Prediction of Parkinsonian Gait in Older Adults with Dementia using Joint Trajectories and Gait Features from 2D Video.

Older adults with dementia have a high risk of developing drug-induced parkinsonism; however, formal clinical gait assessments are too infrequent to capture fluctuations in their gait. Camera-based human pose estimation and tracking provides a means to frequently monitor gait in nonclinical settings. In this study, 2160 walking bouts from 49 participants were recorded using a ceiling-mounted camera. Recorded color videos were processed using AlphaPose to obtain 2D joint trajectories of the participant as they were walking down a hallway of the unit. A subset of 324 walking bouts from 14 participants were annotated with clinical scores of parkinsonism on the Unified Parkinson's Disease Rating Scale (UPDRS)-gait scale. Linear, random forest, and ordinal logistic regression models were evaluated for regression to UPDRS-gait scores using engineered 2D gait features calculated from the AlphaPose joint trajectories. Additionally, spatial temporal graph convolutional networks (ST-GCNs) were trained to predict UPDRS-gait scores from joint trajectories and gait features using a two-stage training scheme (self-supervised pretraining stage on all walks followed by a finetuning stage on labelled walks). All models were trained using leave-one-subject-out cross-validation to simulate testing on previously unseen participants. The macro-averaged F1-score was 0.333 for the best model operating on only gait features and 0.372 for the top ST-GCN model that used both joint trajectories and gait features as input. When accepting predicted scores that were only off by at most 1 point on the UPDRS-gait scale, the accuracy of the model that only used gait features was 82.8%, while the model that also used joint trajectories had an accuracy of 94.2%.Clinical Relevance- The combination of gait features and joint trajectories capture parkinsonian qualities in gait better than either group of data individually.