Simultaneously Measuring Gait and Cognitive Performance in Cognitively Healthy and Cognitively Impaired Older Adults: The Basel Motor-Cognition Dual-Task Paradigm

Abstract

OBJECTIVES: To investigate dual-task performance of gait and cognition in cognitively healthy and cognitively impaired older adults using a motor-cognition dual-task paradigm.DESIGN: Cross-sectional retrospective study. SETTING: The Basel Memory Clinic and the Basel Study on the Elderly (Project BASEL).PARTICIPANTS: Seven hundred eleven older adults (mean age 77.2 ± 6.2, 350 (49.2%) female and 361 (50.8%) male). MEASUREMENTS: Gait velocity and cognitive task performance using a working memory (counting backward from 50 by 2s) and a semantic memory (enumerating animal names) task were measured during single-and dual-task conditions. Gait was assessed using the GAITRite electronic walkway system. Cognitive impairment was defined as a score less than 25 on the Mini-Mental State Examination.RESULTS: During dual tasks, participants reduced gait velocity (P<.001) and calculated fewer numbers (P=.03) but did not enumerate fewer animals and did not make more errors or repetitions (P>.10). Cognitively impaired individuals had lower baseline gait velocity and a greater reduction in gait velocity but not cognitive performance during dual tasks than cognitively healthy participants (P<.01).CONCLUSION: Gait velocity was lower during both dual tasks, whereas decrease in cognitive performance depended on the cognitive ability needed in the dual-task condition. Cognitively impaired individuals generally have poorer baseline performance and greater dual task-related gait velocity reduction than those who are cognitively healthy. Future research should include different conditions for gait to determine adaptive potentials of older adults. MEASUREMENTS: Gait velocity and cognitive task performance using a working memory (counting backward from 50 by 2s) and a semantic memory (enumerating animal names) task were measured during single and dual task conditions. Gait was assessed with the GAITRite electronic walkway system. Cognitive impairment was defined as a score less than 25 on the Mini-Mental State Examination.RESULTS: During dual tasks, participants reduced gait velocity (p < .001) and calculated fewer numbers (p = .03), but did not enumerate fewer animals and did not make more errors or repetitions (p > .10). Cognitively impaired individuals had lower baseline gait velocity and showed a greater reduction in gait velocity but not cognitive performance during dual tasks than cognitively healthy participants (p < .01).CONCLUSION: Gait velocity was lower during both dual tasks, whereas decrease of cognitive performance depended on the cognitive ability needed in the dual task condition. Cognitively impaired individuals generally have poorer baseline performance and greater dual task-related gait velocity reduction than those who are cognitively healthy. Future research should include different conditions for gait to determine adaptive potentials of older adults. Theill et al.: motor-cognition dual-task performance3

Oscillations in the human brain during walking execution, imagination and observation

“…In such tasks, priority is generally given to motor control over cognition and this has been interpreted as a strategy preventing falls [5,6] [7]. However, other prioritization strategies have been described such as the executive function to divide attention during a cognitive task while walking or the prioritization of balance over the cognitive task in dual task conditions when no specific instructions are given about task priorities [8,9].…”

Range of motion of ankle and the simultaneous tasks paradigm during gait in the community-dwelling elderly

“…Estudos têm mostrado que, durante a realização de uma segunda tarefa de ordem cognitiva, as alterações na marcha se acentuam, com impacto negativo sobre a velocidade da marcha, comprimento do passo, cadência, maior tempo de permanência em duplo-suporte e aumento da largura do passo (Bock, 2008;Doi et al, 2011;Lindenberger, Marsiske, & Baltes, 2000;Theill, Martin, Schumacher, Bridenbaugh, & Kressig, 2011).…”

“…A literatura tem demonstrado alterações nos parâmetros da marcha associadas ao envelhecimento, as quais se acentuam em situações de duplas-tarefas, aumentando o risco de quedas (Lindenberge et al, 2000;Theill et al, 2011). Portanto, torna-se relevante identificar idosos que apresentam alterações na marcha antes que a primeira queda ocorra, uma vez que após a primeira queda os idosos se tornam mais suscetíveis às quedas recorrentes (Perracini & Ramos, 2002).…”

Immobilität im Alter: Fahreignung, Gang und Stürze

“…So zeigen kognitiv eingeschränkte Personen eine niedrigere freigewählte Ganggeschwindigkeit als kognitiv Gesunde und nach Hinzunahme der kognitiven Übung eine stärkere Reduktion der Ganggeschwindigkeit[19].Ein Sturz mit Fraktur, vor allem der unteren Extremität, ist eine häufige Ursache einer Pflegebedürftigkeit. Auch wenn nur ca.…”