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Handwriting in Mild Cognitive Impairment: Reliability Assessment and Machine Learning–Based Screening
Simone Toffoli, Carlo Abbate, Francesca Lunardini, Edoardo Corno, Nicholas Diani, Alessia Gallucci, Emanuele Tomasini, Pietro Davide Trimarchi et al.. JMIR Aging, 2025-09-23
Topic: Risk, prevention and care in population studies
Results When dealing with reliability, 93% and 44% of the indicators were characterized by a significant reliability of at least moderate intensity for cursive and block letters respectively. As for the correlation analysis, patients with preserved cognitive status and daily life functionality were associated with significantly better temporal performances, both in free writing and PnP. The analysis of PnP highlighted the presence of surface dysgraphia in the recruited sample, as irregular words showed significantly worse temporal indicators with respect to regular and made-up ones. Conclusions The presented results suggest the suitability of ecological handwriting analysis for the all-around monitoring of MCI, from early screening to disease progression evaluation.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Toffoli, S., Abbate, C., Lunardini, F., Corno, E., Diani, N., Gallucci, A., et al. (2025). Handwriting in Mild Cognitive Impairment: Reliability Assessment and Machine Learning–Based Screening. JMIR Aging. https://doi.org/10.2196/73074
Vancouver
Toffoli S, Abbate C, Lunardini F, Corno E, Diani N, Gallucci A, et al. Handwriting in Mild Cognitive Impairment: Reliability Assessment and Machine Learning–Based Screening. JMIR Aging. 2025. doi:10.2196/73074. PMID: 40986851.
BibTeX
@article{toffoli2025-40986851,
author = {Toffoli, Simone and Abbate, Carlo and Lunardini, Francesca and Corno, Edoardo and Diani, Nicholas and Gallucci, Alessia and Tomasini, Emanuele and Trimarchi, Pietro Davide and others},
title = {{Handwriting in Mild Cognitive Impairment: Reliability Assessment and Machine Learning–Based Screening}},
journal = {JMIR Aging},
year = {2025},
doi = {10.2196/73074},
pmid = {40986851},
url = {https://doi.org/10.2196/73074}
}
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Key findings
- Results When dealing with reliability, 93% and 44% of the indicators were characterized by a significant reliability of at least moderate intensity for cursive and block letters respectively.
- As for the correlation analysis, patients with preserved cognitive status and daily life functionality were associated with significantly better temporal performances, both in free writing and PnP.
- The analysis of PnP highlighted the presence of surface dysgraphia in the recruited sample, as irregular words showed significantly worse temporal indicators with respect to regular and made-up ones.
- Conclusions The presented results suggest the suitability of ecological handwriting analysis for the all-around monitoring of MCI, from early screening to disease progression evaluation.
Why it matters
This work suggests handwriting analysis could help screen for and track mild cognitive impairment, but it does not test any treatment, cure or prevention. The findings are preliminary and based on a recruited sample, so more research is needed before this could be used in care.
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Study details
- Participants57
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (JMIR Aging) |
| Journal's citation record | 0 / 4 | JMIR Aging: journal h-index 49 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 57 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Simona Ferrante: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Politecnico di Milano: institution h-index 545 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40986851) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
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