An investigation of handwriting legibility and pencil use tasks in healthy older adults

Abstract

This project explores handwriting legibility and pencil use tasks in 120 healthy older Australian adults, aged 60 to 99 years. A cross sectional study design was used. The aim of these studies was to explore if handwriting legibility or pencil use performance deteriorated as people aged. This is important to help therapists determine if handwriting difficulties following stroke, or other medical conditions, are more likely a consequence of condition-related impairments or due to ‘normal ageing’. Tasks performed under standardised test conditions included writing copied and self-composed sentences, shopping lists, transcribing a telephone message and completing the ‘lines’ and ‘dots’ pencil use Motor Assessment Scale (MAS) subtests. Handwriting legibility was scored using the Modified Four Point Scale-version 2. The first study explored the distribution of handwriting legibility scores in healthy older adults, relationships between handwriting legibility, age and writing task and reliability of rating procedures. Results indicated that handwriting generally remained legible in older adults, regardless of increasing age. The second study explored the performance of older adults without stroke on the ‘lines’ and ‘dots’ tasks, the relationship between age and task performance, and the relationship between writing speed and performance on the ‘lines’ task. Results indicated that many older adults failed the ‘lines’ task and many over 90 years of age failed the ‘dots’ task. Results suggest that impaired handwriting legibility in older adults who have had a stroke (or other medical condition) is likely due to the effects of the medical condition (or the complexity of the task) rather than ‘normal ageing’. However, failure to pass the ‘lines’ and ‘dots’ tasks is likely related to a combination of age and individual skill level and not solely due to condition-related impairment. A revised method for rating performance on the ‘lines’ and ‘dots’ tasks is also proposed.