可穿戴设备步态信息采集在老年人认知功能障碍评估中的应用
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摘要
目的:阿尔茨海默病痴呆前阶段的预警与早期干预对于延迟发病、降低发病率具有重要意义。轻度认知功能障碍是阿尔茨海默病痴呆前期的主要特征,而这一阶段的诊断方法尚未成熟。近年来的研究表明步态是认知功能的无创生物学指标,步态参数可以用来评估个体的认知能力。本研究利用可穿戴设备对受试者进行步态信息采集,结合受试者的临床认知功能评定,探讨可穿戴设备在阿尔茨海默病痴呆前阶段患者步态信息采集中的应用。方法:选取MMSE/MoCA量表评定具有认知功能障碍的受试者10例,利用可穿戴设备对受试者的日常步态进行采集,收集受试者人口学与临床量表评定信息。对比不同受试者的行走步态参数信息与认知评定结果,以及个体受试者的连续步态参数情况,探讨步态信息在认知功能评定中的应用可能。结果:利用可穿戴设备成功对10名受试者进行了连续跟踪步态信息采集并得到相关步态参数信息。其中认知功能评定结果较差的受试者在步相、步频与跨步时间等参数方面表现出异常。进一步的统计学分析结果需要在此初步研究的基础上扩大受试者数量与队列分组得出。结论:利用可穿戴设备对个体进行连续的步态信息采集与步态参数分析,结合临床认知功能评定在阿尔茨海默病痴呆前阶段患者辅助诊断方面具有广阔前景。
Objective Early warning and intervention in the pre-dementia stage of Alzheimer's disease are important for delaying the onset and reducing the incidence of AD. Mild cognitive impairment is a major feature of pre-dementia in Alzheimer's disease, and the diagnosisat this stage is difficult. Recent studies have shown that gait is a non-invasive biological indicator of cognitive function, and gait parameters can be used to assess an individual's cognitive ability. In this study, the gait information was collected from the subjects using wearable devices, and the clinical cognitive evaluation of the subjects wascombined to investigate the application of wearable devices in the gait information collection of patients with Alzheimer's disease dementia. Methods Ten patients with cognitive impairment were assessed with the MMSE/MoCA scale. The daily gait of the subjects was collected using wearable devices, and the demographic and clinical scale assessment information was collected. The gait parameter information and cognitive assessment results of different subjects and the continuous gait parameters of individual subjects were compared to explore the application of gait information in cognitive function assessment. Results Ten subjects were successfully tracked with gait information and the relevant gait parameter information was obtained using the wearable device. Subjects with poor cognitive function assessment showed abnormalities in parameters such as step phase, stride frequency and stride time. Further statistical analysis results need to expand the number of subjects and queues.Conclusion The use of wearable devices for continuous gait information collection and gait parameter analysis, combined with clinical cognitive function assessment, has broad prospects in the auxiliary diagnosis of patients with Alzheimer's disease dementia.
Objective Early warning and intervention in the pre-dementia stage of Alzheimer's disease are important for delaying the onset and reducing the incidence of AD. Mild cognitive impairment is a major feature of pre-dementia in Alzheimer's disease, and the diagnosisat this stage is difficult. Recent studies have shown that gait is a non-invasive biological indicator of cognitive function, and gait parameters can be used to assess an individual's cognitive ability. In this study, the gait information was collected from the subjects using wearable devices, and the clinical cognitive evaluation of the subjects wascombined to investigate the application of wearable devices in the gait information collection of patients with Alzheimer's disease dementia. Methods Ten patients with cognitive impairment were assessed with the MMSE/MoCA scale. The daily gait of the subjects was collected using wearable devices, and the demographic and clinical scale assessment information was collected. The gait parameter information and cognitive assessment results of different subjects and the continuous gait parameters of individual subjects were compared to explore the application of gait information in cognitive function assessment. Results Ten subjects were successfully tracked with gait information and the relevant gait parameter information was obtained using the wearable device. Subjects with poor cognitive function assessment showed abnormalities in parameters such as step phase, stride frequency and stride time. Further statistical analysis results need to expand the number of subjects and queues.Conclusion The use of wearable devices for continuous gait information collection and gait parameter analysis, combined with clinical cognitive function assessment, has broad prospects in the auxiliary diagnosis of patients with Alzheimer's disease dementia.
引文
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[3]中国痴呆与认知障碍诊治指南写作组.2018中国痴呆与认知障碍诊治指南(六):阿尔茨海默病痴呆前阶段[J].中华医学杂志,2018,19(98).
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[6]Tao,S.,X.Zhang,H.Cai,et al.Gait based biometric personal authentication by using MEMS inertial sensors[J].Journal of Ambient Intelligence and Humanized Computing,2018:1-8.
[7]Rosano,C.,S.A.Studenski,H.J.Aizenstein,et al.Slower gait,slower information processing and smaller prefrontal area in older adults[J].Age Ageing,2012,41(1):58-64.
[8]Rosso,A.L.,J.Verghese,A.L.Metti,et al.Slowing gait and risk for cognitive impairment:The hippocampus as a shared neural substrate[J].Neurology,2017,89(4):336-342.
[9]Best,J.R.,T.Liu-Ambrose,R.M.Boudreau,et al.An Evaluation of the Longitudinal,Bidirectional Associations Between Gait Speed and Cognition in Older Women and Men[J].J Gerontol A Biol Sci Med Sci,2016,71(12):1616-1623.
[10]Gras,L.Z.,S.F.Kanaan,J.M.McDowd,et al.Balance and gait of adults with very mild Alzheimer disease[J].J Geriatr Phys Ther,2015,38(1):1-7.
[11]Cedervall,Y.,K.Halvorsen and A.C.Aberg.Alongitudinal study of gait function and characteristics of gait disturbance in individuals with Alzheimer's disease[J].Gait Posture,2014,39(4):1022-1027.
[12]Gillain,S.,M.Drame,F.Lekeu,et al.Gait speed or gait variability,which one to use as a marker of risk to develop Alzheimer disease?A pilot study[J].Aging Clin Exp Res,2016,28(2):249-255.
[13]Castrillo,A.,L.M.Olmos,F.Rodriguez,et al.Gait Disorder in a Cohort of Patients With Mild and Moderate Alzheimer’s Disease[J].Am J Alzheimers Dis Other Demen,2016,31(3):257-262.
[14]Montero-Odasso,M.,S.W.Muir-Hunter,A.OtengAmoako,et al.Donepezil improves gait performance in older adults with mild Alzheimer’s disease:a phase IIclinical trial[J].J Alzheimers Dis,2015,43(1):193-199.
[15]TarniTa,D.Wearable sensors used for human gait analysis[J].Rom J Morphol Embryol,2016,57(2):373-382.
[16]Mc Ardle,R.,R.Morris,A.Hickey,et al.Gait in Mild Alzheimer’s Disease:Feasibility of Multi-Center Measurement in the Clinic and Home with Body-Worn Sensors:A Pilot Study[J].J Alzheimers Dis,2018,63(1):331-341.
[2]Sperling,R.A.,P.S.Aisen,L.A.Beckett,et al.Toward defining the preclinical stages of Alzheimer’s disease:recommendations from the National Institute on AgingAlzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease[J].Alzheimers Dement,2011,7(3):280-292.
[3]中国痴呆与认知障碍诊治指南写作组.2018中国痴呆与认知障碍诊治指南(六):阿尔茨海默病痴呆前阶段[J].中华医学杂志,2018,19(98).
[4]陶帅.步态在老年认知功能障碍中的研究与应用进展[J].中国老年保健医学,2017,5(15).
[5]Snijders,A.H.,B.P.van de Warrenburg,N.Giladi,et al.Neurological gait disorders in elderly people:clinical approach and classification[J].Lancet Neurol,2007,6(1):63-74.
[6]Tao,S.,X.Zhang,H.Cai,et al.Gait based biometric personal authentication by using MEMS inertial sensors[J].Journal of Ambient Intelligence and Humanized Computing,2018:1-8.
[7]Rosano,C.,S.A.Studenski,H.J.Aizenstein,et al.Slower gait,slower information processing and smaller prefrontal area in older adults[J].Age Ageing,2012,41(1):58-64.
[8]Rosso,A.L.,J.Verghese,A.L.Metti,et al.Slowing gait and risk for cognitive impairment:The hippocampus as a shared neural substrate[J].Neurology,2017,89(4):336-342.
[9]Best,J.R.,T.Liu-Ambrose,R.M.Boudreau,et al.An Evaluation of the Longitudinal,Bidirectional Associations Between Gait Speed and Cognition in Older Women and Men[J].J Gerontol A Biol Sci Med Sci,2016,71(12):1616-1623.
[10]Gras,L.Z.,S.F.Kanaan,J.M.McDowd,et al.Balance and gait of adults with very mild Alzheimer disease[J].J Geriatr Phys Ther,2015,38(1):1-7.
[11]Cedervall,Y.,K.Halvorsen and A.C.Aberg.Alongitudinal study of gait function and characteristics of gait disturbance in individuals with Alzheimer's disease[J].Gait Posture,2014,39(4):1022-1027.
[12]Gillain,S.,M.Drame,F.Lekeu,et al.Gait speed or gait variability,which one to use as a marker of risk to develop Alzheimer disease?A pilot study[J].Aging Clin Exp Res,2016,28(2):249-255.
[13]Castrillo,A.,L.M.Olmos,F.Rodriguez,et al.Gait Disorder in a Cohort of Patients With Mild and Moderate Alzheimer’s Disease[J].Am J Alzheimers Dis Other Demen,2016,31(3):257-262.
[14]Montero-Odasso,M.,S.W.Muir-Hunter,A.OtengAmoako,et al.Donepezil improves gait performance in older adults with mild Alzheimer’s disease:a phase IIclinical trial[J].J Alzheimers Dis,2015,43(1):193-199.
[15]TarniTa,D.Wearable sensors used for human gait analysis[J].Rom J Morphol Embryol,2016,57(2):373-382.
[16]Mc Ardle,R.,R.Morris,A.Hickey,et al.Gait in Mild Alzheimer’s Disease:Feasibility of Multi-Center Measurement in the Clinic and Home with Body-Worn Sensors:A Pilot Study[J].J Alzheimers Dis,2018,63(1):331-341.