title: Older age relates to worsening of fine motor skills: a population-based study of middle-aged and elderly persons.
abstract: BACKGROUND
  In a population-based study of 1,912 community-dwelling persons of 45 years and older, we investigated the relation between age and fine motor skills using the Archimedes spiral-drawing test. Also, we studied the effect of brain volume on fine motor skills.
  
  
  METHODS
  Participants were required to trace a template of a spiral on an electronic drawing board. Clinical scores from this test were obtained by visual assessment of the drawings. Quantitative measures were objectively determined from the recorded data of the drawings. As tremor is known to occur increasingly with advancing age, we also rated drawings to assess presence of tremor.
  
  
  RESULTS
  We found presence of a tremor in 1.3% of the drawings. In the group without tremor, we found that older age was related to worse fine motor skills. Additionally, participants over the age of 75 showed increasing deviations from the template when drawing the spiral. Larger cerebral volume and smaller white matter lesion volume were related to better spiral-drawing performance, whereas cerebellar volume was not related to spiral-drawing performance.
  
  
  CONCLUSIONS
  Older age is related to worse fine motor skills, which can be captured by clinical scoring or quantitative measures of the Archimedes spiral-drawing test. Persons with a tremor performed worse on almost all measures of the spiral-drawing test. Furthermore, larger cerebral volume is related to better fine motor skills.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Yoo Young
authors.initials: YY
authors.lastname: Hoogendam
authors.affiliation: Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Medical Informatics, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Fedde
authors.initials: F
authors.lastname: van der Lijn
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Medical Informatics, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Faculty of Applied Sciences, Delft University of Technology , Delft , Netherlands.
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Radiology, Erasmus MC University Medical Center , Rotterdam , Netherlands ; Department of Neurology, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Neuroscience, Erasmus MC University Medical Center , Rotterdam , Netherlands.
authors.forename: Jos N
authors.initials: JN
authors.lastname: van der Geest
keywords: cerebellum; cerebrum; elderly; fine motor skills; magnetic resonance imaging; middle-aged; population-based; spiral-drawing