Authors: Benjamin Tseng
Published: 2020-12-07
DOI: 10.1002/alz.043038
Source: Full article
AbstractBackgroundAlzheimer’s Disease (AD) and AD related dementia (ADRD) are under‐recognized and under‐treated in individuals with Asian cultural heritages due to the social stigma. Asians account for more than 60% of the world population. With the rapidly aging society, it is imperative to effectively detect and prevent AD & ADRD prior to its onset in order to alleviate social healthcare burden in the next decades to come.MethodWe conducted a 1‐year observational study in 42 non‐AD adults of Asian races (age=55±9, m=13, f=29) to monitor changes in gait profile using augmented reality (AR) technology via RADAR (i.e. Report for Alzheimer’s Disease Accumulated Risks), an in‐house smart device app developed by the PI. Gait profile (i.e. velocity (m/s), stride length (cm), deviation (%)) was recorded and calculated at baseline, 6 months, and 12 months with and without dual‐task conditions (i.e. delayed recall+sorting). Cognitive performance was evaluated using previously described methods. To the best of our knowledge, this was the first attempt to use a novel behavioral marker (i.e. gait deteriorations under dual‐task conditions) to predict early stages of cognitive decline in Asian adults.ResultUsing multiple linear regression modeling, we found that gait velocity decline (i.e. >10%Δ compared to baseline under dual‐task conditions or >20%Δ compared to non‐dual‐task condition) independently predicts AD risks (adjusted R2=.38, p=.01) in Asian adults.ConclusionWe have demonstrated a cost‐effective alternative instrument that is shown to be sensitive in detecting early dementia. Current consensus emphasizes the prominence in early AD diagnosis. Although existing diagnostic tools such as positron emission tomography (PET) is effective in detecting beta‐amyloid protein, the hallmark of AD, PET scan is costly and not readily accessible for most patients. Emerging literature suggests that gait deteriorations at middle age are predictive of AD. Further more, AD prevalence and care in Asian people is under‐recognized; this novel tool that can be implemented in those cultures that might be reluctant to seek professional consultation due to cultural bias.