Many of us probably don’t get much time to put pen to paper these days, with our world of correspondence now dominated by digital communication. But a new study from Portugal’s University of Évora suggests that changes in handwriting could be an early red flag of serious age-related cognitive decline.
While we don’t think a whole lot about our handwriting as we scrawl it (besides how much slower it is than sending an email, perhaps), the process involves a lot of coordination between our brain and networks of muscles guiding locomotion. And the researchers believe that while everyone has different mental aptitude when it comes to what they’re writing about, how they’re writing it is the key.
One hallmark of early cognitive decline can be seen in the way we put things on paper, producing signs that the brain isn’t coping with the complex sensory interactions that allow us to write at speed. If the brain isn’t processing the information you take for granted when writing, it could be because it needs to step down a gear to process the signals it’s receiving.
“Writing is not just a motor activity, it’s a window into the brain,” said senior author Dr Ana Rita Matias, an assistant professor at the University of Évora.
“We found that older adults with cognitive impairment displayed distinct patterns in the timing and organization of their handwriting movements. Tasks involving higher cognitive demands showed that cognitive decline is reflected in how efficiently and coherently handwriting movements are organized over time.”
The team examined handwriting characteristics in 58 older adults aged between 62 and 92 years living in aged-care facilities. These characteristics included speed and stroke organization – features that show a marked difference in people with cognitive decline. In this cohort, 38 people had cognitive decline reported in their medical history.
All participants performed two tasks using an inking pen on a tablet. To many of us, the tasks might seem simple – participants were required to draw 10 horizontal lines on a page within 20 seconds and mark 10 dots or more within the same time frame. Then, the researchers conducted two copying and two dictation exercises while recording handwriting speed.
“Timing and stroke organization are closely linked to how the brain plans and executes actions, which depends on working memory and executive control,” explains Matias. “As these cognitive systems decline, writing becomes slower, more fragmented, and less coordinated.
“In contrast, other features can remain relatively preserved, especially in the early stages of cognitive decline, making them less sensitive indicators,” she adds.
The scientists found that these simple tasks were not reliable indicators of potential cognitive decline, nor was a copying exercise undertaken by the 58 participants. The copying task – more demanding than the lines and dots, but less demanding than writing from dictation – offered subtle, indistinct signs of the brain’s condition.
However, the dictation exercise – which involved listening, processing, and then writing – was more revealing.
“Dictation tasks are more sensitive because they require the brain to do multiple things at once: listen, process language, convert sounds into written form, and coordinate movement,” says Matias. “Even within dictation tasks, differences can emerge. A longer, less predictable, or linguistically demanding sentence places greater strain on cognitive resources.”
Among the 38 individuals with a medical history of cognitive impairment, start time and number of strokes differed from those of the others in the group in the dictation task that featured short sentences – the simpler exercise. When sentences became more complex, not two but three indicators set the participants apart – handwriting vertical size, start time and duration.
While cognitive decline is more complex to diagnose, the researchers believe these results offer a practical test for healthcare professionals to monitor brain health in a low-cost, non-invasive way. And the authors point out the study has limitations, including the limited population involved and omitting potential influences like medication that could impact writing performance and speed.
“The long-term goal is to develop a tool that is easy to administer, time-efficient, and affordable, allowing integration into everyday healthcare contexts without requiring specialized or expensive equipment,” adds Matias.
The study was published in the journal Frontiers in Human Neuroscience.
Source: University of Évora via EurekAlert!
Fact-checked by Mike McRae
