Single-Task or Dual-Task? Gait Assessment as a Potential Diagnostic Tool for Alzheimer’s Dementia

Abstract

Background: A person’s gait performance requires the integration of sensorimotor and cognitive systems. Therefore, a person’s gait may be influenced by concurrent cognitive load such as simultaneous talking. Although it has been known that gait performance of people with Alzheimer’s dementia (AD) is compromised when they attempt a dual-task walking task, it is unclear if using a dual-task gait performance during an AD assessment yields higher diagnostic accuracy. Objective: This study was designed to investigate the predictive power for AD of dual-task gait performance in an AD assessment. Methods: Participants (14 with AD and 15 healthy controls) walked across the GAITRite© Portable Walkway mat under three different cognitive load conditions: no simultaneous cognitive load, walking while counting numbers by ones, and walking while completing category naming. Results: Multiple logistic regression revealed that the high cognitive load (i.e., category naming) with or without the low cognitive load (i.e., concurrent counting) increased the proportion of variance explained by the FAP, SL, and DST. Conclusion: Dual-task walking and talking may be a more effective diagnostic feature than single-task walking in a comprehensive AD diagnostic assessment.

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

“…Dual-task walking is walking while performing another task that occupies cognitive resources, such as using mobile phones or talking. Compared with single-task walking, dual-task walking is more challenging, more common in daily life, and more conducive to the discovery of potential gait abnormalities in activities of daily living (ADL) ( Liang et al, 2019 ; Oh, 2021 ). Imaging studies have also shown that gait and cognitive control share a brain network, especially in the cognitive and motor zones of the frontal cortex ( Rosano et al, 2006 ; Annweiler et al, 2012 ; Montero-Odasso et al, 2017 ).…”

Prediction of Disorientation by Accelerometric and Gait Features in Young and Older Adults Navigating in a Virtually Enriched Environment

“…A relationship between gait characteristics and disorientation has already been demonstrated in conditions such as delirium and dementia ( Arjunan et al, 2019 ; Evensen et al, 2019 ; Oh, 2021 ; Weizman et al, 2021 ). In contrast, the detection of disorientation events using gait and accelerometry features has been little explored.…”

“…Some of these real-world studies were primarily aimed at exploring different components of spatial orientation in normal human behavior and the underlying neural basis but did not aim to map the full range of navigational behavior in everyday situations ( Wei et al, 2020 ). Other studies mainly focused on the early detection of dementia symptoms using gait characteristics in real-world environments ( Mc Ardle et al, 2021 ; Mulas et al, 2021 ; Weizman et al, 2021 ) or under dual task conditions ( Oh, 2021 ).…”

Extracted step parameters during the Timed Up and Go test discriminate between groups with different levels of cognitive ability - A cross-sectional study.

“…Accordingly, it has been suggested that motor-cognitive dual-task performance may be a more effective diagnostic tool than gait alone in people with dementia [20].…”