scholarly journals GAIT UNSTEADINESS AS AN INDICATOR OF COGNITIVE STATUS IN INDIVIDUALS WITH PERIPHERAL NEUROPATHY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S845-S845
Author(s):  
Gu Eon Kang ◽  
Jacqueline Yang ◽  
He Zhou ◽  
Changhong Wang ◽  
Bareera Akhtar ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Dual Task ◽  
Stride Length ◽  
Cognitive Status ◽  
Additional Risk Factor ◽  
Normal Walking ◽  
Intact Group ◽  
Impaired Group ◽  
Risk Of Falls

Abstract Neuropathic individuals are at risk of falls, however potential impact of cognitive impairment in neuropathic individuals is not well-understood. Since cognitive impairment is considered an independent risk factor for falls, knowing its potential, additional impact may help better understand underlying mechanism of risk of falls in neuropathic individuals. We aimed to investigate stride-to-stride variability in neuropathic individuals with cognitive impairment (NP-Cog-Impaired) and without cognitive impairment (NP-Cog-Intact) during normal and dual-task walking. Neuropathic symptoms and cognitive status was measured using maximum vibration perception threshold (VPTmax) in the feet and the Montreal Cognitive Assessment (MoCA), respectively. We analyzed data from 19 NP-Cog-Impaired (8 men; 68.5±9.1 years; 29.0±6.2 kg/m2; VPTmax=27.2±12.1 volts; MoCA=19.6±2.4) and 25 NP-Cog-Intact (15 men; 66.5±9.1 years; 31.3±5.9 kg/m2; VPTmax=26.3±12.7 volts; MoCA=25.6±1.6). We collected movement data using five inertial sensors (LEGSysTM, BioSensics LLC, Watertown, MA) attached on the shanks, thighs and lower back. We used previously validated algorithm to calculate coefficient of variations (CV) of stride velocity and stride length. CV of stride velocity and stride length were significantly greater for the NP-Cog-Impaired group (11.07±5.22% and 7.31±3.20%, respectively) than for the NP-Cog-Intact group (7.31±3.20% and 4.81±2.80%, respectively) for dual-task walking but not for normal walking. Between normal and dual-task walking, CV of stride velocity and stride length increased 43.2% (significantly) and 46.4% (marginally), respectively, from normal walking to dual-task walking for the NP-Cog-Impaired group but not for the NP-Cog-Intact group. Results suggest that cognitive impairment may be an additional risk factor of falls in neuropathic individuals.

scholarly journals Does the Presence of Cognitive Impairment Exacerbate the Risk of Falls in People with Peripheral Neuropathy? An Application of Body-Worn Inertial Sensors to Measure Gait Variability

Sensors ◽  
2020 ◽  
Vol 20 (5) ◽  
pp. 1328 ◽  
Author(s):  
Gu Eon Kang ◽  
Jacqueline Yang ◽  
Bijan Najafi
Keyword(s):  
Cognitive Impairment ◽  
Peripheral Neuropathy ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Gait Variability ◽  
Group Differences ◽  
Risk Of Falling ◽  
Single Task ◽  
Risk Of Falls

People with peripheral neuropathy (PN) are at risk of falling. Many people with PN have comorbid cognitive impairment, an independent risk factor of falls, which may further increase the risk of falling in people with PN. However, the negative synergic effect of those factors is yet to be reported. We investigated whether the presence of cognitive impairment exacerbates the risk of falls in people with PN by measuring gait variability during single-task walking and dual-task walking. Forty-four adults with PN were recruited. Based on the Montreal Cognitive Assessment (MoCA) scores, 19 and 25 subjects were cognitively impaired and intact, respectively. We measured coefficients of variation of gait speed, stride length, and stride time using validated body-worn sensors. During single-task walking, no between-group differences were observed (all p > 0.05). During dual-task walking, between-group differences were significant for gait variability for gait speed and stride length (51.4% and 71.1%, respectively; p = 0.014 and 0.011, respectively). MoCA scores were significantly correlated with gait variability for gait speed (r = 0.319, p = 0.035) and stride length (r = 0.367, p = 0.014) during dual-task walking. Our findings suggest that the presence of cognitive impairment exacerbates the risk of falls in people with PN.

scholarly journals Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

2020 ◽  
pp. jnnp-2020-324081
Author(s):  
David D Ward ◽  
Lindsay M K Wallace ◽  
Kenneth Rockwood
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Frailty Index ◽  
Apoe Genotype ◽  
Cognitive Status ◽  
Lower Probability ◽  
Deficit Accumulation ◽  
Cognitive Improvement ◽  
Health Deficit

ObjectiveTo determine whether health-deficit accumulation is associated with the risks of mild cognitive impairment (MCI) and dementia independently of APOE genotype.MethodsA frailty index was calculated using the deficit-accumulation approach in participants aged 50 years and older from the National Alzheimer’s Coordinating Center. Cognitive status was determined by clinical evaluation. Using multistate transition models, we assessed the extent to which an increasing degree of frailty affected the probabilities of transitioning between not cognitively impaired (NCI), MCI, and dementia.ResultsParticipants (n=14 490) had a mean age of 72.2 years (SD=8.9 years; range=50–103 years). Among those NCI at baseline (n=9773), each 0.1 increment increase in the frailty index was associated with a higher risk of developing MCI and a higher risk of progressing to dementia. Among those with MCI at baseline (n=4717), higher frailty was associated with a higher risk of progressing to dementia, a lower probability of being reclassified as NCI, and a higher likelihood of returning to MCI in those that were reclassified as NCI. These risk effects were present and similar in both carriers and non-carriers of the APOE ε4 allele.ConclusionAmong older Americans, health-deficit accumulation affects the likelihood of progressive cognitive impairment and the likelihood of cognitive improvement independently of a strong genetic risk factor for dementia. Frailty represents an important risk factor for cognitive dysfunction and a marker of potential prognostic value.

scholarly journals Dual-task during gait between elderly with mild cognitive impairment and Alzheimer: systematic review

2017 ◽  
Vol 30 (4) ◽  
pp. 849-857
Author(s):  
Vanessa Santa Rosa Bragatto ◽  
Larissa Pires de Andrade ◽  
Paulo Giusti Rossi ◽  
Juliana Hotta Ansai
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Stride Length ◽  
Web Of Science ◽  
Secondary Tasks ◽  
Scientific Papers ◽  
Study Characteristics ◽  
Motor Tests

Abstract Introduction: Studies report that mobility changes could be present in early stages of Alzheimer’s disease (AD) or even in previous stages, such as mild cognitive impairment (MCI). The use of motor tests, involving dual task, could facilitate screening and differentiation between elderly with AD and MCI. Objective: to verify if gait tests associated with secondary tasks could differentiate elderly with AD and MCI. Methods: We conducted a systematic review in Pubmed, Web of Science, Medline and Scielo databases. Of the articles included, we collected information about year of the study, characteristics of the sample and the dual task test studied. Results: The databases were accessed during November 2014 and August 2015 and a total of 198 scientific papers was obtained. After reading first the summaries and then the full texts, five studies were inserted in the review. Elderly with AD presented a reduction of gait speed and stride length, using executive functions and countdown as secondary cognitive tasks. The type of MCI appears to influence the differentiation with AD. Conclusion: The review showed that some gait tests associated with a secondary task differentiate elderly with AD and MCI. It emphasizes the need of new studies involving this issue in order to obtain cut-off points and facilitate prevention, early diagnosis and observation of cognitive impairment’s evolution in clinical practice of elderly.

Dual Task Gait Performance in Frail Individuals with and without Mild Cognitive Impairment

2016 ◽  
Vol 42 (1-2) ◽  
pp. 7-16 ◽  
Author(s):  
Alicia Martínez-Ramírez ◽  
Ion Martinikorena ◽  
Pablo Lecumberri ◽  
Marisol Gómez ◽  
Nora Millor ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Inertial Sensor ◽  
Strong Predictor ◽  
Oldest Old ◽  
Cognitive Status ◽  
Gait Velocity ◽  
Walking Performance ◽  
Walking Tests

Background: Several studies have stated that frailty is associated with cognitive impairment. Based on various studies, cognition impairment has been considered as a component of frailty. Other authors have shown that physical frailty is associated with low cognitive performance. Dual task gait tests are used as a strong predictor of falls in either dementia or frailty. Consequently, it is important to investigate dual task walking tests in elderly populations including control robust oldest old, frail oldest old with mild cognitive impairment (MCI) and frail oldest old without MCI. Methods: Dual task walking tests were carried out to examine the association between frailty and cognitive impairment in a population with advanced age. Forty-one elderly men and women participated in this study. The subjects from control, frail with MCI and frail without MCI groups, completed the 5-meter walk test at their own gait velocity. Arithmetic and verbal dual task walking performance was also assessed. Kinematic data were acquired from a unique tri-axial inertial sensor. Results: The spatiotemporal and frequency parameters related to gait disorders did not show any significant differences between frail with and without MCI groups. Conclusions: The evaluation of these parameters extracted from the acceleration signals led us to conclude that these results expand the knowledge regarding the common conditions in frailty and MCI and may highlight the idea that the impairment in walking performance does not depend of frailty and cognitive status.

scholarly journals The Performance of Dual-Task Tests Can Be a Combined Neuro-Psychological and Motor Marker of Mild Cognitive Impairment, Depression and Dementia in Geriatric Patients—A Cross-Sectional Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5358
Author(s):  
Agnieszka Kasiukiewicz ◽  
Lukasz Magnuszewski ◽  
Marta Swietek ◽  
Zyta Beata Wojszel
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cognitive Status ◽  
Healthy Controls ◽  
Timed Up And Go ◽  
Geriatric Population ◽  
Cross Sectional

The study aims to assess the performance of dual-task tests in the geriatric population and their association with the cognitive status of the patients. Methods: Patients admitted to the Department of Geriatrics, Hospital of the Ministry of Interior and Administration on Bialystok, Poland, in 2019 and 2020 were enrolled in the study. Data on the patients’ clinical, functional, and cognitive status were collected based on the comprehensive geriatric assessment. Dual-task tests included Timed Up and Go (TUG) test while counting backward (CB7), enumerating animals (EA), and holding a cup (TUG M). Results: 250 patients were included in the study, with a median age of 81.5 years (IQR 76–86) and most above 75 years of age (80.8%). Only 29 (11.6%) of study participants had no cognitive or mood disorders. Depression was diagnosed in 30.4%, MCI in 12%, and dementia in 38.4% of cases with median Mini-Mental Score Evaluation (MMSE) 17 (12–20) points. Dual-task TUG CB7 results did not differ between cognitive conditions of patients. TUG EA differed between healthy controls and other cognitive groups and TUG between healthy controls and depression and dementia, but not mild cognitive impairment (MCI). The performance of all dual-task tests differed in patients with and without dementia. Ability to finish TUG CB7 was low even in the group without dementia. There were statistically significant differences in median scores of MMSE and Clock Drawing Test (CDT) between patients who were able or not to finish single and dual-task gait tests. Conclusion: Dual-task test results and the performance of these tasks can differentiate patients with depression, MCI and dementia compared to healthy controls in the geriatric population.

scholarly journals Effect of Heart Rate Reserve on Prefrontal Cortical Activation While Dual-Task Walking in Older Adults

2021 ◽  
Vol 19 (1) ◽  
pp. 47
Author(s):  
Alka Bishnoi ◽  
Gioella N. Chaparro ◽  
Manuel E. Hernandez
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Dual Task ◽  
Cognitive Task ◽  
Task Demands ◽  
Cortical Activation ◽  
Heart Rate Reserve ◽  
Prefrontal Cortical

Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is still unclear. The objective of this study was to examine the effects of HRR on prefrontal cortical (PFC) activation under varying dual-task demands in older adults. Twenty-eight older adults (50–82 years of age) were included in this study and divided into higher (n = 14) and lower (n = 14) HRR groups. Participants engaged in the cognitive task which was the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while walking. Participants with higher HRR demonstrated increased PFC activation in comparison to lower HRR, even after controlling for covariates in analysis. Furthermore, as cognitive task difficulty increased (from neutral to congruent to incongruent to switching), PFC activation increased. In addition, there was a significant interaction between tasks and HRR group, with older adults with higher HRR demonstrating increases in PFC activation, faster gait speed, and increased accuracy, relative to those with lower HRR, when going from neutral to switching tasks. These results provide evidence of a relationship between HRR and prefrontal cortical activation and cognitive and physical performance, suggesting that HRR may serve as a biomarker for cognitive health of an older adult with or without cardiovascular risk.

scholarly journals Mendelian randomization of dyslipidemia on cognitive impairment among older Americans

2020 ◽  
Author(s):  
Mingzhou Fu ◽  
Kelly M. Bakulski ◽  
Cesar Higgins ◽  
Erin B. Ware
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Total Cholesterol ◽  
Instrumental Variable ◽  
Mendelian Randomization ◽  
Density Lipoprotein ◽  
Cognitive Status ◽  
European Ancestry ◽  
High Total Cholesterol ◽  
Low Hdl

AbstractBackgroundAltered lipid metabolism may be a risk factor for dementia, and blood cholesterol level has a strong genetic component. We tested the hypothesis that dyslipidemia (either low levels of high-density lipoprotein cholesterol (HDL-C) or high total cholesterol) is associated with cognitive status and domains, and assessed inferred causality using genetic predisposition to dyslipidemia as an instrumental variable.MethodsUsing data from European and African genetic ancestry participants in the Health and Retirement Study, we selected observations at the first non-missing biomarker assessment (waves 2006 to 2012). Cognition domains were assessed using episodic memory, mental status, and vocabulary tests. Overall cognitive status was categorized in three levels (normal, cognitive impairment non-dementia, dementia). Based on 2018 clinical guidelines, we compared low HDL-C or high total cholesterol to normal levels. Polygenic scores for dyslipidemia were used as instrumental variables in a Mendelian randomization framework. Multivariable logistic regressions and Wald-type ratio estimators were used to examine associations.ResultsAmong European ancestry participants (n = 8781), at risk HDL-C levels were associated with higher odds of cognitive impairment (OR = 1.20, 95%CI: 1.03, 1.40) and worse episodic memory, specifically. Using cumulative genetic risk for HDL-C levels as a valid instrumental variable, a significant causal estimate was observed between at risk low HDL-C levels and higher odds of dementia (OR = 2.15, 95%CI: 1.16, 3.99). No significant associations were observed between total cholesterol levels and cognitive status. No significant associations were observed in the African ancestry sample (n = 2101).ConclusionOur study demonstrates low blood HDL-C is a potential causal risk factor for impaired cognition during aging in non-Hispanic whites of European ancestry. Dyslipidemia can be modified by changing diets, health behaviors, and therapeutic strategies, which can improve cognitive aging. Studies on low density lipoprotein cholesterol, the timing of cholesterol effects on cognition, and larger studies in non-European ancestries are needed.

The sensitivity of dual-task performance to cognitive status in aging

2004 ◽  
Vol 10 (2) ◽  
pp. 230-238 ◽  
Author(s):  
ROEE HOLTZER ◽  
RICHARD G. BURRIGHT ◽  
PETER J. DONOVICK
Keyword(s):  
Cognitive Impairment ◽  
Task Performance ◽  
Dual Task ◽  
Cognitive Impairments ◽  
Digit Span ◽  
Cognitive Status ◽  
Community Control ◽  
Dual Task Performance ◽  
Task Conditions ◽  
Normal Controls

The present study examined dual-task performance in elders with cognitive impairments and normal controls. The participants (N = 60; M age = 84.6) were recruited from residential facilities and the community. They were assigned to one of three groups: (1) cognitive impairment; (2) residential facility control; (3) community control. Two different dual-task conditions were comprised of simple tests that are presumably processed via separate perceptual modalities: 1 visual–manual and 1 auditory–verbal. The first condition consisted of a visual cancellation test and an auditory digit span. The second condition was comprised of an alternate form of the visual cancellation test and letter fluency. MANOVA examined the effect of cognitive status (3-level independent variable) on 3 indices of dual-task performance (letter fluency, digit span, visual cancellation). Analyses controlled for age, education and performance on each test when performed alone. The results revealed that the cognitive impairment group incurred significantly greater dual-task costs compared to both control groups. Furthermore, as was evident from discriminant function analyses, the dual-task measures were very accurate and better than the traditional neuropsychological measures at discriminating elders with cognitive impairments from normal controls. (JINS, 2004, 10, 230–238.)

Sign in / Sign up

Export Citation Format

Share Document