Dual-task walking speed in older people with cognitive decline

Česká verzia

Authors: I. Hereitová ^1,2; T. Votík ¹; T. Dorňák ²
Authors place of work: Fakulta zdravotnických studií, Západočeská univerzita v Plzni ¹; Neurologická klinika LF UP a FN Olomouc ²
Published in the journal: Cesk Slov Neurol N 2023; 86(4): 271-276
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2023271

Summary

Aim: The aim of the study was to analyze the effect of different dual task conditions on walking speed in older adults with cognitive decline and to compare this with a control group of cognitively intact subjects. Patients and methods: A total of 50 participants were included in this cross-sectional study (25 probands with cognitive decline according to the Montreal Cognitive Assessment [MoCA] ≤ 25 at a mean age of 69.6 ± 9.4 years; 25 cognitively intact probands with MoCA ≥ 26 at a mean age of 59.5 ± 7.0 years). To analyze the effect of single-task difficulty with the greatest interference, the dual-task effect (DTE) on walking speed was calculated in six random-order conditions assessed under comfortable walking speed, and at maximal walking speed in combination with the visual-verbal Stroop test and the motor task. Results: The dual-task cost (negative DTE) during the 10 Meter Walk Test (10MWT) combined with the visual-verbal Stroop test with prioritization to maximal walking speed was statistically significantly higher (P < 0.001) than the motor task-based slowing at comfortable and maximal speed according to the Wilcoxon paired test for the group of older people with cognitive decline. According to the Mann-Whitney test, the dual-task cost at maximum walking speed during the cognitive task was also shown to be significantly higher (P = 0.017) in older people with cognitive decline. Conclusion: Increased interference effects associated with reduced walking speed were most pronounced in situations with combined cognitive-motor load under divided attention effects. Thus, it may provide a new direction in the detection of older adults at a high risk of dementia for potential clinical use.

Keywords:

dementia – cognitive decline – walking speed

Zdroje

1. Laske C, Sohrabi HR, Frost SM et al. Innovative diagnostic tools for early detection of Alzheimer‘s disease. Alzheimers Dement 2015; 11 (5): 561–578. doi: 10.1016/j.jalz.2014.06.004.

2. Fiest KM, Jetté N, Roberts JI et al. The prevalence and incidence of dementia: a systematic review and meta-analysis. Can J Neurol Sci 2016; 43 (Suppl 1): S3–S50. doi: 10.1017/cjn.2016.18.

3. Petersen RC. Mild cognitive impairment. New Engl J Med 2011; 364: 2227–2234. doi: 10.1056/NEJMcp0910237.

4. Verhaeghen P, Cerella J. Aging, executive control, and attention: a review of meta-analyses. Neurosci Biobehav Rev 2002; 26 (7): 849–857. doi: 10.1016/s0149-7634 (02) 00071-4.

5. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002; 16 (1): 1–14. doi: 10.1016/s0966-6362 (01) 00156-4.

6. Montero-Odasso M, Verghese J, Beauchet O et al. Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc 2012; 60 (11): 2127–2136. doi: 10.1111/j.1532-5415.2012.04209.x.

7. Al-Yahya E, Dawes H, Smith L et al. Cognitive motor interference while walking: a systematic review and meta-analysis. Neurosci Biobehav Rev 2011; 35 (3): 715–728. doi: 10.1016/j.neubiorev.2010.08.008.

8. Montero-Odasso M, Pieruccini-Faria F, Ismail Z et al. CCCDTD5 recommendations on early non cognitive markers of dementia: a Canadian consensus. Alzheimers Dement (N Y) 2020; 6 (1): e12068. doi: 10.1002/trc2.12068.

9. Bridenbaugh SA, Kressig RW. Motor cognitive dual tasking: early detection of gait impairment, fall risk and cognitive decline. Z Gerontol Geriatr 2015; 48 (1): 15–21. doi: 10.1007/s00391-014-0845-0.

10. Plummer P, Zukowski LA, Giuliani C et al. Effects of Physical exercise interventions on gait-related dual--task interference in older adults: a systematic review and meta-analysis. Gerontology 2015; 62 (1): 94–117. doi: 10.1159/000371577.

11. Longhurst JK, Rider JV, Cummings JL et al. A novel way of measuring dual-task interference: the reliability and construct validity of the dual-task effect battery in neurodegenerative disease. Neurorehabil Neural Repair 2022; 36 (6): 346–359. doi: 10.1177/15459683221088864.

12. Nascimbeni A, Caruso S, Salatino A et al. Dual task-related gait changes in patients with mild cognitive impairment. Funct Neurol 2015; 30 (1): 59–65.

13. Nasreddine ZS, Phillips NA, Bedirian V et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (4): 695–699.

14. Hoops S, Nazem S, Siderowf AD et al. Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology 2009; 73 (21): 1738–1745. doi: 10.1212/WNL.0b013e3181c34b47.

15. Kelly VE, Janke AA, Shumway-Cook A. Effects of instructed focus and task difficulty on concurrent walking and cognitive task performance in healthy young adults. Exp Brain Res 2010; 207 (1–2): 65–73. doi: 10.1007/s00221-010-2429-6.

16. Plummer P, Eskes G. Measuring treatment effects on dual-task performance: a framework for research and clinical practice. Front Hum Neurosci 2015; 9: 225. doi: 10.3389/fnhum.2015.00225.

17. Tombu M, Jolicoeur P. Testing the predictions of the central capacity sharing model. J Exp Psychol Hum Percept Perform 2005; 31 (4): 790–802. doi: 10.1037/0096-1523.31.4.790.

18. Yogev-Seligmann G, Hausdorff JM, Giladi N. Do we always prioritize balance when walking? Towards an integrated model of task prioritization. Mov Disord 2012; 27 (6): 765–770. doi: 10.1002/mds.24963.

19. Verghese J, Annweiler C, Ayers E et al. Motoric cognitive risk syndrome: multicountry prevalence and dementia risk. Neurology 2014; 83 (8): 718–726. doi: 10.1212/WNL.0000000000000717.

20. Kelly VE, Janke AA, Shumway-Cook A. Effects of instructed focus and task difficulty on concurrent walking and cognitive task performance in healthy young adults. Exp Brain Res 2010; 207 (1–2): 65–73. doi: 10.1007/s00221-010-2429-6.

21. Sherwood DE, Lohse KR, Healy AF. The effect of an external and internal focus of attention on dual-task performance. J Exp Psychol Hum Percept Perform 2020; 46 (1): 91–104. doi: 10.1037/xhp0000698.

22. Allali G, Montembeault M, Saj A et al. Structural brain volume covariance associated with gait speed in patients with amnestic and non-amnestic mild cognitive impairment: a double dissociation. J Alzheimers Dis 2019; 71 (s1): S29–S39. doi: 10.3233/JAD-190 038.

23. Scherder E, Eggermont L, Swaab D et al. Gait in ageing and associated dementias; its relationship with cognition. Neurosci Biobehav Rev 2007; 31 (4): 485–497. doi: 10.1016/j.neubiorev.2006.11.007.

24. Montero-Odasso M, Oteng-Amoako A, Speechley M et al. The motor signature of mild cognitive impairment: results from the gait and brain study. J Gerontol A Biol Sci Med Sci 2014; 69 (11): 1415–1421. doi: 10.1093/gerona/glu155.

25. Whitwell JL, Petersen RC, Negash S et al. Patterns of atrophy differ among specific subtypes of mild cognitive impairment. Arch Neurol 2007; 64 (8): 1130–1138. doi: 10.1001/archneur.64.8.1130.

26. Chaparro G N, Stine-Morrow EAL, Hernandez ME. Effects of aerobic fitness on cognitive performance as a function of dual-task demands in older adults. Exp Gerontol 2019; 118: 99–105. doi: 10.1016/j.exger.2019.01.013.

27. MacAulay RK, Wagner MT, Szeles D et al. Improving sensitivity to detect mild cognitive impairment: cognitive load dual-task gait speed assessment. J Int Neuropsychol Soc 2017; 23 (6): 493–501. doi: 10.1017/S135561 7717000261.

28. Wollesen B, Wildbredt A, van Schooten KS et al. The effects of cognitive-motor training interventions on executive functions in older people: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2020; 17: 9. doi: 10.1186/s11556-020-00240-y.

29. Moore DS, Ellis R. Measurement of fall-related psychological constructs among independent-living older adults: a review of the research literature. Aging Ment Health 2008; 12 (6): 684–699. doi: 10.1080/13607860802148855.