JMIR Publications

ABSTRACT

Background:

Cognitive decline in older adults is frequently accompanied by impairments in fine motor control and physical performance. However, there remains a pressing need for early detection methods that are accessible, non-invasive, and suitable for community-based settings.

Objective:

To explore the diagnostic potential of combining digital handwriting kinematic parameters with standardised physical performance tests to identify early indicators of cognitive decline in community-dwelling older adults.

Methods:

A cross-sectional study was conducted involving 174 adults aged ≥60 years (93 cognitively healthy; 81 with signs of cognitive impairment as assessed by the Pentagon Copying Test). Participants completed 10 digital handwriting tasks categorised by cognitive effort, fine motor control and mechanical, along with a battery of physical tests assessing strength, balance, speed, and functional capacity. Statistical comparisons, including parametric and non-parametric tests, were performed between healthy and impaired groups.

Results:

Significant differences were observed in multiple handwriting parameters, including lower mean pressure and increased acceleration in individuals with cognitive impairment (p < 0.05), particularly during fine motor control tasks. In physical assessments, the impaired group exhibited reduced countermovement jump height (7.6 cm vs. 9.2 cm; p = 0.009), increased anteroposterior postural sway frequency (0.6 Hz vs. 0.5 Hz; p = 0.029), and greater completion time in the 400-metre walk test (284.9 s vs. 270.6 s; p = 0.016).

Conclusions:

The integration of handwriting kinematic analysis and physical assessments effectively distinguishes individuals with indicative features of cognitive decline. These findings support the use of both methods as complementary screening tools for the early detection of cognitive decline in primary care and community health contexts.