Dual Tasking for the Differentiation between Depression and Mild Cognitive Impairment

Abstract

Differentiation of mild cognitive impairment from depression in elderly adults is a clinically relevant issue which is not sufficiently solved. Gait and dual task (DT) parameters may have the potential to complement current diagnostic work-up, as both dementia and depression are associated with changes of gait and DT parameters. Methods: Seven hundred and four participants of the TREND study (Tübinger evaluation of Risk factors for Early detection of NeuroDegeneration) aged 50–80 years were assessed using the Consortium to Establish a Registry for Alzheimer's Disease Plus test battery for testing cognition and Beck's Depression Inventory for evaluation of depression. Based on these results, four groups were defined: acute depressed (N = 53), cognitively mildly impaired (N = 97), acute depressed, and cognitively mildly impaired (N = 15), and controls (N = 536). Participants underwent a 20 m walk and checking boxes task under single (ST) and DT conditions. ST and DT performance and dual task costs (DTC) were calculated. Due to the typical age of increasing incidence of depressive and also cognitive symptoms, the 7th decade was calculated separately. Results: ST speeds of gait and checking boxes, DT walking speed, and walking DTC were significantly different between groups. Healthy controls were the fastest in all paradigms and cognitively mildly impaired had higher DTC than depressed individuals. Additionally, we constructed a multivariate predictive model differentiating the groups on a single-subject level. Conclusion: DT parameters are simply and comfortably measureable, and DTC can easily be determined. The combination of these parameters allows a differentiation of depressed and cognitively mildly impaired elderly adults.

Gait analysis with wearables predicts conversion to Parkinson disease

“…21,22 Participants were included in the study if they were aged 50 to 80 years and were excluded if they had any orthopedic or cardiothoracic conditions that might have markedly affected their walking or safety during the testing sessions. Six hundred and ninety-six HCs recruited in the Tubingen Evaluation of Risk Factors for Early Detection of Neurodegeneration (TREND) study were assessed.…”

“…32 asked to perform intermittent straight line walking trials over a 20m walkway under 4 different conditions: (1) single task at their usual (preferred) speed, (2) single task at fast speed, (3) dual task at fast speed with checking boxes (participants marked as many boxes as possible on a sheet of paper on a clipboard as fast as possible with a cross using a pen, defined as dual task 1), and (4) dual task at fast speed with serial subtractions (counting backward in sevens, defined as dual task 2; Fig 1B). 21 Fourteen gait characteristics comprising 5 domains (pace, variability, rhythm, asymmetry, and postural control; Fig 1C, D), representative of a conceptual model of gait, 33 were evaluated from the accelerometer signals with a validated gait analysis algorithm from our group, which are extensively described. 34,35 Briefly, triaxial acceleration signals were downloaded to a computer, segmented into individual walking trials using time stamps, and analyzed by a bespoke MATLAB (R2015a) program (see Fig 1B).…”

“…Six hundred and ninety-six HCs recruited in the Tubingen Evaluation of Risk Factors for Early Detection of Neurodegeneration (TREND) study were assessed. 21,22 Participants were included in the study if they were aged 50 to 80 years and were excluded if they had any orthopedic or cardiothoracic conditions that might have markedly affected their walking or safety during the testing sessions. To maximize generalizability of the results, we included the whole TREND cohort.…”

Dual task in healthy elderly, depressive and Alzheimer’s disease patients

“…Likewise, DT tests has been suggested to evaluate cognition due to lower influence of educational level 23 . Lastly, comparisons between Health Elderly and those with neuropsychiatric diseases, such as MDD and AD, have been studied [24][25][26] , being increasingly suggested the use of DT walking tests as a way of early identifying the signs of these diseases. Recently, Montero-Odasso et al 27 concluded that elderly with mild cognitive impairment (MCI) with a high DT cost (>20%) are more likely to progress to dementia.…”

“…Recently, Montero-Odasso et al 27 concluded that elderly with mild cognitive impairment (MCI) with a high DT cost (>20%) are more likely to progress to dementia. Metzger et al 26 compared four groups: acute depressed plus cognitively mildly impaired, acute depressed, cognitively mildly impaired and health control, and found that health control group was the fastest in DT tests in comparison to other groups.…”