Instrumented trail making task (iTMT)
Inventors
Najafi, Bijan • Razjouyan, Javad • Zhou, He • Kunik, Mark
Assignees
Baylor College of Medicine • US Department of Veterans Affairs • Arizona State University Downtown Phoenix campus
Publication Number
US-12011282-B2
Publication Date
2024-06-18
Expiration Date
2037-09-18
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Abstract
An instrumented trail-making task (iTMT) platform includes a wearable sensor and interactive interface technology configured to identify cognitive-cognitive impairment in individuals such as older adults. The iTMT platform may be programmed with neuropsychological tests for assessing individuals. The iTMT may provide information on visual search, scanning, speed of processing, mental flexibility, and/or executive functions as well as physical biomarkers of motor performance including slowness, weakness, exclusion, and/or motor planning error. Results of tests administered by the iTMT system may be reported to a patient or caregiver and used in identifying cogni-tive-motor impairment among individuals suffering from cognitive impairment, dementia, and/or those with frailty status, and/or cognitive frailty, and/or high risk of falling, and/or high likelihood of decline in cognitive-motor over time.
Core Innovation
The invention relates to an instrumented trail-making task (iTMT) platform that includes a wearable sensor and an interactive interface technology configured to identify cognitive-motor impairment in individuals such as older adults. The platform is programmed with neuropsychological tests for assessing cognitive functions like visual search, scanning, speed of processing, mental flexibility, and executive functions, alongside physical biomarkers of motor performance including slowness, weakness, motor planning error, and exhaustion. This combination allows the simultaneous assessment of cognitive impairment and physical frailty.
The problem addressed by the invention arises from the significant challenges dementia, cognitive, and motor impairments impose on the medical care system, especially given the aging population. Current diagnosis is often initiated only upon clinician suspicion based on symptoms or caregiver concerns and is hampered by impracticality and unsuitability of existing diagnostic modalities for routine or widespread use, leading to underdiagnosis and late-stage identification. This creates an urgent need for a robust, rapid, and practical cognitive assessment tool capable of early identification of cognitive-motor impairment and tracking subtle changes over time.
The iTMT platform overcomes these limitations by providing a simple, safe, and practical testing system using a low-cost wearable sensor in combination with an interactive interface accessible on common computing devices. It allows real-time, objective measurement of both cognitive and motor performance, can be administered in various postures such as sitting or standing, and is not dependent on examiner training or experience. The platform can detect cognitive impairment, physical frailty, and cognitive frailty, and provides granularity by administering various tests of differing cognitive complexity.
Claims Coverage
The patent claims three independent inventions comprising a method, a computer program product, and a system, each encompassing the presentation of requested motions to an individual, receiving motion data from a wearable sensor for different postures, analyzing the data to determine cognitive-motor impairment scores, and reporting the scores.
Presenting cognitive-motor tasks and receiving motion data from multiple postures
The invention presents a series of requested motions for an individual to perform while recording motion data from a sensor worn on a body joint during instances of the motions in at least two different postures. The movement controls a cursor on a display, even when the sight-line between sensor and display is obstructed.
Analyzing motion data to determine impairment scores based on velocity and jerkiness parameters
Analysis involves determining values of parameters associated with cursor velocity during each motion instance by decomposing velocity into frequency components and calculating ratios to evaluate jerkiness. The impairment score is based on comparisons of these parameters between different postures, capturing interaction between cognitive impairment and motor performance.
Using various sequences and object presentations in requested motions for cognitive challenge
Requested motions can be presented as fixed or random ordered sequences of numbers, numbers and letters, or objects, increasing the cognitive complexity and flexibility of testing.
Evaluating performance metrics including time, mistakes, working memory, and executive functions
The invention analyzes total time to complete motions, counts mistakes to assess working memory, and measures latency between movement onset and visual target display to evaluate cognitive abilities such as visual search, speed of processing, and executive functions.
Separating cognitive and motor performance by multiple parameter comparisons
The impairment score determination includes comparing jerkiness, speed of point-to-point reaching movements, and time to complete motions across postures, enabling separate cognitive and motor performance scoring.
Reporting impairment scores indicative of cognitive impairment, motor impairment, physical frailty, or cognitive frailty
The system reports scores indicating the presence or absence of conditions including Mild Cognitive Impairment, Alzheimer's Disease, motor impairment, physical frailty, or their combinations.
System and program product configured to implement the above methods
The claims cover a computing system with a display, wearable sensor, and processor performing the described method steps, as well as a computer program product causing a processor to perform the method operations.
The independent claims cover the comprehensive method, system, and software for administering instrumented trail-making tasks via a wearable sensor and interactive interface, analyzing motion data from multiple postures based on velocity-derived jerkiness parameters and cognitive task complexity, and reporting impairment scores indicative of various cognitive and motor conditions.
Stated Advantages
Provides a simple, safe, and practical testing system that can be administered rapidly and with minimal supervision.
Utilizes low-cost wearable sensors combined with widely available computing devices, enhancing feasibility and accessibility.
Enables simultaneous and objective assessment of cognitive and motor functions, including assessment of cognitive frailty.
Reduces examiner bias due to automated and objective data collection and analysis.
Offers sensitivity to subtle changes in cognitive-motor performance over time, improving early detection and tracking.
Allows administration in various postures and settings, addressing the impracticalities of conventional gait or cognitive tests.
Improves diagnostic accuracy through combination of motor and cognitive measurements and different test complexities.
Documented Applications
Identification of cognitive-motor impairment among older adults including those with Mild Cognitive Impairment and Alzheimer's Disease.
Detection and quantification of physical frailty and cognitive frailty by assessing motor and cognitive simultaneously.
Tracking subtle changes in cognitive-motor performance over time for disease progression monitoring.
Assessment of Chemotherapy-Related Cognitive Impairment in cancer populations.
Evaluation of risk of falling, motor planning errors, exhaustion, weakness, and slowness as physical biomarkers.
Dual-task assessment examining the interaction between cognitive impairment and motor performance.
Use in various clinical and non-clinical settings including busy clinics, nursing homes, and home environments.
Potential use as an exercise program to enhance cognitive-motor performance.
Assessment and prediction related to dementia and Alzheimer's disease pathways.
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