Dual-task tests discriminate between dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls – a cross-sectional cohort study

Åhman, Hanna Bozkurt; Cedervall, Ylva; Kilander, Lena; Giedraitis, Vilmantas; Berglund, Lars; McKee, Kevin; Rosendahl, Erik; Ingelsson, Martin; Åberg, Anna Cristina

doi:10.1186/s12877-020-01645-1

Cited by 44 publications

(33 citation statements)

References 47 publications

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“…To our knowledge, "words per time unit" has not been used for this purpose before in longitudinal dual-task studies. However, in our previous cross-sectional study, as well as in studies by other researchers, "words per time unit" has been found to differentiate between dementia, MCI, SCI, and healthy controls [32,48,49]. Moreover, we have previously shown that "animals/10 s" correlates with neurodegeneration based on cerebrospinal fluid biomarkers [28].…”

Section: Discussionmentioning

confidence: 57%

“…The current study forms part of the Uppsala-Dalarna Dementia and Gait (UDDGait) project [28,32,33]. UDDGait is an ongoing, longitudinal cohort project with the overall aim of investigating dual-task test outcomes as markers for dementia disorders.…”

Section: Setting and Participantsmentioning

confidence: 99%

“…The data collection procedures used in UDDGait have been described in detail previously [28,32,33]. All participants reported demographic characteristics including educational level (university education or not) and marital status.…”

Section: Data Collection At Baselinementioning

confidence: 99%

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Dual-Task Tests Predict Conversion to Dementia—A Prospective Memory-Clinic-Based Cohort Study

Åhman

Berglund

Cedervall

et al. 2020

IJERPH

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The aim of this study was to investigate whether Timed Up-and-Go (TUG) dual-task (TUGdt) tests predict dementia incidence among patients with subjective or mild cognitive impairment (SCI; MCI). Other study objectives were to determine whether TUGdt improves dementia prediction compared to a) demographic characteristics and standard cognitive tests alone; and b) TUG and Verbal Fluency performed separately. Patients (n = 172, age range 39–91 years, 78 women) with SCI or MCI performed TUGdt tests, including 1) naming animals and 2) reciting months backwards, and clinical cognitive tests at baseline. Diagnoses were identified at follow-up after 2.5 years. Logistic regression was used to predict dementia incidence, receiver operating characteristic (ROC) curves and c-statistics for predictive capacity. Analyses were stratified by age and gender. At follow-up, 51 patients had developed dementia. The TUGdt result “animals/10 s” was associated with dementia incidence (standardized odds ratio (OR) = 4.06, 95% confidence interval (CI) 2.28–7.23, p < 0.001), more so among patients under the median age of 72 years (standardized OR = 19.4, 95% CI 3.53–106.17, p < 0.001). TUGdt “animals/10 s” improved dementia prediction compared to demographic characteristics and standard tests alone (c-statistics 0.88 to 0.94) and single-task tests (c-statistics 0.86 to 0.89), but only in the younger patient group. TUGdt has the potential to become a useful tool for dementia prediction.

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Section: Discussionmentioning

confidence: 57%

Section: Setting and Participantsmentioning

confidence: 99%

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Dual-Task Tests Predict Conversion to Dementia—A Prospective Memory-Clinic-Based Cohort Study

Åhman

Berglund

Cedervall

et al. 2020

IJERPH

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“…Our study is in line with previous research showing that gait performance change deteriorates, and instability increases when a cognitive load is augmented. These results have clinical impact, since low performance in dual-task activities is associated with an increased risk for dementia [ 19 , 20 ], falls, and functional decline [ 21 , 22 ]. Furthermore, in older adults low gait speed is a significant clinical parameter associated with functional decline, falls, morbidity, and survival [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

Barros

Melo

Domingos

et al. 2021

JPM

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Numerous of our daily activities are performed within multitask or dual task conditions. These conditions involve the interaction of perceptual and motor processes involved in postural control. Age-related changes may negatively impact cognition and balance control. Studies identifying changes related to dual-task actions in older people are need. This study aimed to determine the effects of different types of dual-tasking on the balance control of healthy older adults. The sample included 36 community-living older adults, performing two tests—a sway test and a timed up-and-go test—in three conditions: (a) single motor task; (b) dual motor task; and (c) dual motor task with cognitive demands. Cognitive processes (dual-task and cognition) affected static balance, increasing amplitude (p < 0.001) and frequency (p < 0.001) of the center of mass displacements. Dynamic balance revealed significant differences between the single motor condition and the other two conditions during gait phases (p < 0.001). The effect of dual-tasking in older adults suggests that cognitive processes are a main cause of increased variability in balance and gait when under an automatic control. During sit-to-stand, turning, and turn-to-sit movements under dual-tasking, the perceptive information becomes the most important focus of attention, while any cognitive task becomes secondary.

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“…“Animals/10 s” correlates with concentrations of the Alzheimer disease cerebrospinal fluid biomarkers t -tau and p -tau among participants undergoing memory assessment 13 and has a high discriminative capacity for differentiating between groups of individuals with dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls. 14 Most importantly, animals/10 s has shown an excellent capacity for predicting dementia incidence in younger participants (<72 years) with subjective or mild cognitive impairment. 15 To enable further interpretation of our results as well as to explore the clinical usefulness of TUGdt tests, normative reference values and investigations of reliability are required.…”

Section: Introductionmentioning

confidence: 99%

Timed “Up & Go” Dual-Task Tests: Age- and Sex-Specific Reference Values and Test–Retest Reliability in Cognitively Healthy Controls

et al. 2021

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Objective To establish reference values for the Uppsala-Dalarna Dementia and Gait (UDDGait) Timed “Up & Go” dual-task (TUGdt) test variables in cognitively healthy adults and to assess these variables’ test–retest reliability. Methods For reference values, 166 participants were recruited with approximately equal numbers and proportions of women and men in the age groups 50 to 59, 60 to 69, 70 to 79, and 80+ (mean age = 70 years, age range = 50–91 years, 51% women). For reliability testing, 43 individuals (mean age = 69 years, age range = 50–89 years, 51% women) were recruited. Two dual-task tests were carried out: TUGdt naming animals and TUGdt months backward, representing 8 test variables: time scores, costs (the relative difference between single- and dual-task time scores), “number of animals”, “number of months”, “animals/10 s”, and “months/10 s”. Reference ranges for the variables were established by quantile regression in age- and sex-specific groups. For reliability, ICCs, standard error of measurement, minimal detectable change, and Bland–Altman plots were used. Results Reference values for the TUGdt test variables are presented for the 2.5th and 97.5th percentile. The reliability of TUGdt time scores was excellent (ICCs between 0.85 and 0.86). “Number of animals” and “animals/10 s” as well as “months/10 s” showed fair to good levels of reliability (ICCs between 0.45 and 0.58), whereas the reliability for both cost measures and “number of months” was poor (ICCs between 0.34 and 0.39). Conclusions Normative reference values, potentially useful for clinical and research purposes, were presented in 4 age- and sex-specific groups from 50 years and above. Reliability for the test variables varied between poor and excellent, the lower estimates partly explained by some variables being the ratio of 2 other variables. In UDDGait, TUGdt tests are intended for diagnostic and predictive purposes, for which these tests are promising and require further investigations. Impact We present normative reference values and test–retest reliability results for the UDDGait TUGdt test variables. These results should be useful for both clinical and research purposes.

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Dual-task tests discriminate between dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls – a cross-sectional cohort study

Cited by 44 publications

References 47 publications

Dual-Task Tests Predict Conversion to Dementia—A Prospective Memory-Clinic-Based Cohort Study

Dual-Task Tests Predict Conversion to Dementia—A Prospective Memory-Clinic-Based Cohort Study

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

Timed “Up & Go” Dual-Task Tests: Age- and Sex-Specific Reference Values and Test–Retest Reliability in Cognitively Healthy Controls

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