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How You Hold Your Pen May Reveal Risk Of Alzheimer's Disease

It could be used as a diagnostic for the neurological disease.


Jack Dunhill


Jack Dunhill

Social Media Coordinator and Staff Writer

Jack is a Social Media Coordinator and Staff Writer for IFLScience, with a degree in Medical Genetics specializing in Immunology.

Social Media Coordinator and Staff Writer

Holding pen
How you draw may say a lot about your cognition. Image Credit: Bangkok Click Studio/

One risk factor for Alzheimer’s disease is thought to be how you hold a pen and draw a picture, and new research has illuminated potential links between these factors and Alzheimer’s disease, suggesting drawing analysis could be a useful tool in cognitive assessments. 

The research was published in JMIR Formative Research. 


According to the researchers, around 75 percent of people with dementia have not been diagnosed, and finding an effective diagnostic tool is vital for early detection. Previous research has shown that analyzing how people draw could be indicative of cognitive decline, but current tests are restricted to a few small tasks and often inaccurate.  

"Although it's clear that motion- and pause-related drawing traits can be used to screen for cognitive impairments, most screening tests remain relatively inaccurate" says senior author Professor Tetsuaki Arai in a statement.  

"We wondered what might happen if we were to analyze these traits while people performed a range of different drawing tasks." 

So, the researchers took a sample of 92 older adults and subjected them to a drawing task while analyzing 22 different features of their drawing technique. Such features included pen pressure, pauses while drawing, how they hold the pen, and drawing speed. These results were then fed into a machine learning model to categorize into "normal cognition", "mild cognitive impairment" (MCI), and Alzheimer’s disease (AD). 


The results showed people lower on the cognitive index used to measure ability showed higher variability in their drawing speed and how they held the pen, as well as pausing more while drawing. The differences were greater between MCI and AD subjects than between normal and MCI, suggesting the test could be used on people with early warning signs to show whether they may progress to AD. 

"Although this was a relatively small study, the results are encouraging," says Professor Arai.  

"Our results pave the way for better screening tests for cognitive impairments." 

The researchers believe this could be used as an online self-assessment if collected into an accessible program, potentially improving the quality of life for future AD patients. 


The team has made an appeal for Alzheimer’s and dementia prevention to change course – focus on prevention through minimalizing risk factors, rather than a miracle cure. Identifying risk factors and then creating a diagnostic for them should therefore be priority number one, and scientists are hard at work doing so.


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  • medicine,

  • cognition,

  • dementia,

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  • neuroscience,

  • Alzheimer's disease