The Closing-In Phenomenon in an Ecological Walking Task.

Area of Science:

• Neuroscience
• Gerontology
• Clinical Psychology

Background:

• Alzheimer's disease (AD) is associated with cognitive deficits, including spatial and executive impairments.
• Closing-in (CI) is a visuo-constructive deficit observed in AD patients, characterized by reproducing figures superimposed on the model.
• The impact of CI on functional independence and daily living activities in AD remains under-investigated.

Purpose of the Study:

• To investigate whether AD patients with CI exhibit an increased tendency to veer their walking trajectory toward irrelevant objects compared to AD patients without CI.
• To assess the relationship between CI, walking trajectory errors, and functional independence in daily living activities.

Main Methods:

• Fifty AD patients and 20 healthy adults underwent a graphic copying task to identify CI.
• A novel walking task was employed to evaluate veering tendencies and object collisions.
• Participants completed a comprehensive neuropsychological battery assessing dementia severity, cognitive domains, and functional independence.

Main Results:

• 68% of AD patients exhibited graphic CI (AD-CI group), showing significantly lower scores in frontal/executive abilities and daily functioning.
• Over half of AD-CI patients (58.8%) demonstrated veering errors during the walking task.
• AD patients with both CI and veering errors performed worse on the Stroop test and had lower functional independence than those with CI alone.

Conclusions:

• Closing-in (CI) on graphic tasks serves as a valuable indicator of walking difficulties and challenges in daily activities for Alzheimer's disease patients.
• Assessing CI in copying tasks can aid in identifying AD patients at higher risk for functional decline.
• These findings highlight the clinical utility of CI assessment in managing AD patient care and support.