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Chen Y, Tang H, Wang Y, Jin C, Wang L, Miao W, Wang X. The effect of complex cognitive context on the dynamic stability during gait initiation in older women. Front Aging Neurosci 2024; 15:1342570. [PMID: 38274990 PMCID: PMC10808313 DOI: 10.3389/fnagi.2023.1342570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background Changes in cognitive control are considered potential factors affecting voluntary motor movements during gait initiation (GI). Simulating environments with higher cognitive resource demands have an effect on the stability of GI task performance, which is of significant importance for assessing fall risk in the older adults and devising fall risk management measures in multiple environments. This study aims to reveal the influence of complex cognitive competitive environment with increased cognitive demands on the dynamic stability during GI in the older women. Methods Twenty-three older females and twenty-three younger females performed walking tests under three conditions: voluntary initiation (SI), visual light reaction time task (LRT), and cognitive interference + visual light reaction time task (C + LRT). Eight cameras (Qualisys, Sweden, model: Oqus 600) and three force plates (Kistler, Switzerland, model: 9287C) are used to obtain kinematic and kinetic data. To recorde the trajectory of center of pressure (CoP) and the position of the foot placement, and compute the anterior-posterior (A-P) and medio-lateral (M-L) dynamic stability at the onset and end moments of the single-leg support by means of center of mass (CoM) and gait spatiotemporal parameters. Results Older women responded to the effect of complex environments involving cognitive competition on body stability by prolonging the lateral displacement time of the CoP during the anticipatory postural adjustments (APAs) phase, reducing step length and velocity, and increasing step width and foot inclination angle. Conclusion Complex initiation environments lead to competition for cognitive resources in the brain, resulting in decreased stability of GI motor control in older adults. The higher the complexity of the cognitive resource demands environment, the lower the stability of GI in older adults, and the greater the effect on their M-L stability at the onset of stepping.
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Affiliation(s)
- Yuxia Chen
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Hongyuan Tang
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Yuanxin Wang
- Henan Provincial Third People's Hospital, Zhengzhou, Henan, China
| | - Chunxia Jin
- Huanghe Science and Technology College, Zhengzhou, Henan, China
| | - Lihong Wang
- School of Physical Education, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Xiangdong Wang
- School of Physical Education, Jimei University, Xiamen, Fujian, China
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Åberg AC, Petersson JR, Giedraitis V, McKee KJ, Rosendahl E, Halvorsen K, Berglund L. Prediction of conversion to dementia disorders based on timed up and go dual-task test verbal and motor outcomes: a five-year prospective memory-clinic-based study. BMC Geriatr 2023; 23:535. [PMID: 37660032 PMCID: PMC10475186 DOI: 10.1186/s12877-023-04262-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND While assessment tools can increase the detection of cognitive impairment, there is currently insufficient evidence regarding clinical outcomes based on screening for cognitive impairment in older adults. METHODS The study purpose was to investigate whether Timed Up and Go dual-task test (TUGdt) results, based on TUG combined with two different verbal tasks (name different animals, TUGdt-NA, and recite months in reverse order, TUGdt-MB), predicted dementia incidence over a period of five years among patients (N = 186, mean = 70.7 years; 45.7% female) diagnosed with Subjective Cognitive Impairment (SCI) and Mild Cognitive Impairment (MCI) following assessment at two memory clinics. Associations between TUG parameters and dementia incidence were examined in Cox regression models. RESULTS During follow-up time (median (range) 3.7 (0.1-6.1) years) 98 participants converted to dementia. Novel findings indicated that the TUGdt parameter words/time, after adjustment for age, gender, and education, can be used for the prediction of conversion to dementia in participants with SCI or MCI over a period of five years. Among the TUG-related parameters investigated, words/time showed the best predictive capacity, while time scores of TUG and TUGdt as well as TUGdt cost did not produce significant predictive results. Results further showed that the step parameter step length during TUGdt predicts conversion to dementia before adjustment for age, gender, and education. Optimal TUGdt cutoffs for predicting dementia at 2- and 4-year follow-up based on words/time were calculated. The sensitivity of the TUGdt cutoffs was high at 2-year follow-up: TUGdt-NA words/time, 0.79; TUGdt-MB words/time, 0.71; reducing respectively to 0.64 and 0.65 at 4-year follow-up. CONCLUSIONS TUGdt words/time parameters have potential as cost-efficient tools for conversion-to-dementia risk assessment, useful for research and clinical purposes. These parameters may be able to bridge the gap of insufficient evidence for such clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05893524: https://www. CLINICALTRIALS gov/study/NCT05893524?id=NCT05893524&rank=1 .
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Affiliation(s)
- Anna Cristina Åberg
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden.
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, y, Box 564, 52 37, UPPSALA, Sweden.
| | - Johanna R Petersson
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, y, Box 564, 52 37, UPPSALA, Sweden
| | - Vilmantas Giedraitis
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, y, Box 564, 52 37, UPPSALA, Sweden
| | - Kevin J McKee
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden
| | - Kjartan Halvorsen
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Department of Mechatronics, School of Engineering and Sciences, Campus Estado de Mexico, Tecnologico de Monterrey, Atizapan, Mexico, Carretera Lago de Guadalupe Km 3.5, 52926, Atizapan, Estado de Mexico, Mexico
| | - Lars Berglund
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, y, Box 564, 52 37, UPPSALA, Sweden
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