15 TAS test clinical validation: automated hand movement analysis helps discriminate subjective cognitive decline, mild cognitive impairment and dementia

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Objectives New brief cognitive screening tools that are not language-specific are required. Motor function declines across the dementia continuum and may aid screening. We evaluated the accuracy of TAS Test, a new automated online hand movement assessment, to discriminate healthy controls (HC) from adults with Subjective Cognitive Decline (SCD), Mild Cognitive Impairment (MCI) and Dementia. Methods Participants attending the Tasmanian ISLAND Cognitive Clinic completed >2 hours of neuropsychological and medical assessments and a consensus diagnosis was formulated. They also completed TAS Test keyboard tapping tests (5 minutes duration). Motor features of frequency, rhythm, accuracy, and dwell time were extracted. Cognitively asymptomatic HCs with normal cognition completed TAS Test. Discriminatory accuracy of TAS Test motor features, adjusted for age, in multiple regression models was assessed using area under ROC curves (AUC) and compared to a null model comprising confounding variables only. Results 205 participants were recruited (mean [SD] age 69.0 [8.9] years): 16 SCD, 40 MCI, 35 Dementia and 114 HCs. TAS Test discriminated better than null models with AUCs [95% CI]: SCD vs HC: 0.82 [0.73–0.91], MCI vs HC: 0.78 [0.69–0.86], Dementia vs HC: 0.91 [0.86–0.97], MCI vs SCD: 0.7 [0.63- 0.92], Dementia vs MCI: 0.82 [0.82–0.97], all p <0.01. Hand movements were progressively slower, less rhythmic and more inaccurate across the dementia continuum, especially for the dominant hand. Conclusions Brief keyboard tapping tests aided stratification of diagnostic groups. This novel hand motor approach is accessible and opens new opportunities for objective motor measure in cognitive clinics and research applications.

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