A framework for secondary cognitive and motor tasks in dual-task gait testing in people with mild cognitive impairment

Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso, Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso

Abstract

Background: Cognition is a key factor in the regulation of normal walking and dual-task gait assessment is an accepted method to evaluate the relationship. The objective of this study was to create a framework for task complexity of concurrent motor and cognitive tasks with gait in people with mild cognitive impairment (MCI).

Methods: Community-dwelling people with MCI (n = 41, mean age = 76.20 ± 7.65 years) and cognitively normal controls (n = 41, mean age = 72.10 ± 3.80 years) participated in this study. Gait velocity was collected using an instrumented walkway under one single task and six combined tasks of motor and cognitive activities. The cognitive cost was the difference between the single gait task and each of the concurrent motor and cognitive challenges. A repeated two-way measure ANOVA assessed the effect of cognitive group and walking test condition for each gait task test.

Results: Gait velocity was significantly slower in the MCI group under all tasks. For both groups, the concurrent motor task of carrying a glass of water conferred a challenge not different from the cognitive task of counting backwards by ones. Performance of the complex cognitive task of serial seven subtractions reduced gait velocity in both groups, but produced a greater change in the MCI group (31.8%).

Conclusions: Not all concurrent tasks challenge cognition-motor interaction equivalently. This study has created a framework of task difficulty which allows for the translation of dual-task test conditions to future research and clinical practice to ensure the accuracy of assessing patient deficits and risk.

Keywords: Aged; Cognitive dysfunction; Gait.

Conflict of interest statement

Ethics approval and consent to participate

The project was conducted in accordance to the Declaration of Helsinki and was approved by the University of Western Ontario Research Ethics Board for Health Sciences Research Involving Human Subjects REB 12936E. Written informed consent was obtained from participants prior to the start of data collection.

Consent for publication

Prior to analysis all participant identifying information was removed.

Competing interests

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Framework for changes in gait velocity and cognitive cost across gait testing conditions. Note: Gait tests within the same level were not statistically different from one another. Gait velocity decreased on moving from level 1 to level 3. Cognitive cost increased on moving from level 1 to level 3

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Source: PubMed

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