Dual-task performance in old adults: cognitive, functional, psychosocial and socio-demographic variables

The contribution of cognitive reserve in explaining the dual-task walking performance in iNPH patients: comparison with other cognitive, functional, and socio-demographic variables

BACKGROUND

Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent neurological disorder, but its diagnosis remains challenging. Dual-task (DT) walking performance is a reliable indicator of iNPH but less is known about the role of cognitive reserve (CR) in predicting DT walking performance.

AIMS

The objective of this study was to evaluate the contribution of CR on DT walking in healthy controls (HC) and in iNPH patients (iNPH-P).

METHODS

68 iNPH-P (77.2 +/- 6.7 years old) and 28 HC (74.5 +/- 5.7 years old) were evaluated on their single-task walking (Vsimple) and on 4 DT walking (walking and counting or counting backwards, naming animals, naming words beginning with the letter P) (Vcount, VcountB, Vanimals and Vletter respectively). The contribution of CR on the different DT walking speeds was compared between HC and iNPH-P. In iNPH-P, the contribution of CR on the walking speeds was compared with regard to other cognitive, functional, and socio-demographic variables.

RESULTS

Simple linear regression demonstrated a moderate influence of CR on single and DT walking speed in iNPH-P (β > 0.3, p < .001) but not in HC where the relation was not significant. In iNPH-P, results showed that CR played a major role in explaining each of the single and DT walking speeds with NPH-scale.

CONCLUSION

As CR could be improved through the life cycle, these results support the idea of developing and supporting physical activity programs that will enrich social, physical, and cognitive resources to protect against age-related functional decline, especially in iNPH-P patients where the age-related deficits are greater.

Global Cognition, Gender, and Level of Education Predict Dual-Task Gait Speed Variability Metrics in Older Adults

INTRODUCTION

The purpose of this study was to determine if demographic variables and measures of cognitive function, functional mobility, self-reported balance self-efficacy, and self-reported physical activity can predict gait speed variability during single-task walking (STGSCV), during cognitive-motor dual-tasking (DTGSCV), and dual-task effect on gait speed variability (DTEGSCV) in older adults.

METHODS

In 62 older adults, demographics were recorded and cognitive function (including the Montreal Cognitive Assessment, MoCA), functional mobility, balance self-efficacy (Activities-specific Balance Confidence Scale, ABC), and self-reported physical activity (Physical Activity Scale for the Elderly, PASE) were assessed. Three linear regression models were used to determine whether the functional mobility tests, PASE score, ABC score, and tests of cognitive function predicted gait speed variability outcomes (STGSCV, DTGSCV, DTEGSCV), with demographics included as covariates.

RESULTS

MoCA score (p = 0.003), gender (p = 0.040), and years of education (p = 0.010) significantly predicted DTGSCV (R2 = 0.297, p = 0.002). MoCA score (p = 0.008) and years of education (p < 0.001) also significantly predicted DTEGSCV. Despite a significant regression model (R2 = 0.316, p = 0.001), there were no significant individual predictors of STGSCV.

CONCLUSION

Older adults with lower cognitive function scores, according to the MoCA, and higher levels of education demonstrate larger gait speed variability during dual-tasking and may be at increased risk of real-world mobility issues or falling.

The Effectiveness of Goal-Oriented Dual Task Proprioceptive Training in Subacute Stroke: A Retrospective Observational Study

OBJECTIVE

To show the effectiveness of goal-oriented proprioceptive training in subacute stroke for balance, autonomy, and fall risk.

METHODS

Out a total of 35 patients, consistent in age (75.31±8.65 years), type of stroke (ischemic, 3 to 11 weeks before), and motor impairment, 18 patients underwent solely proprioceptive rehabilitation, the other 17 dual task exercises. The study assessed autonomy using Barthel Index, fall risk with Timed Up and Go Test (TUG), balance through Berg Balance Scale (BBS) and Tinetti test.

RESULTS

After two months, significant improvements were recorded in Barthel Index, BBS (p<0.0001), Tinetti test (p<0.0001 in dual task group, p=0.0029 in single task group), and TUG (p=0.0052 in dual task group, p=0.0020 in single task group) in both groups. Comparing the two groups, dual task group showed a significant difference in Tinetti balance assessment (p=0.0052), between the total score of Tinetti test and TUG in single (p=0.0271), and dual task (p=0.0235). Likewise, Tinetti gait test was significantly related to TUG in single (p=0.0536), and dual task (p=0.0466), while Tinetti balance test to Barthel Index (p=0.0394), BBS (p<0.0001), and TUG in single (p=0.0219), and dual task (p=0.0196). Lastly, there is a positive correlation of the use of aids with BBS (p=0.0074), and total score of Tinetti test (p=0.0160).

CONCLUSION

In subacute stroke, goal-oriented proprioceptive training improved balance, but only partially autonomy. Furthermore, the use of aids after dual-task exercises improved recovery of balance, but did not reduced falls.

Single and Dual Task Gait Speed in Frailty Screening of Community-Dwelling Older Adults

OBJECTIVE

This study compares dual task (DT) gait speed between robust and frail older adults in the setting of a community-based frailty screening program.

METHODS

A cross-sectional study was conducted involving older adults aged 50 years or older. Participants were categorized as robust, pre-frail or frail using the FRAIL phenotype. Gait speed was measured under single task (ST) and 2 DT conditions: arithmetic (DT1) and verbal fluency (DT2) tasks. For the arithmetic task, participants counted upwards in multiples of 2, starting from 16. For the verbal fluency task, they named different animals as they walked.

RESULTS

A total of 976 participants were recruited, of which 779 were robust, 181 were pre-frail and 16 were frail. Robust participants exhibited significantly faster DT gait speeds (DT1: 1.12 (0.25)m/s; DT2: 0.97 (0.27)m/s than pre-frail/frail (PFF) participants (DT1: 0.88 (0.30)m/s); DT2: 0.78 (0.30)m/s). Robust participants also demonstrated a significantly faster ST gait speed (1.31 (0.22)m/s) vs 1.05 (0.31)m/s).

CONCLUSION

DT gait assessment combines both physical and cognitive domains and may serve as a more holistic tool for early frailty detection in the community. The significant differences observed in DT gait speeds highlight the need for integrating cognitive assessments into frailty screening protocols, supporting timely interventions to improve health outcomes.

Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome

Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.

Machine Learning for Prediction of Cognitive Health in Adults Using Sociodemographic, Neighbourhood Environmental, and Lifestyle Factors

The environment we live in, and our lifestyle within this environment, can shape our cognitive health. We investigated whether sociodemographic, neighbourhood environment, and lifestyle variables can be used to predict cognitive health status in adults. Cross-sectional data from the AusDiab3 study, an Australian cohort study of adults (34-97 years) (n = 4141) was used. Cognitive function was measured using processing speed and memory tests, which were categorized into distinct classes using latent profile analysis. Sociodemographic variables, measures of the built and natural environment estimated using geographic information system data, and physical activity and sedentary behaviours were used as predictors. Machine learning was performed using gradient boosting machine, support vector machine, artificial neural network, and linear models. Sociodemographic variables predicted processing speed (r2 = 0.43) and memory (r2 = 0.20) with good accuracy. Lifestyle factors also accurately predicted processing speed (r2 = 0.29) but weakly predicted memory (r2 = 0.10). Neighbourhood and built environment factors were weak predictors of cognitive function. Sociodemographic (AUC = 0.84) and lifestyle (AUC = 0.78) factors also accurately classified cognitive classes. Sociodemographic and lifestyle variables can predict cognitive function in adults. Machine learning tools are useful for population-level assessment of cognitive health status via readily available and easy-to-collect data.