Supplementary Material for: Factors That Influence Habitual Activity in Mild Cognitive Impairment and Dementia

Background: Reduced engagement with habitual activity (HA) is associated with greater risk and progression of cognitive decline and falls in older adults and people with dementia. Understanding external and intrinsic factors that affect HA may provide novel targets for non-pharmacologic interventions. Objective: This study primarily aims to identify factors that influence HA in normal ageing and cognitive impairment, such as cognitive and motor problems and disease subtype. Methods: 108 older adults participated in this study; 36 with cognitive impairment due to Alzheimer’s disease (AD), 30 with dementia with Lewy bodies (DLB), 16 with Parkinson’s disease dementia (PDD), and 26 controls. A tri-axial accelerometer recorded continuous data of volume, variability, and pattern of HA over 7 days. Participants undertook a battery of cognitive and neuropsychological assessments. Results: One-way analysis of variance controlling for age and gender shows that people with DLB and PDD engage less with HA than controls (p ≤ 0.01), but there were no significant differences between AD and controls (p ≥ 0.01). Multivariate analysis demonstrated motor disease and impairments in activities of daily living (ADLs) independently explained 10–26% of volume, variability, and pattern of HA in people with cognitive impairment. Conclusion: People with cognitive impairment have reduced HA engagement compared to controls. Motor disease and impairments in ADLs most strongly contribute to these findings and may be important to consider for disease management. Wearable technology can provide a personalised picture of an individual’s daily behaviours and may be a useful tool for person-centred care.背景：老年人及痴呆患者的日常活动（Habitual Activity，HA）参与度降低，与认知衰退、跌倒风险升高及病情进展显著相关。明确影响HA的外在与内在因素，可为非药物干预提供全新靶点。 研究目的：本研究旨在明确正常衰老及认知障碍人群中影响HA的相关因素，包括认知与运动障碍、疾病亚型等。 方法：本研究共纳入108名老年受试者，其中阿尔茨海默病（Alzheimer’s disease, AD）相关性认知障碍患者36例、路易体痴呆（dementia with Lewy bodies, DLB）患者30例、帕金森病痴呆（Parkinson’s disease dementia, PDD）患者16例，健康对照26例。采用三轴加速度计（tri-axial accelerometer）连续7天记录HA的活动量、变异性及模式的连续数据；所有受试者均接受成套认知与神经心理学评估。 结果：校正年龄与性别后的单因素方差分析（one-way analysis of variance）显示，DLB及PDD患者的HA参与度显著低于健康对照（p≤0.01），而AD患者与健康对照之间无统计学差异（p≥0.01）。多因素分析（multivariate analysis）表明，运动功能障碍与日常生活活动能力（Activities of Daily Living, ADLs）受损可独立解释认知障碍人群HA活动量、变异性及模式10%~26%的变异。 结论：与健康对照相比，认知障碍患者的HA参与度显著降低。运动功能障碍与ADLs受损是该研究结果的最强影响因素，在疾病管理中具有重要参考价值。可穿戴技术（wearable technology）可精准呈现个体日常行为特征，有望成为个体化照护的有效工具。