Timed Up and Go Test With a Cognitive Task: Correlations With Neuropsychological Measures in People With Parkinson's Disease

Kübra Çekok, Turhan Kahraman, Gözde Duran, Berril Dönmez Çolakoğlu, Görsev Yener, Deniz Yerlikaya, Arzu Genç, Kübra Çekok, Turhan Kahraman, Gözde Duran, Berril Dönmez Çolakoğlu, Görsev Yener, Deniz Yerlikaya, Arzu Genç

Abstract

Background The Timed Up and Go (TUG) test is a simple and widely used clinical test for the assessment of lower extremity function, balance, mobility, and fall risk in various populations. The TUG has been found as a valid and reliable measure in people with Parkinson's disease (PD). Besides, the addition of a cognitive task to the TUG (TUG-cognitive) enhances predictive validity related to fall risk in people with PD. However, further investigation is needed about the correlations of the TUG-cognitive test with neuropsychological measures in people with PD. Methods Thirty-three people with PD [modified Hoehn and Yahr scale, median (min-max)=2.5 (1.0-3.0)] participated in this cross-sectional study. The TUG was administered in the traditional way and with a cognitive task (counting backward by three from any number between 20 and 100). Neuropsychological measures included the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and the Simple Reaction Time (SRT) test for stepping. The self-reported number of falls in the last six months was also recorded. Results The TUG-cognitive [13.1 (SD=8.5) seconds] was significantly longer than the TUG-traditional [12.2 (SD=8.1) seconds] (p<0.01). The TUG-cognitive significantly correlated with the MoCA [(rho=-0.712), TMT part A (TMT-A; rho=0.722), TMT part B (TMT-B; rho=0.694), SRT (rho=0.794), and number of falls (rho=0.960)] (p<0.01). The TUG-traditional also significantly correlated with the MoCA (rho=-0.682), TMT-A (rho=0.684), TMT-B (rho=0.746), SRT (rho=0.755), and number of falls (rho=0.702) (p<0.01). Conclusion Both the TUG-cognitive and TUG-traditional strongly correlated with neuropsychological measures; while the correlations were slightly stronger for the TUG-cognitive, the difference was not significant. The TUG-cognitive can be used in the clinical practice as a simple and more informative alternative to the TUG-traditional in people with PD.

Keywords: executive function; neuropsychological tests; parkinson’s disease; postural balance; reaction time.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, Çekok et al.

References

    1. Dual task performance: a comparison between healthy elderly individuals and those with Parkinson’s disease. Floriano EN, Alves JF, de Almeida IA, de Souza RB, Christofoletti G, Santos SM. Fisioter Mov. 2015;28:251–258.
    1. A review of dual-task walking deficits in people with Parkinson's disease: motor and cognitive contributions, mechanisms, and clinical implications. Kelly VE, Eusterbrock AJ, Shumway-Cook A. Parkinsons Dis. 2012;2012:918719.
    1. Gait dynamics in Parkinson's disease: common and distinct behavior among stride length, gait variability, and fractal-like scaling. Hausdorff JM. Chaos. 2009;19:26113.
    1. Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease. Morris S, Morris ME, Iansek R. Phys Ther. 2001;81:810–818.
    1. Attention, frailty, and falls: the effect of a manual task on basic mobility. Lundin-Olsson L, Nyberg L, Gustafson Y. J Am Geriatr Soc. 1998;46:758–761.
    1. Cognitive function as a prospective predictor of falls. Chen TY, Peronto CL, Edwards JD. J Gerontol B Psychol Sci Soc Sci. 2012;67:720–728.
    1. Executive functions are associated with gait and balance in community-living elderly people. van Iersel MB, Kessels RP, Bloem BR, Verbeek AL, Olde Rikkert MG. J Gerontol A Biol Sci Med Sci. 2008;63:1344–1349.
    1. Parkinsonism: onset, progression and mortality. Hoehn MM, Yahr MD. Neurology. 1967;17:427–442.
    1. Frequency and cooccurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. Logemann JA, Fisher HB, Boshes B, Blonsky ER. J Speech Hear Disord. 1978;43:47–57.
    1. Executive functioning, muscle power and reactive balance are major contributors to gait adaptability in people with Parkinson's disease. Caetano MJD, Lord SR, Allen NE, Song J, Paul SS, Canning CG, Menant JCC. Front Aging Neurosci. 2019;11:154.
    1. Relationship between cognitive performance and motor dysfunction in patients with Parkinson's disease: a pilot cross-sectional study. Varalta V, Picelli A, Fonte C, et al. Biomed Res Int. 2015;2015:365959.
    1. Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Hoops S, Nazem S, Siderowf AD, Duda JE, Xie SX, Stern MB, Weintraub D. Neurology. 2009;73:1738–1745.
    1. Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson's disease. Ozdilek B, Kenangil G. Clin Neuropsychol. 2014;28:333–343.
    1. Trail Making Test: normative data for Turkish elderly population by age, sex and education. Cangoz B, Karakoc E, Selekler K. J Neurol Sci. 2009;283:73–78.
    1. Deficits in stepping response time are associated with impairments in balance and mobility in people with Huntington disease. Goldberg A, Schepens SL, Feely SM, Garbern JY, Miller LJ, Siskind CE, Conti GE. J Neurol Sci. 2010;298:91–95.
    1. Which cognitive dual-task walking causes most interference on the Timed Up and Go test in Parkinson's disease: a controlled study. Zirek E, Ersoz Huseyinsinoglu B, Tufekcioglu Z, Bilgic B, Hanagasi H. Neurol Sci. 2018;39:2151–2157.
    1. Rethinking the neurological examination II: dynamic balance assessment. Maranhão-Filho PA, Maranhão ET, Lima MA, Silva MM. Arq Neuropsiquiatr. 2011;69:959–963.
    1. Cohen J. Hillsdale, NJ: L Erlbaum associates. Hillsdale, NJ: L Erlbaum Associates; 1998. Statistical Power Analysis for the Behavioral Sciences (2nd ed.)
    1. A central capacity sharing model of dual-task performance. Tombu M, Jolicoeur P. J Exp Psychol Hum Percept Perform. 2003;29:3–18.
    1. Improving dual-task walking paradigms to detect prodromal Parkinson's and Alzheimer's diseases. Belghali M, Chastan N, Davenne D, Decker LM. Front Neurol. 2017;8:207.
    1. Predictors of cognitive impairment in an early stage Parkinson's disease cohort. Hu MT, Szewczyk-Królikowski K, Tomlinson P, et al. Mov Disord. 2014;29:351–359.
    1. The role of executive function and attention in gait. Yogev-Seligmann G, Hausdorff JM, Giladi N. Mov Disord. 2008;23:329–342.
    1. A common cognitive profile in elderly fallers and in patients with Parkinson's disease: the prominence of impaired executive function and attention. Hausdorff JM, Doniger GM, Springer S, Yogev G, Simon ES, Giladi N. Exp Aging Res. 2006;32:411–429.
    1. Dual-task decrements in gait: contributing factors among healthy older adults. Hausdorff JM, Schweiger A, Herman T, Yogev-Seligmann G, Giladi N. J Gerontol A Biol Sci Med Sci. 2008;63:1335–1343.
    1. Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations. Plotnik M, Dagan Y, Gurevich T, Giladi N, Hausdorff JM. Exp Brain Res. 2011;208:169–179.
    1. The effect of withdrawal of dopaminergic medication on simple and choice reaction time and the use of advance information in Parkinson's disease. Jahanshahi M, Brown RG, Marsden CD. J Neurol Neurosurg Psychiatry. 1992;55:1168–1176.
    1. The relative contribution of physical and cognitive fall risk factors in people with Parkinson's disease: a large prospective cohort study. Paul SS, Sherrington C, Canning CG, Fung VS, Close JC, Lord SR. Neurorehabil Neural Repair. 2014;28:282–290.
    1. The nature of dual-task interference during gait in incident Parkinson's disease. Rochester L, Galna B, Lord S, Burn D. Neuroscience. 2014;265:83–94.

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