title: Kinematic and Pressure Features of Handwriting and Drawing: Preliminary Results Between Patients with Mild Cognitive Impairment, Alzheimer Disease and Healthy Controls.
abstract: Alzheimer's disease (AD) is the most common neurodegenerative dementia of old age, and the leading chronic disease contributor to disability and dependence among older people worldwide. Clinically, AD is characterized by a progressive cognitive decline that interferes with the ability to perform the activities of daily living. Handwriting and drawing are complex human activities that entail an intricate blend of cognitive, kinesthetic, and perceptual-motor features.
  
  
  
  To compare the kinematic characteristics of handwriting and drawing between patients with AD, patients with mild cognitive impairment (MCI) and healthy controls.
  
  
  
  We used a cross-sectional and observational design to assess the kinematic and pressure features of handwriting and drawing using a computerized system. Participants were asked to copy one sentence, write a dictated sentence and an own sentence, copy two and-three dimensions drawings, and to execute the clock drawing test. By means of discriminant analyses, we explored the value of several kinematic features in order to classify participants depending on their degree of cognitive functioning.
  
  
  
  The sample consisted of 52 participants (23 AD, 12 MCI, and 17 healthy controls) with a mean age of 69.7 years (SD=8.11). The degree of correct classification was largely dependent on the nature of the groups to be classified and the specific task, and ranged between 63.5% and 100%. Diagnostic accuracy based on kinematic measures showed higher specificity values for distinguishing between normal and impaired cognition (MCI and AD), and higher sensitivity was obtained when distinguishing between impaired cognition levels (MCI vs. AD).
  
  
  
  The kinematic features of writing and drawing procedures, rather than the final product, may be a useful and objective complement to the clinical assessment of patients with cognitive impairment.
authors.affiliation: Girona Biomedical Research Institute [IDIBGI]-Institut d'Assistència Sanitària, Girona, Catalonia. Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Garre-Olmo
authors.affiliation: Grup de recerca en tractament del senyal Tecnocampus- Mataró de la Universidad Pompeu Fabra, Barcelona, Catalonia. Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Faúndez-Zanuy
authors.affiliation: Deparment of Systems Engineering and Automation, University of the Basque Country, UPV/EHU, Donostia, Gipuzkoa. Spain.
authors.forename: Karmele
authors.initials: K
authors.lastname: López-de-Ipiña
authors.affiliation: Girona Biomedical Research Institute [IDIBGI]-Institut d'Assistència Sanitària, Girona, Catalonia. Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Calvó-Perxas
authors.affiliation: Girona Biomedical Research Institute [IDIBGI]-Institut d'Assistència Sanitària, Girona, Catalonia. Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Turró-Garriga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted; D016002:Discriminant Analysis; D006225:Hand / Q000503:physiopathology; D006236:Handwriting; D006801:Humans; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D009483:Neuropsychological Tests; D011312:Pressure
keywords: Alzheimer's disease; dementia; handwriting; kinematics; memory loss; mild cognitive impairment