Longitudinal Study on Sustained Attention to Response Task (SART): Clustering Approach for Mobility and Cognitive...

Area of Science:

• Neuroscience
• Gerontology
• Cognitive Psychology

Background:

• The Sustained Attention to Response Task (SART) is crucial for assessing neurocognitive function in older adults.
• Traditional analysis of SART data often oversimplifies complex information, masking links to clinical outcomes.
• A need exists for advanced methods to interpret detailed SART performance for better clinical insights.

Purpose of the Study:

• To develop and validate a novel approach for analyzing individual trial SART data.
• To identify distinct subgroups of older adults based on SART performance trajectories over time.
• To improve the detection of clinically significant cognitive and functional decline in population-based studies.

Main Methods:

• Utilized raw SART trial data from 3468 participants aged 50+ in a large Irish population study.
• Applied a thresholding method based on 'bad performance' (SART trials with >=4 mistakes) to flag poorer performance.
• Employed fuzzy c-mean (FCM) clustering to partition participants into subgroups based on 4-year SART performance evolution.

Main Results:

• Identified three distinct clusters representing degrees of physiological dysregulation.
• The largest cluster (94%) comprised healthy participants.
• A small cluster (5%) showed cognitive and psychological improvement, while the smallest (1%) exhibited significant mobility and cognitive decline.

Conclusions:

• The novel SART analysis method effectively identifies a small, high-risk group of older adults with declining mobility and cognition.
• This approach offers greater specificity than current methods for detecting individuals at risk of functional decline and independence loss.
• The findings highlight the potential for early identification and management of at-risk older adults in community settings.