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      A detection model of cognitive impairment via the integrated gait and eye movement analysis from a large Chinese community cohort

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          Abstract

          INTRODUCTION

          Whether the integration of eye‐tracking, gait, and corresponding dual‐task analysis can distinguish cognitive impairment (CI) patients from controls remains unclear.

          METHODS

          One thousand four hundred eighty‐one participants, including 724 CI and 757 controls, were enrolled in this study. Eye movement and gait, combined with dual‐task patterns, were measured. The LightGBM machine learning models were constructed.

          RESULTS

          A total of 105 gait and eye‐tracking features were extracted. Forty‐six parameters, including 32 gait and 14 eye‐tracking features, showed significant differences between two groups ( P < 0.05). Of these, the Gait_3Back‐TurnTime and Dual‐task cost‐TurnTime patterns were significantly correlated with plasma phosphorylated tau 181 (p‐tau181) level. A model based on dual‐task gait, dual‐task smooth pursuit, prosaccade, and anti‐saccade achieved the best area under the receiver operating characteristics curve (AUC) of 0.987 for CI detection, while combined with p‐tau181, the model discriminated mild cognitive impairment from controls with an AUC of 0.824.

          DISCUSSION

          Combining dual‐task gait and dual‐task eye‐tracking analysis is feasible for the detection of CI.

          Highlights

          • This is the first study to report the efficiency of integrated parameters of dual‐task gait and eye‐tracking for cognitive impairment (CI) detection in a large cohort.

          • We identified 46 gait and eye‐tracking features associated with CI, and two were correlated to plasma phosphorylated tau 181.

          • We constructed the model based on dual‐task gait, smooth pursuit, prosaccade, and anti‐saccade, achieving the best area under the curve of 0.987 for CI detection.

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          Most cited references57

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          Blood phosphorylated tau 181 as a biomarker for Alzheimer's disease: a diagnostic performance and prediction modelling study using data from four prospective cohorts

          CSF and PET biomarkers of amyloid β and tau accurately detect Alzheimer's disease pathology, but the invasiveness, high cost, and poor availability of these detection methods restrict their widespread use as clinical diagnostic tools. CSF tau phosphorylated at threonine 181 (p-tau181) is a highly specific biomarker for Alzheimer's disease pathology. We aimed to assess whether blood p-tau181 could be used as a biomarker for Alzheimer's disease and for prediction of cognitive decline and hippocampal atrophy.
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            Plasma P-tau181 in Alzheimer’s disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer’s dementia

            Plasma phosphorylated tau181 (P-tau181) might be increased in Alzheimer's disease (AD), but its usefulness for differential diagnosis and prognosis is unclear. We studied plasma P-tau181 in three cohorts, with a total of 589 individuals, including cognitively unimpaired participants and patients with mild cognitive impairment (MCI), AD dementia and non-AD neurodegenerative diseases. Plasma P-tau181 was increased in preclinical AD and further increased at the MCI and dementia stages. It correlated with CSF P-tau181 and predicted positive Tau positron emission tomography (PET) scans (area under the curve (AUC) = 0.87-0.91 for different brain regions). Plasma P-tau181 differentiated AD dementia from non-AD neurodegenerative diseases with an accuracy similar to that of Tau PET and CSF P-tau181 (AUC = 0.94-0.98), and detected AD neuropathology in an autopsy-confirmed cohort. High plasma P-tau181 was associated with subsequent development of AD dementia in cognitively unimpaired and MCI subjects. In conclusion, plasma P-tau181 is a noninvasive diagnostic and prognostic biomarker of AD, which may be useful in clinical practice and trials.
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              Discriminative Accuracy of Plasma Phospho-tau217 for Alzheimer Disease vs Other Neurodegenerative Disorders

              There are limitations in current diagnostic testing approaches for Alzheimer disease (AD).
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                Author and article information

                Contributors
                jiaobin@csu.edu.cn
                Journal
                Alzheimers Dement
                Alzheimers Dement
                10.1002/(ISSN)1552-5279
                ALZ
                Alzheimer's & Dementia
                John Wiley and Sons Inc. (Hoboken )
                1552-5260
                1552-5279
                24 October 2023
                February 2024
                : 20
                : 2 ( doiID: 10.1002/alz.v20.2 )
                : 1089-1101
                Affiliations
                [ 1 ] Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases Xiangya Hospital Central South University Changsha China
                [ 2 ] Department of Biology Emory University Atlanta Georgia USA
                [ 3 ] Department of Neurology Xiangya Hospital Central South University Changsha China
                [ 4 ] National Clinical Research Center for Geriatric Disorders Xiangya Hospital Central South University Changsha China
                [ 5 ] Engineering Research Center of Hunan Province in Cognitive Impairment Disorders Central South University Changsha China
                [ 6 ] Institute of Software Chinese Academy of Sciences Beijing China
                [ 7 ] School of Computer Science and Technology University of Chinese Academy of Sciences Beijing China
                [ 8 ] Department of Neurology Liuyang Jili Hospital Changsha China
                Author notes
                [*] [* ] Correspondence

                Bin Jiao, Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.

                Email: jiaobin@ 123456csu.edu.cn

                Article
                ALZ13517
                10.1002/alz.13517
                10916936
                37876113
                7be84053-6e98-4840-a228-e10b659953fa
                © 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 26 September 2023
                : 06 August 2023
                : 28 September 2023
                Page count
                Figures: 7, Tables: 1, Pages: 13, Words: 7546
                Funding
                Funded by: National Key R&D Program of China , doi 10.13039/501100012166;
                Award ID: 2020YFC2008500
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 82071216
                Funded by: China Postdoctoral Science Foundation , doi 10.13039/501100002858;
                Award ID: 2022M723554
                Funded by: Science and Technology Major Project of Hunan Province
                Award ID: 2021SK1020
                Funded by: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University
                Award ID: 2022LNJJ16
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                February 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.8 mode:remove_FC converted:28.02.2024

                cognitive impairment,diagnosis,dual task,eye movement,gait
                cognitive impairment, diagnosis, dual task, eye movement, gait

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