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Lookup NU author(s): Dr Ríona McArdle, Dr Andrew KingstonORCiD, Dr Silvia Del DinORCiD, Dr Brook Galna, Emeritus Professor Alan Thomas, Professor Lynn RochesterORCiD, Dr Lisa AlcockORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background: Mobility impairments during straight-line walking show utility in detecting dementia-related cognitive impairment (e.g. Alzheimer’s disease). Wearable technologies can now derive mobility outcomes related to turning, considered a more cognitively complex movement. However, it is unclear which turning variables would best detect cognitive impairment. Objective: This study aimed to develop a data-driven model of turning performance relevant to cognitive impairment and compare selected turning variables between people with cognitive impairment and cognitively-intact older adults. Methods: 77 people with cognitive impairment (31 Mild Cognitive Impairment, 46 dementia) and 28 cognitively-intact older adults. performed six intermittent walking trials with a 180° turn while wearing an inertial measurement unit (APDM Opal) attached to their lower back. 102 spatiotemporal and signal-based turning variables were captured. Following data reduction, 15 variables underwent exploratory factor analysis. One-way ANCOVA, adjusting for age, sex and height, explored between-group differences (Bonferroni correction applied). Results: Three factors emerged: turn initiation, magnitude and smoothness, accounting for 67% of the total variance in turning performance. The cognitively impaired group demonstrated significant differences in turn initiation (start-phase root mean square (RMS) in vertical direction, start-phase jerk RMS in vertical/mediolateral/anterior-posterior directions) and magnitude (mid-phase RMS in mediolateral direction, mean RMS in vertical direction) domains (p<.003) with moderate-large effect sizes (Partial η2 = 0.09-0.17). Turn initiation and magnitude factor scores were associated with cognitive performance. Conclusions: Key findings suggest that people with cognitive impairment exhibit smaller and slower turning movements specifically during turn initiation and demonstrate lower signal magnitude (RMS) across the turn. Further work should consider use of these variables in predicting incidence of cognitive impairment in at-risk populations.
Author(s): Mc Ardle R, Kingston A, Del Din S, Rehman RZU, Galna B, Thomas AJ, Rochester L, Alcock L
Publication type: Article
Publication status: Published
Journal: Journal of Alzheimer's Disease
Year: 2026
Issue: ePub ahead of Print
Online publication date: 27/05/2026
Acceptance date: 01/04/2026
Date deposited: 01/04/2026
ISSN (print): 1387-2877
ISSN (electronic): 1875-8908
Publisher: Sage Publications, Inc.
URL: https://doi.org/10.1177/13872877261450969
DOI: 10.1177/13872877261450969
ePrints DOI: 10.57711/xetm-6227
Data Access Statement: Data can be shared upon reasonable request to the corresponding author.
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