Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables

<p dir="ltr">Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment...

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Main Author: He Zhou (224270) (author)
Other Authors: Fadwa Al-Ali (8735619) (author), Changhong Wang (666191) (author), Abdullah Hamad (8735622) (author), Rania Ibrahim (816634) (author), Talal Talal (8735625) (author), Bijan Najafi (729544) (author)
Published: 2020
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_version_ 1864513511777894400
author He Zhou (224270)
author2 Fadwa Al-Ali (8735619)
Changhong Wang (666191)
Abdullah Hamad (8735622)
Rania Ibrahim (816634)
Talal Talal (8735625)
Bijan Najafi (729544)
author2_role author
author
author
author
author
author
author_facet He Zhou (224270)
Fadwa Al-Ali (8735619)
Changhong Wang (666191)
Abdullah Hamad (8735622)
Rania Ibrahim (816634)
Talal Talal (8735625)
Bijan Najafi (729544)
author_role author
dc.creator.none.fl_str_mv He Zhou (224270)
Fadwa Al-Ali (8735619)
Changhong Wang (666191)
Abdullah Hamad (8735622)
Rania Ibrahim (816634)
Talal Talal (8735625)
Bijan Najafi (729544)
dc.date.none.fl_str_mv 2020-04-20T06:00:00Z
dc.identifier.none.fl_str_mv 10.1371/journal.pone.0225358
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Harnessing_digital_health_to_objectively_assess_cognitive_impairment_in_people_undergoing_hemodialysis_process_The_Impact_of_cognitive_impairment_on_mobility_performance_measured_by_wearables/26020918
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Medical physiology
Neurosciences
Health sciences
Health services and systems
Cognitive impairment
Walking
Medical dialysis
Depression
Alzheimer's disease
Feet
Musculoskeletal system
Diabetes mellitus
dc.title.none.fl_str_mv Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients. Sixty-nine diabetes mellitus hemodialysis patients (age = 64.1±8.1years, body mass index = 31.7±7.6kg/m2) were recruited. According to the Mini-Mental State Exam, 44 (64%) were determined as cognitive-intact, and 25 (36%) as cognitive-impaired. Mobility performance, including cumulated posture duration (sitting, lying, standing, and walking), daily walking performance (step and unbroken walking bout), as well as postural-transition (daily number and average duration), were measured using a validated pendant-sensor for a continuous period of 24-hour during a non-dialysis day. Motor capacity was quantified by assessing standing balance and gait performance under single-task and dual-task conditions. No between-group difference was observed for the motor capacity. However, the mobility performance was different between groups. The cognitive-impaired group spent significantly higher percentage of time in sitting and lying (Cohens effect size d = 0.78, p = 0.005) but took significantly less daily steps (d = 0.69, p = 0.015) than the cognitive-intact group. The largest effect of reduction in number of postural-transition was observed in walk-to-sit transition (d = 0.65, p = 0.020). Regression models based on demographics, addition of daily walking performance, and addition of other mobility performance metrics, led to area-under-curves of 0.76, 0.78, and 0.93, respectively, for discriminating cognitive-impaired cases. This study suggests that mobility performance metrics could be served as potential digital biomarkers of cognitive impairment among hemodialysis patients. It also highlights the additional value of measuring cumulated posture duration and postural-transition to improve the detection of cognitive impairment. Future studies need to examine potential benefits of mobility performance metrics for early diagnosis of cognitive impairment/dementia and timely intervention.</p><h2>Other Information</h2><p dir="ltr">Published in: PLOS ONE<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1371/journal.pone.0225358" target="_blank">https://dx.doi.org/10.1371/journal.pone.0225358</a></p><p dir="ltr">Additional institutions affiliated with: Fahad Bin Jassim Kidney Center - Hamad General Hospital, Podiatric Service - HMC</p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.1371/journal.pone.0225358
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/26020918
publishDate 2020
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spelling Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearablesHe Zhou (224270)Fadwa Al-Ali (8735619)Changhong Wang (666191)Abdullah Hamad (8735622)Rania Ibrahim (816634)Talal Talal (8735625)Bijan Najafi (729544)Biomedical and clinical sciencesClinical sciencesMedical physiologyNeurosciencesHealth sciencesHealth services and systemsCognitive impairmentWalkingMedical dialysisDepressionAlzheimer's diseaseFeetMusculoskeletal systemDiabetes mellitus<p dir="ltr">Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients. Sixty-nine diabetes mellitus hemodialysis patients (age = 64.1±8.1years, body mass index = 31.7±7.6kg/m2) were recruited. According to the Mini-Mental State Exam, 44 (64%) were determined as cognitive-intact, and 25 (36%) as cognitive-impaired. Mobility performance, including cumulated posture duration (sitting, lying, standing, and walking), daily walking performance (step and unbroken walking bout), as well as postural-transition (daily number and average duration), were measured using a validated pendant-sensor for a continuous period of 24-hour during a non-dialysis day. Motor capacity was quantified by assessing standing balance and gait performance under single-task and dual-task conditions. No between-group difference was observed for the motor capacity. However, the mobility performance was different between groups. The cognitive-impaired group spent significantly higher percentage of time in sitting and lying (Cohens effect size d = 0.78, p = 0.005) but took significantly less daily steps (d = 0.69, p = 0.015) than the cognitive-intact group. The largest effect of reduction in number of postural-transition was observed in walk-to-sit transition (d = 0.65, p = 0.020). Regression models based on demographics, addition of daily walking performance, and addition of other mobility performance metrics, led to area-under-curves of 0.76, 0.78, and 0.93, respectively, for discriminating cognitive-impaired cases. This study suggests that mobility performance metrics could be served as potential digital biomarkers of cognitive impairment among hemodialysis patients. It also highlights the additional value of measuring cumulated posture duration and postural-transition to improve the detection of cognitive impairment. Future studies need to examine potential benefits of mobility performance metrics for early diagnosis of cognitive impairment/dementia and timely intervention.</p><h2>Other Information</h2><p dir="ltr">Published in: PLOS ONE<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1371/journal.pone.0225358" target="_blank">https://dx.doi.org/10.1371/journal.pone.0225358</a></p><p dir="ltr">Additional institutions affiliated with: Fahad Bin Jassim Kidney Center - Hamad General Hospital, Podiatric Service - HMC</p>2020-04-20T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1371/journal.pone.0225358https://figshare.com/articles/journal_contribution/Harnessing_digital_health_to_objectively_assess_cognitive_impairment_in_people_undergoing_hemodialysis_process_The_Impact_of_cognitive_impairment_on_mobility_performance_measured_by_wearables/26020918CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/260209182020-04-20T06:00:00Z
spellingShingle Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
He Zhou (224270)
Biomedical and clinical sciences
Clinical sciences
Medical physiology
Neurosciences
Health sciences
Health services and systems
Cognitive impairment
Walking
Medical dialysis
Depression
Alzheimer's disease
Feet
Musculoskeletal system
Diabetes mellitus
status_str publishedVersion
title Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
title_full Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
title_fullStr Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
title_full_unstemmed Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
title_short Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
title_sort Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables
topic Biomedical and clinical sciences
Clinical sciences
Medical physiology
Neurosciences
Health sciences
Health services and systems
Cognitive impairment
Walking
Medical dialysis
Depression
Alzheimer's disease
Feet
Musculoskeletal system
Diabetes mellitus