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Clinical Manifestations.

Kylie R Kadey1, Subhamoy Pal1,2, Bruno Giordani1,2

  • 1University of Michigan, Ann Arbor, MI, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Motor impairments predict cognitive decline. Black older adults showed better balance than White individuals, contrary to hypotheses. Dementia of the Alzheimer

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Area of Science:

  • Neurology
  • Gerontology
  • Public Health

Background:

  • Motor impairments are early indicators of amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer's type (DAT).
  • Racial disparities in healthcare access and chronic disease prevalence can impact motor performance in Black individuals.
  • This study investigated motor performance differences across racial and diagnostic groups using the NIH Toolbox Motor Battery (NIHTB-MB).

Purpose of the Study:

  • To examine racial differences in motor performance between Black and White older adults.
  • To assess motor performance across normal cognition (NC), aMCI, and DAT diagnostic groups.
  • To test hypotheses of poorer motor performance in Black individuals and linear motor decline with cognitive impairment.

Main Methods:

  • 557 older adults (ages 65-99) from the ARMADA study completed NIHTB-MB assessments.
  • Multiple linear regression analyzed racial differences in NC participants (controlling for age, sex).
  • ANCOVA with post-hoc tests examined diagnostic group differences (NC, aMCI, DAT).

Main Results:

  • Motor performance declined with age (p < .001).
  • Black participants outperformed White participants in standing balance (p = .005), with no other significant racial differences.
  • Individuals with DAT showed worse performance in balance, grip strength, dexterity, and endurance compared to NC and aMCI groups.

Conclusions:

  • Contrary to hypotheses, Black older adults demonstrated superior balance compared to White individuals.
  • Motor decline is most pronounced in DAT, particularly in fine motor dexterity, grip strength, endurance, and balance.
  • The NIH Toolbox Motor Battery may not fully capture early motor changes in aMCI, suggesting the need for more sensitive measures like dual-task conditions.