Are Cognitive Subtypes Associated with Dual-Task Gait Performance in a Clinical Setting?

Issue title: Gait Disorders in Alzheimer’s Disease and Other Dementias

Guest editors: Manuel Montero-Odasso and George Perry

Article type: Research Article

Authors: Cullen, Stephanie^{a; b} | Borrie, Michael^{a; c; d} | Carroll, Susan^d | Sarquis-Adamson, Yanina^a | Pieruccini-Faria, Frederico^{a; c} | McKay, Scott^e | Montero-Odasso, Manuel^{a; b; c; d; *}

Affiliations: [a] Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada | [b] School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada | [c] Department of Medicine (Geriatrics), Schulich School of Medicine and Dentistry, London, ON, Canada | [d] Department of Geriatric Medicine, Division of Geriatric Medicine, Parkwood Institute, London, ON, Canada | [e] Department of Family Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada

Correspondence: [*] Correspondence to: Manuel Montero-Odasso, MD, PhD, AGSF, FGSA, FRCPC, 550 Wellington Road E., Rm A3-116, London, ON N6C 0A7, Canada. Tel.: +1 519 685 4292 /Ext. 42369; Fax: +1 519 685 4808; E-mail: [email protected].

Abstract: Background:Poor dual-task gait (walking while performing a cognitively demanding task) has been linked to progression to dementia in older adults with mild cognitive impairment (MCI). However, many of these findings come from research environments; gait performance across the cognitive spectrum has not previously been studied in a clinical setting. Objective:To examine whether patients from a memory clinic show differences in usual and dual-task gait speed and dual-task cost (DTC) based on cognitive diagnosis. Methods:Patients in the Aging Brain and Memory Clinic (London, ON) performed a usual gait walk and three dual-task gait walks: counting backwards by ones, naming animals, and counting backwards by seven (serial sevens) out loud. Patients were timed with a stopwatch over a six-meter path marked on the floor. One-way ANOVA was performed to evaluate associations between gait speed and DTC (%) across groups. Results:One hundred ninety-four patients with subjective cognitive impairment (SCI; n = 46), MCI (n = 77), or dementia (n = 71) were assessed. Performance in usual (p < 0.001) and dual-task gait speed (counting gait p < 0.001; naming animals p < 0.001; serial sevens p = 0.004) decreased across the spectrum of cognitive impairment. Patients with dementia had significantly higher DTC in both counting gait (p = 0.02) and naming animals (p = 0.04) conditions compared with patients with SCI and MCI, who had statistically similar DTC in all conditions. Conclusion:Dual-task gait performance significantly declines across the cognitive spectrum in a clinical setting. Dual-task gait testing may be used in conjunction with traditional assessments for diagnosing cognitive impairments.

Keywords: Aging, cognition, dual-task gait, gait

DOI: 10.3233/JAD-181196

Journal: Journal of Alzheimer's Disease, vol. 71, no. s1, pp. S57-S64, 2019