Walking While Talking and Prefrontal Oxygenation in Motoric Cognitive Risk Syndrome: Clinical and Pathophysiological Aspects

Article type: Research Article

Authors: Udina, Cristina^{a; b} | Ayers, Emmeline^c | Inzitari, Marco^{a; b} | Verghese, Joe^c

Affiliations: [a] REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain | [b] Medicine Department, Universitat Autonoma de Barcelona, Barcelona, Spain | [c] Albert Einstein College of Medicine, Bronx, NY, USA

Correspondence: [*] Correspondence to: Cristina Udina, MD, Parc Sanitari Pere Virgili, Carrer Esteve Terradas, 30, 08023 Barcelona, Spain. Tel.: +34 932594000; E-mail: [email protected].

Abstract: Background:Motoric cognitive risk syndrome (MCR) combines slow gait and cognitive complaints and has been proposed as a predementia syndrome. The nature of dual-task performance in MCR has not been established. Objective:To assess differences in dual-task performance between participants with and without MCR and to study the prefrontal cortex (PFC)-based brain activity during dual-task using functional near-infrared spectroscopy. Methods:Cohort study of community-dwelling non-demented older adults included in the “Central Control of Mobility in Aging” study. Comprehensive assessment included global cognition and executive function tests along with clinical variables. Dual-task paradigm consisted in walking while reciting alternate letters of the alphabet (WWT) on an electronic walkway. We compared dual-task performance between MCR (n = 60) and No MCR (n = 478) participants and assessed the relationship of dual-task performance with cognitive function. In a subsample, we compared PFC oxygenation during WWT between MCR (n = 32) and No MCR (n = 293). Results:In our sample of 538 high-functioning older adults (76.6±6.5 years), with 11.2% prevalence of MCR, dual-task cost was not significantly different, compared to No MCR participants. Among MCR participants, no significant relationship was found between WWT velocity and cognitive function, whereas No MCR participants with better cognitive function showed faster WWT velocities. PFC oxygenation during WWT was higher in MCR compared to No MCR (1.02±1.25 versus 0.66±0.83, p = 0.03). Conclusion:MCR participants showed no significant differences in the dual-task cost while exhibiting higher PFC oxygenation during dual-task walking. The dual-task performance (WWT velocity) in MCR participants was not related to cognition.

Keywords: Cognition, dual-task, motoric cognitive risk syndrome, near-infrared spectroscopy, prefrontal cortex

DOI: 10.3233/JAD-210239

Journal: Journal of Alzheimer's Disease, vol. 84, no. 4, pp. 1585-1596, 2021