analysis of hand and speech-like movements to detect AD risk. This study aims to [1] determine which combinations of hand-speech movement data most accurately predict preclinical AD [2], determine usability, reliability, and validity of TapTalk in cognitively asymptomatic older adults and [3], prospectively validate TapTalk in older adults who have cognitive symptoms against cognitive tests and clinical diagnoses of Mild Cognitive Impairment and AD dementia.

METHODS

Aim 1 will be addressed in a cross-sectional study of at least 500 cognitively asymptomatic older adults who will complete computerised tests comprising measures of hand motor control (finger tapping) and oro-motor control (syllabic diadochokinesis). So far, 1382 adults, mean (SD) age 66.20 (7.65) years, range 50-92 (72.07% female) have been recruited. Motor measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 to develop an algorithm that classifies preclinical AD risk. Aim 2 comprises three sub-studies in cognitively asymptomatic adults: (i) a cross-sectional study of 30-40 adults to determine the validity of data collection from different types of smartphones, (ii) a prospective cohort study of 50-100 adults ≥ 50 years old to determine usability and test-retest reliability, and (iii) a prospective cohort study of ~1,000 adults ≥ 50 years old to validate against cognitive measures. Aim 3 will be addressed in a cross-sectional study of ~200 participants with cognitive symptoms to validate TapTalk against Montreal Cognitive Assessment and interdisciplinary consensus diagnosis.

DISCUSSION

This study will establish the precision of TapTalk to identify preclinical AD and estimate risk of cognitive decline. If accurate, this innovative smartphone app will enable low-cost, accessible screening of individuals for AD risk. This will have wide applications in public health initiatives and clinical trials.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT06114914, 29 October 2023. Retrospectively registered.

Brief webcam test of hand movements predicts episodic memory, executive function, and working memory in a community sample of cognitively asymptomatic older adults

INTRODUCTION

Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger-tapping were associated with cognitive performance in older adults.

METHODS

A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference.

RESULTS

Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2).

DISCUSSION

This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline.