scholarly journals Impairment of dual-task gait dynamics in older adults with mild cognitive impairment: Relationships to neuropsychological status, fitness and brain morphology

2019 ◽  
Author(s):  
Tess C Hawkins ◽  
Rebecca Samuel ◽  
Maria A Fiatarone Singh ◽  
Nicola Gates ◽  
Guy C Wilson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Dual Task ◽  
Well Being ◽  
Gait Variability ◽  
Time Variability ◽  
Stride Time ◽  
Gait Dynamics ◽  
Dual Tasking ◽  
Task Conditions

ABSTRACTBackgroundIndividuals with Mild Cognitive Impairment (MCI) have more gait variability under dual-task conditions than cognitively healthy adults. However, characteristics associated with this susceptibility of gait to dual-task stress are unknown.MethodsTesting was performed at baseline in the Study of Mental And Resistance Training (SMART). Ninety-three adults with MCI (age 70±6.8 years; 66.6% female) performed a single- and dual-task walk (cognitive distractor=letter fluency), in random order. Linear and non-linear gait variability were measured using force-sensitive insoles. Cognitive performance during dual-tasking was assessed by the number of correct words vocalized. Cognitive function, brain Magnetic Resonance Imaging (MRI), muscle strength, aerobic capacity, body composition, physical and psychosocial function were also assessed as potential correlates of gait dynamics.ResultsGait dynamics worsened during dual-tasking, with decrements in both stride time variability (p<0.001) and detrended fluctuation analysis (DFA) (p=0.001). Lower aerobic capacity and thinner posterior cingulate cortex were associated with greater decrements in DFA (p<0.05). Smaller hippocampal volume, worse psychological well-being and poorer static balance were associated with greater decrements in stride time variability (p<0.05). By contrast, cognitive performance did not change under dual-task conditions compared to seated testing (p=0.13).ConclusionsUnder dual-task conditions, participants with MCI preserved their cognitive performance at the expense of gait stability. Decrements in dual-tasking gait were associated with lower aerobic fitness, balance, psychological well-being, and brain volume in cognitively-relevant areas of the posterior cingulate and hippocampus, all potentially modifiable characteristics. Trials of targeted interventions are needed to determine the potential plasticity of gait variability in high-risk cohorts.

Dual-Task Gait Assessment in a Clinical Sample: Implications for Improved Detection of Mild Cognitive Impairment

2019 ◽  
Vol 75 (7) ◽  
pp. 1372-1381 ◽  
Author(s):  
Deborah A Lowe ◽  
Rebecca K MacAulay ◽  
Dana M Szeles ◽  
Nicholas J Milano ◽  
Mark T Wagner
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Dual Task ◽  
Gait Speed ◽  
Medical Setting ◽  
Executive Attention ◽  
Cognitive Complaints ◽  
Gait Assessment ◽  
Task Conditions

Abstract Objectives Research has longitudinally linked dual-task gait dysfunction to mild cognitive impairment (MCI) and dementia risk. Our group previously demonstrated that dual-task gait speed assessment distinguished between subjective cognitive complaints (SCC) and MCI in a memory clinic setting, and also found that differences in dual-task gait speed were largely attributable to executive attention processes. This study aimed to reproduce these findings in a larger diverse sample and to extend them by examining whether there were group differences in single- versus dual-task cognitive performance (number of letters correctly sequenced backward). Method Two-hundred fifty-two patients (M age = 66.01 years, SD = 10.46; 119 MCI, 133 SCC) presenting with cognitive complaints in an academic medical setting underwent comprehensive neuropsychological and gait assessment (single- and dual-task conditions). Results Patients with MCI walked slower and showed greater decrement in cognitive performance than those with SCC during dual-task conditions. Neuropsychological measures of executive attention accounted for significant variance in dual-task gait performance across diagnostic groups beyond demographic and health risk factors. Discussion Reproduction of our results within a sample over four times the previous size provides support for the use of dual-task gait assessment as a marker of MCI risk in clinical settings.

Walking and talking: an investigation of cognitive—motor dual tasking in multiple sclerosis

2009 ◽  
Vol 15 (10) ◽  
pp. 1215-1227 ◽  
Author(s):  
F. Hamilton ◽  
L. Rochester ◽  
L. Paul ◽  
D. Rafferty ◽  
CP O'Leary ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dual Task ◽  
Cognitive Task ◽  
Time Variability ◽  
Healthy Controls ◽  
Motor Functioning ◽  
Dual Tasking ◽  
Risk Of Falls ◽  
Clinical Tools ◽  
Task Conditions

Background: Deficits in motor functioning, including walking, and in cognitive functions, including attention, are known to be prevalent in multiple sclerosis (MS), though little attention has been paid to how impairments in these areas of functioning interact. Objectives: This study investigated the effects of performing a concurrent cognitive task when walking in people with MS. Level of task demand was manipulated to investigate whether this affected level of dual-task decrement. Method: Eighteen participants with MS and 18 healthy controls took part. Participants completed walking and cognitive tasks under single- and dual-task conditions. Results: Compared to healthy controls, MS participants showed greater decrements in performance under dual-task conditions in cognitive task performance, walking speed and swing time variability. In the MS group, the degree of decrement under dual-task conditions was related to levels of fatigue, a measure of general cognitive functioning and self-reported everyday cognitive errors, but not to measures of disease severity or duration. Conclusions: Difficulty with walking and talking in MS may be a result of a divided attention deficit or of overloading of the working memory system, and further investigation is needed. We suggest that difficulty with walking and talking in MS may lead to practical problems in everyday life, including potentially increasing the risk of falls. Clinical tools to assess cognitive—motor dual-tasking ability are needed.

Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

Gerontology ◽  
2018 ◽  
Vol 65 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Frederico Pieruccini-Faria ◽  
Yanina Sarquis-Adamson ◽  
Manuel Montero-Odasso
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Gait Speed ◽  
Step Length ◽  
Gait Control ◽  
Dual Tasking ◽  
Brain Study

Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

scholarly journals How Does Physical Demand Affect Cognitive Performance? Interference Between Outdoor Running And Narrative Memory

2018 ◽  
Vol 62 (1) ◽  
pp. 237-241
Author(s):  
Samantha L. Epling ◽  
Graham K. Edgar ◽  
Paul N. Russell ◽  
William S. Helton
Keyword(s):  
High Risk ◽  
Task Performance ◽  
Cognitive Performance ◽  
Real World ◽  
Dual Task ◽  
Memory Task ◽  
Search And Rescue ◽  
Dual Tasking ◽  
Physical Demand ◽  
Dual Task Paradigm

Dual-tasking situations are common in military, firefighting, search and rescue, and other high risk operations. Cognitive and physical demands can occur at the same time, but little is known about the specific demands of real world tasks or how they might interfere with one another. It is well known that attempting simultaneous tasks will divide and divert attention, but to what extent? In this experiment, a narrative memory task was paired with an outdoor running task, and as expected, memory task performance declined when participants were asked to run at the same time. It is suggested that more cognitively demanding physical tasks be used within this dual-task paradigm for a better understanding of the human cognitive resource structure, i.e., how and why certain tasks interfere.

scholarly journals Asymmetric interference between cognitive task components and concurrent sensorimotor coordination

2018 ◽  
Vol 120 (1) ◽  
pp. 330-342
Author(s):  
Joshua Baker ◽  
Antonio Castro ◽  
Andrew K. Dunn ◽  
Suvobrata Mitra
Keyword(s):  
Information Processing ◽  
Dual Task ◽  
Time Course ◽  
Cognitive Task ◽  
Tracking Task ◽  
Cognitive Tasks ◽  
State Monitoring ◽  
Sensorimotor Coordination ◽  
Dual Tasking ◽  
Task Conditions

Everyday cognitive tasks are frequently performed under dual-task conditions alongside continuous sensorimotor coordinations (CSCs) such as driving, walking, or balancing. Observed interference in these dual-task settings is commonly attributed to demands on executive function or attentional resources, but the time course and reciprocity of interference are not well understood at the level of information-processing components. Here we used electrophysiology to study the detailed chronometry of dual-task interference between a visual oddball task and a continuous visuomanual tracking task. The oddball task’s electrophysiological components were linked to underlying cognitive processes, and the tracking task served as a proxy for the continuous cycle of state monitoring and adjustment inherent to CSCs. Dual-tasking interfered with the oddball task’s accuracy and attentional processes (attenuated P2 and P3b magnitude and parietal alpha-band event-related desynchronization), but errors in tracking due to dual-tasking accrued at a later timescale and only in trials in which the target stimulus appeared and its tally had to be incremented. Interference between cognitive tasks and CSCs can be asymmetric in terms of timing as well as affected information-processing components. NEW & NOTEWORTHY Interference between cognitive tasks and continuous sensorimotor coordination (CSC) has been widely reported, but this is the first demonstration that the cognitive operation that is impaired by concurrent CSC may not be the one that impairs the CSC. Also demonstrated is that interference between such tasks can be temporally asymmetric. The asynchronicity of this interference has significant implications for understanding and mitigating loss of mobility in old age, and for rehabilitation for neurological impairments.

scholarly journals Balancing the Demands of Two Tasks: An Investigation of Cognitive–Motor Dual-Tasking in Relapsing Remitting Multiple Sclerosis

2017 ◽  
Vol 24 (3) ◽  
pp. 247-258 ◽  
Author(s):  
Emma Butchard-MacDonald ◽  
Lorna Paul ◽  
Jonathan J. Evans
Keyword(s):  
Multiple Sclerosis ◽  
Dual Task ◽  
Postural Stability ◽  
Digit Span ◽  
Dual Tasking ◽  
Stable Surface ◽  
Relapsing Remitting ◽  
Task Conditions ◽  
Relapsing Remitting Multiple Sclerosis ◽  
The Impact

AbstractBackground:People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance.Objectives:This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined.Methods:A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measuredviathe Modified Fatigue Index Scale.Results:No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527;p=.001) and depression (rho=0.451;p=.007).Conclusions:RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties. (JINS, 2018,24, 247–258)

Effects of Hearing Loss on Dual-Task Performance in an Audiovisual Virtual Reality Simulation of Listening While Walking

2016 ◽  
Vol 27 (07) ◽  
pp. 567-587 ◽  
Author(s):  
Sin Tung Lau ◽  
M. Kathleen Pichora-Fuller ◽  
Karen Z. H. Li ◽  
Gurjit Singh ◽  
Jennifer L. Campos
Keyword(s):  
Virtual Reality ◽  
Hearing Loss ◽  
Word Recognition ◽  
Dual Task ◽  
Recognition Accuracy ◽  
Lower Probability ◽  
Stride Time ◽  
Task Condition ◽  
Kinematic Parameters ◽  
Task Conditions

Background: Most activities of daily living require the dynamic integration of sights, sounds, and movements as people navigate complex environments. Nevertheless, little is known about the effects of hearing loss (HL) or hearing aid (HA) use on listening during multitasking challenges. Purpose: The objective of the current study was to investigate the effect of age-related hearing loss (ARHL) on word recognition accuracy in a dual-task experiment. Virtual reality (VR) technologies in a specialized laboratory (Challenging Environment Assessment Laboratory) were used to produce a controlled and safe simulated environment for listening while walking. Research Design: In a simulation of a downtown street intersection, participants completed two single-task conditions, listening-only (standing stationary) and walking-only (walking on a treadmill to cross the simulated intersection with no speech presented), and a dual-task condition (listening while walking). For the listening task, they were required to recognize words spoken by a target talker when there was a competing talker. For some blocks of trials, the target talker was always located at 0° azimuth (100% probability condition); for other blocks, the target talker was more likely (60% of trials) to be located at the center (0° azimuth) and less likely (40% of trials) to be located at the left (270° azimuth). Study Sample: The participants were eight older adults with bilateral HL (mean age = 73.3 yr, standard deviation [SD] = 8.4; three males) who wore their own HAs during testing and eight controls with normal hearing (NH) thresholds (mean age = 69.9 yr, SD = 5.4; two males). No participant had clinically significant visual, cognitive, or mobility impairments. Data Collection and Analysis: Word recognition accuracy and kinematic parameters (head and trunk angles, step width and length, stride time, cadence) were analyzed using mixed factorial analysis of variances with group as a between-subjects factor. Task condition (single versus dual) and probability (100% versus 60%) were within-subject factors. In analyses of the 60% listening condition, spatial expectation (likely versus unlikely) was a within-subject factor. Differences between groups in age and baseline measures of hearing, mobility, and cognition were tested using t tests. Results: The NH group had significantly better word recognition accuracy than the HL group. Both groups performed better when the probability was higher and the target location more likely. For word recognition, dual-task costs for the HL group did not depend on condition, whereas the NH group demonstrated a surprising dual-task benefit in conditions with lower probability or spatial expectation. For the kinematic parameters, both groups demonstrated a more upright and less variable head position and more variable trunk position during dual-task conditions compared to the walking-only condition, suggesting that safe walking was prioritized. The HL group demonstrated more overall stride time variability than the NH group. Conclusions: This study provides new knowledge about the effects of ARHL, HA use, and aging on word recognition when individuals also perform a mobility-related task that is typically experienced in everyday life. This research may help inform the development of more effective function-based approaches to assessment and intervention for people who are hard-of-hearing.

scholarly journals Digital Natives and Dual Task: Handling It But Not Immune Against Cognitive-Locomotor Interferences

2019 ◽  
Author(s):  
Dierick Frédéric ◽  
Buisseret Fabien ◽  
Renson Mathieu ◽  
Luta Adèle Mae
Keyword(s):  
Long Range ◽  
Dual Task ◽  
Digital Natives ◽  
Safety Index ◽  
Dual Tasks ◽  
Dual Tasking ◽  
Stride Interval ◽  
Task Conditions ◽  
Relative Change ◽  
Raven’S Matrices

AbstractDigital natives developed in an electronic dual tasking world. This paper addresses two questions. Do digital natives respond differently under a cognitive load realized during a locomotor task in a dual-tasking paradigm and how does this address the concept of safety? We investigate the interplay between cognitive (talking and solving Raven’s matrices) and locomotor (walking on a treadmill) tasks in a sample of 17 graduate level participants. The costs of dual-tasking on gait were assessed by studying changes in stride interval time and its variability at long-range. A safety index was designed and computed from total relative change between the variability indices in the single walking and dual-task conditions. As expected, results indicate high Raven’s scores with gait changes found between the dual task conditions compared to the single walking task. Greater changes are observed in the talking condition compared to solving Raven’s matrices, resulting in high safety index values observed in 5 participants. We conclude that, although digital natives are efficient in performing the dual tasks when they are not emotional-based, modification of gait are observable. Due to the variation within participants and the observation of high safety index values in several of them, individuals that responded poorly to low cognitive loads should be encouraged to not perform dual task when executing a primate task of safety to themselves or others.

scholarly journals Smartphone App�Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability (Preprint)

2017 ◽  
Author(s):  
Brad Manor ◽  
Wanting Yu ◽  
Hao Zhu ◽  
Rachel Harrison ◽  
On-Yee Lo ◽  
...  
Keyword(s):  
Dual Task ◽  
Intraclass Correlation ◽  
Motor Task ◽  
Motion Sensors ◽  
Stride Time ◽  
Validity And Reliability ◽  
Home Based ◽  
Reliable Assessment ◽  
Highly Correlated ◽  
Task Conditions

BACKGROUND Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and “dual-task” walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. OBJECTIVE The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. METHODS We created an iPhone app that used the phone’s motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user’s pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard–instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times—a clinically meaningful metric of locomotor control—from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms and omitted from stride-time analyses. RESULTS Across all detected strides in the laboratory, stride times derived from the app and GAITRite mat were highly correlated (P<.001, r2=.98). These correlations were independent of walking condition and pocket tightness. App- and GAITRite-derived stride-time dual-task costs were also highly correlated (P<.001, r2=.95). The error of app-derived stride times (mean 16.9, SD 9.0 ms) was unaffected by the magnitude of stride time, walking condition, or pocket tightness. For both normal and dual-task trials, average stride times derived from app walking trials demonstrated excellent test-retest reliability within and between both laboratory and home-based assessments (intraclass correlation coefficient range .82-.94). CONCLUSIONS The iPhone app we created enabled valid and reliable assessment of stride timing—with the smartphone in the pocket—during both normal and dual-task walking and within both laboratory and nonlaboratory environments. Additional work is warranted to expand the functionality of this tool to older adults and other patient populations.

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