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Apraxia in Individuals With Cognitive Impairment: Evidence From Familiar Tool Use
Tang Taoran1, Wang Jinni2, Wei Jingxin2
1School of Nursing, Southern Medical University, Guangzhou, China; Geriatric Neuroscience Center, the Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
Objective:
To evaluate the action selection, production, and execution of familiar tool use in patients with cognitive impairment, and to report the prevalence of Familiar Tool-Use Impairment (FTUI) and its association with cognitive impairment and functional disability.
Design:
Cross-sectional, observational study.
Setting:
The outpatient memory clinic in a tertiary care hospital.
Participants:
A total of 66 patients with mild cognitive impairment and 80 patients with dementia were consecutively recruited, along with 85 healthy controls.
Intervention:
Not applicable.
Main Outcome Measures:
Familiar tool test (FTT) and their association with multiple cognitive domains and basic activity of daily living in patients with cognitive impairment.
Results:
Early signs of FTUI were observed in the mild cognitive impairment stage, with an FTUI rate of 6.0%. The prevalence of FTUI increased significantly from the healthy controls to the dementia group to approximately 65.0% (P<.001). Canonical correlation analysis (r=0.529, P=.006) indicated that semantic and visuospatial impairment contributed substantially to the canonical variables and showed a prominent association with the Selection Scale in FTT deficits. Multiple linear regression analyses revealed that tool selection was associated with the degree of bathing dependency (R²=0.471; 95% CI, -0.49 to -0.13) and dressing (R²=0.429; 95% CI, -0.35 to -0.05).
Conclusions:
This study characterized the prevalence of FTUI in patients with cognitive impairment and its underlying cognitive factors, based on the FTT. The findings provided a new perspective for understanding the cognitive impairment and functional disability, suggesting that FTUI may serve as an early warning indicator of functional decline, and offer a practical clinical tool for individualized cognitive rehabilitation in apraxia.
