Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function: A Mixed Methods Observational Study for Development of the UDDGait Protocol

Abstract

New methods to screen for and identify early-stage dementia disorders are highly sought after. The purpose of this pilot study is to develop a study protocol for a dual-task test aimed at aiding the early detection of dementia disorders. We used the Timed Up-and-Go (TUG) test, which is a mobility task involving starting in a sitting position, standing up, walking three meters to cross a line on the floor, turning around, walking back and sitting down again. We combined TUG with the verbal task of naming different animals. Pilot study participants were 43 individuals with and without established dementia diagnoses who attended a clinic for memory assessment. Video-recorded test performances were systematically analysed. Deviant test performances concerning the interplay between test administration and participants’ responses to the assessment instructions were revealed and led to refinements being made to the final study protocol. Exploration of the dual-task test outcome measures in a sub-sample of 22 persons, ten with and twelve without dementia, indicated that step-length and number of named animals after the turning point of the dual-task test might constitute appropriate measures for examining this kind of sample. We concluded that the refined study protocol is feasible for testing individuals undergoing initial memory assessments and healthy controls. Follow-up studies with larger samples are being carried out and will bring new knowledge to this area of research. It may also provide an opportunity for further studies exploring possibilities for broad clinical implementation.

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

“…The dual-task test procedure used in the current study was previously tested in a pilot study, which resulted in improvements to the test procedures [45]. In the current study, five physical therapists were trained to lead the standardized test procedure, and led all TUG tests.…”

“…The recorded data collection consisted of three different TUG tests; first TUGst, followed by TUG while simultaneously naming different animals (TUGdt NA), and finally TUG while simultaneously reciting months in reverse order (TUGdt MB). The choice of the verbal task NA was based on previous research [29,45,46], while to the best of our knowledge MB has not been used as a part of dual-task research [45]. Participants were instructed to execute all TUG tests at their own pace, with the simultaneous performance of the verbal task at a self-selected speed.…”

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

“…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.…”

“…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.…”

“…The test is timed from the individual's back leaving the backrest to sitting down (their posterior touching the seat) [30]. The TUGdt test procedure used in the current study has previously been tested and developed [33]. The testing was performed in the following order: TUGst, TUGdt naming animals (TUGdt NA), and TUGdt reciting months backwards (TUGdt MB).…”