Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Cortical structure of left superior parietal cortex is associated with cognition and dual tasking: A cross-sectional preliminary study between mild cognitive impairment and healthy controls

BACKGROUND

Individuals with mild cognitive impairment (MCI) exhibit poorer performance in cognition and dual-task paradigm, while the related cortical thickness and surface area alterations remains unclear.

METHODS

Thirty participants with MCI and thirty healthy controls (HC) were recruited. Magnetic resonance imaging, cognitive assessments and dual-task Timed Up and Go test (DT-TUG) were performed to assess cerebral cortical thickness and surface area, cognitive functions, and dual-task cost (DTC) of the execution time in TUG. Spearman correlations were conducted to assess the relationships between the cognitive, TUG performance with the cortical morphological measures.

RESULTS

MCI participants performed worse in the Montreal cognitive assessment (MoCA), WAIS Digit Span, TMT and the modified Posner peripheral cuing task. Their execution time on the DT-TUG was also prolonged. WAIS Digit Span Backwards was correlated with DT-TUG in HC group. A significant between-group difference was observed in the surface area of the left SPC. The cortical thickness of this brain region was positively correlated with the total scores and attention subdomain of MoCA in HC group. The cortical thickness and the surface area were correlated with the time of DT-TUG in HC group only.

CONCLUSIONS

Individuals with MCI demonstrated declines in both cognitive function and dual-task walking performance. This study provides further evidence of surface-based structural differences in the left SPC in individuals with and without MCI, and supports the role of the left SPC in cognition and dual-task walking.

Possible influence of sex on the relationship between dual-task gait costs and cognitive decline in older adults

The impact of cognitive decline in older adults can be evaluated with dual-task gait (DTG) testing in which a cognitive task is performed during walking, leading to increased costs of gait. Previous research demonstrated that higher DTG costs correlate with increasing cognitive deficits and with age. The present study was conducted to explore whether the relationship between the DTG costs and cognitive abilities in older individuals is influenced by sex differences. To address this objective, we conducted a study with 216 elderly participants (age range: 60 to 75 years, 127 females). These underwent Cognitive Functional Dementia (CFD) testing to determine their cognitive abilities and DTG testing to evaluate their gait parameters (gait speed, cadence, stride length, stride variance, and stance phase duration) while performing a backward serial number counting task. We carried out a correlation analysis between the CFD scores and the DTG costs. The DTG costs were calculated as the percentage difference between the gait parameters in single- and in dual-task testing, and the effects were compared considering the factors of sex and age. A significant negative correlation between the CFD scores and the dual-task costs of gait parameters was found only in males. The DTG costs did not differ between the sexes, while women obtained superior scores in the CFD test. The higher DTG costs significantly correlated with older age in men. In summary, our study provides evidence that, unlike in women, the DTG costs during the backward serial number counting task significantly increase in older men, correlating with declines in cognitive performance and increasing age. These findings suggest that the assessment of DT gait characteristics in relation to cognitive decline in older adults may manifest differently between sexes.

Relationship Between Cognitive Abilities and Lower-Limb Movements: Can Analyzing Gait Parameters and Movements Help Detect Dementia? A Systematic Review

Identifying and diagnosing cognitive impairment remains challenging. Some diagnostic procedures are invasive, expensive, and not always accurate. Meanwhile, evidence suggests that cognitive impairment is associated with changes in gait parameters. Certain gait parameters manifesting differences between people with and without cognitive impairment are more pronounced when adding a secondary task (dual-task scenario). In this systematic review, the capability of gait analysis to identify cognitive impairment is investigated. Twenty-three studies published between 2014 and 2024 met the inclusion criteria. A significantly lower gait speed and cadence as well as higher gait variability were found in people with mild cognitive impairment (MCI) and/or dementia, compared with the group with no cognitive impairment. While dual tasks appeared to amplify the differences between the two populations, the type of secondary tasks (e.g., calculations and recalling phone numbers) had an effect on gait changes. The activity and volume of different brain regions were also different between the two populations during walking. In conclusion, while this systematic review supported the potential of using gait analysis to identify cognitive impairment, there are a number of parameters researchers need to consider such as gait variables to be studied, types of dual tasks, and analysis of brain changes while performing the movement tasks.

3D-optical motion capturing examination of sensori- and psychomotor abnormalities in mental disorders: Progress and perspectives

Sensori-/psychomotor abnormalities refer to a wide range of disturbances in individual motor, affective and behavioral functions that are often observed in mental disorders. However, many of these studies have mainly used clinical rating scales, which can be potentially confounded by observer bias and are not able to detect subtle sensori-/psychomotor abnormalities. Yet, an innovative three-dimensional (3D) optical motion capturing technology (MoCap) can provide more objective and quantifiable data about movements and posture in psychiatric patients. To draw attention to recent rapid progress in the field, we performed a systematic review using PubMed, Medline, Embase, and Web of Science until May 01st 2024. We included 55 studies in the qualitative analysis and gait was the most examined movement. The identified studies suggested that sensori-/psychomotor abnormalities in neurodevelopmental, mood, schizophrenia spectrum and neurocognitive disorders are associated with alterations in spatiotemporal parameters (speed, step width, length and height; stance time, swing time, double limb support time, phases duration, adjusting sway, acceleration, etc.) during various movements such as walking, running, upper body, hand and head movements. Some studies highlighted the advantages of 3D optical MoCap systems over traditional rating scales and measurements such as actigraphy and ultrasound gait analyses. 3D optical MoCap systems are susceptible to detecting differences not only between patients with mental disorders and healthy persons but also among at-risk individuals exhibiting subtle sensori-/psychomotor abnormalities. Overall, 3D optical MoCap systems hold promise for objectively examining sensori-/psychomotor abnormalities, making them valuable tools for use in future clinical trials.

Validity of Linear and Nonlinear Measures of Gait Variability to Characterize Aging Gait with a Single Lower Back Accelerometer

The attractor complexity index (ACI) is a recently developed gait analysis tool based on nonlinear dynamics. This study assesses ACI's sensitivity to attentional demands in gait control and its potential for characterizing age-related changes in gait patterns. Furthermore, we compare ACI with classical gait metrics to determine its efficacy relative to established methods. A 4 × 200 m indoor walking test with a triaxial accelerometer attached to the lower back was used to compare gait patterns of younger (N = 42) and older adults (N = 60) during normal and metronome walking. The other linear and non-linear gait metrics were movement intensity, gait regularity, local dynamic stability (maximal Lyapunov exponents), and scaling exponent (detrended fluctuation analysis). In contrast to other gait metrics, ACI demonstrated a specific sensitivity to metronome walking, with both young and old participants exhibiting altered stride interval correlations. Furthermore, there was a significant difference between the young and old groups (standardized effect size: -0.77). Additionally, older participants exhibited slower walking speeds, a reduced movement intensity, and a lower gait regularity. The ACI is likely a sensitive marker for attentional load and can effectively discriminate age-related changes in gait patterns. Its ease of measurement makes it a promising tool for gait analysis in unsupervised (free-living) conditions.

Using dual-task gait to recognize Alzheimer's disease and mild cognitive impairment: a cross-sectional study

Background

Gait is a potential diagnostic tool for detecting mild cognitive impairment (MCI) and Alzheimer's disease (AD). Nevertheless, little attention has been paid to arm movements during walking, and there is currently no consensus on gait asymmetry. Therefore, in this study, we aimed to determine whether arm motion and gait asymmetry could be utilized for identifying MCI and AD.

Methods

In total, 102 middle-aged and elderly individuals were included in the final analysis and were assigned to the following three groups: AD (n = 27), MCI (n = 35), and a normal control group (n = 40). Gait and cognitive assessments were conducted for all participants. Gait detection included a single-task gait with free-speed walking and a dual-task gait with adding a cognitive task of successive minus seven to walking. Original gait parameters were collected using a wearable device featuring the MATRIX system 2.0. Gait parameters were shortened to several main gait domains through factor analysis using principal component extraction with varimax rotation. Subsequently, the extracted gait domains were used to differentiate the three groups, and the area under the receiver operating characteristic curve was calculated.

Results

Factor analysis of single-task gait identified five independent gait domains: rhythm symmetry, rhythm, pace asymmetry, arm motion, and variability. Factor analysis of the dual-task gait identified four gait domains: rhythm, variability, symmetry, and arm motion. During single-task walking, pace asymmetry was negatively correlated with MoCA scores and could distinguish between the AD group and the other two groups. Arm motion was not associated with MoCA scores, and did not exhibit adequate discrimination in either task.

Conclusion

Currently, there is no reliable evidence suggesting that arm motion can be used to recognize AD or MCI. Gait asymmetry can serve as a potential gait marker for the auxiliary diagnosis of AD but not for MCI.

A novel dual-task paradigm with story recall shows significant differences in the gait kinematics in older adults with cognitive impairment: A cross-sectional study

Objective

Cognitive and motor dysfunctions in older people become more evident while dual-tasking. Several dual-task paradigms have been used to identify older individuals at the risk of developing Alzheimer's disease and dementia. This study evaluated gait kinematic parameters for dual-task (DT) conditions in older adults with mild cognitive impairment (MCI), subjective cognitive decline (SCD), and normal cognition (NC).

Method

This is a cross-sectional, clinical-based study carried out at the Zhongshan Rehabilitation Branch of First Affiliated Hospital of Nanjing Medical University, China.

Participants

We recruited 83 community-dwelling participants and sorted them into MCI (n = 24), SCD (n = 33), and NC (n = 26) groups based on neuropsychological tests. Their mean age was 72.0 (5.55) years, and male-female ratio was 42/41 (p = 0.112). Each participant performed one single-task walk and four DT walks: DT calculation with subtracting serial sevens; DT naming animals; DT story recall; and DT words recall.

Outcome and measures

Kinematic gait parameters of speed, knee peak extension angle, and dual-task cost (DTC) were obtained using the Vicon Nexus motion capture system and calculated by Visual 3D software. A mixed-effect linear regression model was used to analyze the data.

Results

The difference in gait speed under DT story recall and DT calculation was -0.099 m/s and - 0.119 m/s (p = 0.04, p = 0.013) between MCI and SCD, respectively. Knee peak extension angle under DT story recall, words recall, and single task was bigger in the MCI group compared to the NC group, respectively (p = 0.001, p = 0.001, p = 0.004). DTC was higher in the DT story recall test than all other DT conditions (p < 0.001).

Conclusion

Kinematic gait parameters of knee peak extension angle for the DT story recall were found to be sensitive enough to discriminate MCI individuals from NC group. DTC under DT story recall was higher than the other DT conditions.