title: Handwriting and pre-frailty in the Lausanne cohort 65+ (Lc65+) study.
abstract: BACKGROUND
  Frailty is detected by weight loss, weakness, slow walking velocity, reduced physical activity or poor endurance/exhaustion. Handwriting has not been examined in the context of frailty, despite its functional importance.
  
  
  OBJECTIVE
  Our goal was to examine quantitative handwriting measures in people meeting 0, 1, and 2 or more (2+) frailty criteria. We also examined if handwriting parameters were associated with gait performance, weakness, poor endurance/exhaustion and cognitive impairment.
  
  
  METHODS
  From the population-based Lc65+, 72 subjects meeting 2+ frailty criteria with complete handwriting samples were identified. Gender-matched controls meeting 1 criterion or no criteria were identified. Cognitive impairment was defined by a Mini-Mental State Examination score of 25 or less or the lowest 20th percentile of Trail Making Test Part B. Handwriting was recorded using a writing tablet and measures of velocity, pauses, and pressure were extracted.
  
  
  RESULTS
  Subjects with 2+ criteria were older, had more health problems and need for assistance but had higher education. No handwriting parameter differed between frailty groups (age and education adjusted). Writing velocity was not significantly slower among participants from the slowest 20th percentile of gait velocity but writing pressure was significantly lower among those from the lowest 20th percentile of grip strength. Poor endurance/exhaustion was not associated with handwriting measures. Low cognitive performance was related to longer pauses.
  
  
  CONCLUSIONS
  Handwriting parameters might be associated with specific aspects of the frailty phenotype, but not reliably with global definitions of frailty at its earliest stages among subjects able to perform handwriting tests.
authors.affiliation: Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada. Electronic address: rcamicio@ualberta.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Camicioli
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University Hospital Medical Centre, University of Lausanne, Lausanne, Switzerland.
authors.forename: Seymour
authors.initials: S
authors.lastname: Mizrahi
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University Hospital Medical Centre, University of Lausanne, Lausanne, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Spagnoli
authors.affiliation: Service of Geriatric Medicine and Rehabilitation, Department of Medicine, University of Lausanne Medical Centre (CHUV), University of Lausanne, Lausanne, Switzerland.
authors.forename: Christophe
authors.initials: C
authors.lastname: Büla
authors.affiliation: Service of Neurology, Department of Clinical Neurosciences, University of Lausanne Medical Centre (CHUV), Lausanne 1011, Switzerland; Leenaards Memory Centre - CHUV, Clinical Neurosciences Department, Vaud University Hospital, Lausanne, Switzerland.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Demonet
authors.affiliation: Service of Neurology, Department of Clinical Neurosciences, University of Lausanne Medical Centre (CHUV), Lausanne 1011, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Vingerhoets
authors.affiliation: Service of Old Age Psychiatry, Department of Psychiatry, University of Lausanne Medical Centre (CHUV), University of Lausanne, Lausanne, Switzerland.
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University Hospital Medical Centre, University of Lausanne, Lausanne, Switzerland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Santos-Eggimann
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006236:Handwriting; D006801:Humans; D008297:Male; D013557:Switzerland / Q000453:epidemiology
keywords: Brain aging; Cognitive aging; Frailty; Gait; Handwriting; Motor control