Handwriting as an Objective Tool to Support the Identification of People With Alzheimer's Disease
NCT Number: NCT06483438
Acronym: HAD
Status: COMPLETED
Study Type: OBSERVATIONAL
Conditions: Dementia
Sponsor: University of Évora
Collaborators: NOVA Medical School|Faculdade de Motricidade Humana|University of Lisbon
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 20
Study Design: Observational Model: |Time Perspective: p
Start Date: 2023-12-02
Completion Date: 2024-07-30
Locations: Casa dos Avós Residence, Ponte De Sôr, 7400, Portugal|Costa Azul Residence, Sesimbra, 2970, Portugal|Espírito Santo Hospital of Évora, Évora, 7000, Portugal

Summary:
Alzheimer's disease (AD) is the most common of dementia, and has associated cognitive and motor disorders, with consequences on daily activities, including handwriting.

Handwriting has been used to study fine motor control or executive functioning in healthy and unhealthy populations. Changes in this skill are present at different stages of the clinical course of Alzheimer's Disease. The sensorimotor deterioration is observed in handwriting tasks (motion kinematics, such as movement time, speed, and profiles) and brain activity rhythms.

Handwriting has been used to study fine motor control or executive functioning in healthy and unhealthy populations, and changes in this skill are present at different stages of the clinical course of dementia. From a theoretical perspective, because sensorimotor deterioration observed in handwriting tasks (motion kinematics, such as movement time, speed, and profiles).

Due to the large number of brain areas related to handwriting performance, brain electrical activity analysis can be an early indicator of brain dysfunction. Although there is a lack of validation across healthy and non-healthy populations Electroencephalogram (EEG) measures have the potential for evaluating cognitive performance.

This research aims to analyze the suitability of the handwriting assessment protocol, which can contribute to a more in-depth knowledge of this subject and potentially support early identification and treatment.

Primary Outcome Measures: Stroke, A stroke is a series of lines or curves written in a single letter, i.e., the path traced by the pen on the paper. Traces are analyzed movements that unite a movement pattern. A movement pattern can be segmented using 2 segmentation methods: zero crossings of the velocity profile after the velocity peak or the minimum velocity after the velocity peak. This measure is obtained through the software Movalyzer, during the handwriting tasks., Baseline|Vertical/horizontal start position, Initial vertical/horizontal position relative to the lower limit of the digitizer area (in cm)., Baseline|Vertical/horizontal size, Vertical vector difference between the start and end of a stroke (in cm)., Baseline|Slant, Segment slope, which is estimated by the orientation of the line by minimizing/reducing the sum of the squares of the perpendicular distances of all pixels to the line through the gravity point (in radians)., Baseline|Reaction time, Is the time from the start of the recording to the start of the trace (in sec)., Baseline|Duration, Time interval between the first and last samples in a stroke/segment (in sec)., Baseline|Pen pressure, Average pen pressure values along a stroke (N/m2)., Baseline|Brain activity, Spectral density mean from the frequency of the three bands (theta, alpha, beta), Baseline
Secondary Outcome Measures: Handwriting legibility, Handwriting legibility will be obtained through the Handwriting Assessment Battery's (HAB) partial score. There is no maximum or minimum. The higher the legibility percentage, the higher the number of legible letters and numbers., Baseline|Handwriting speed, Handwriting speed will be obtained through the Handwriting Assessment Battery's (HAB) partial score. There is no maximum or minimum. The shorter the handwriting time, the better the handwriting speed., Baseline|Visuomotor integration, 1. Visuomotor integration will be obtained through the total score of the test Beery Buktenica - 6 (VMI-6). There is no maximum or minimum score. The higher the raw score, the higher the percentile, which corresponds to better visuomotor integration., Baseline