BRAIN Tap Test for Detecting Cognitive Impairment
Background and Aims: The number of people with dementia is rising rapidly around the world, driven by ageing populations. New cost-effective and accessible tests to help detect the early stages of dementia are urgently needed. Changes in motor function precede cognitive symptoms by many years and progressively worsen across the dementia continuum. We aimed to assess the association of a simple online computer key-tapping test with cognitive impairment in subjective cognitive impairment (SCI), mild cognitive impairment (MCI), dementia and cognitively healthy (CH) groups.
Methods: Participants with SCI (n = 40), MCI (n = 58) and dementia (n = 50) were recruited. Consensus diagnosis was given after a comprehensive assessment by an interdisciplinary team. Sixty CH participants were also recruited. Participants completed the online Bradykinesia Akinesia Incoordination (BRAIN) tap test with each hand, which involves tapping two computer keys alternately for 30 seconds. Five variables were analysed using multiple regression and adjusted for age, sex and years of education. Variables included key-tapping frequency, mean dwell-time on each key, variance of the time interval between key-taps, average correct key-taps (dysmetria score) and the variance of dysmetria score (VDS).
Results: Participants with dementia and MCI had a lower frequency, longer mean dwell-time on each key and larger variance of the time interval between the key-taps compared to participants in HC and SCI groups. Key-tapping frequency and VDS of the left hand were significantly associated with all cognitive groups (p = .001 and p = .005 respectively).
Conclusions and Significance: Key-tapping frequency and rhythm decreased with increase in cognitive impairment across dementia continuum. As a short and simple key tapping test, BRAIN tap test can be used to screen for early motor symptoms of cognitive impairment. It has the potential to be easily incorporated in the routine health checks, whether online or in person.
