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Updated: Jul 16, 2026
Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
Published on: February 8, 2019
Age-Adjusted CKPT App Profiling and Mobility Profiles in Community-Dwelling Older Adults with Near-Ceiling MMSE
Akio Goda1, Hideki Nakano2, Yuki Kikuchi3
1Hokuriku University Well-Being Research Team, Department of Physical Therapy, Faculty of Health and Medical Science, Hokuriku University, Kanazawa 920-1154, Japan.
Abstract:
Background/Objectives: The Mini-Mental State Examination (MMSE) often shows ceiling effects in community-dwelling older adults, limiting the detection of subtle functional vulnerability. We examined whether an age-adjusted score derived from the Color Kanji Pick-Out Test (CKPT) app could identify functional heterogeneity among older adults with near-ceiling MMSE scores. Methods: In this cross-sectional study, 155 community-dwelling older adults aged ≥65 years underwent CKPT app assessment. An age-adjusted score (ΔINDEX1) was calculated as the residual from a linear regression of INDEX1 on age, and participants were classified into two groups using a median split. Group differences in cognitive, physical, psychological, and lifestyle variables were examined across 70 indicators retained after consolidation (Spearman's |r| ≥ 0.75). Effect sizes (rank-biserial r and Cramer's V) were reported, and false discovery rate (FDR) correction was applied (Benjamini-Hochberg). Results: MMSE scores were uniformly high in both the ΔINDEX1 groups (median 29-30, p = 0.138). Of the 70 indicators, 10 reached uncorrected significance (p < 0.05). After FDR correction, both Timed Up and Go (TUG) time (p < 0.001, r = 0.33, q = 0.029) and maximum walking speed (p = 0.001, r = 0.30, q = 0.044) remained statistically significant. Other uncorrected associations (single-leg stance, step length, usual walking speed, sarcopenia, bodily pain, and BMI) did not survive FDR correction and should be regarded as exploratory. Conclusions: Age-adjusted CKPT app profiling was associated with mobility-related differences in TUG and maximum walking speed, both significant after FDR correction, despite uniformly high MMSE scores. Psychosocial and lifestyle associations were preliminary and require confirmation in future studies. Because ΔINDEX1 was both derived and tested within the same predominantly female sample (86.5% women), these cross-sectional findings require external validation before generalization, particularly in older men.
