| Popis: |
BACKGROUND Although promising results concerning dual-task gait predicting dementia progression in older adults with Mild Cognitive Impairment have been established, the question remains whether this can also be applied to older adults who are not yet suffering from overt cognitive impairments. Spatiotemporal gait analysis has proven to be valuable and reliable in this context. Nevertheless, these instruments are not common in clinical environments. This study aims to investigate whether easy applicable, inexpensive instruments can be used in the detection of gait alterations associated with early cognitive decrements.METHODS Eighty-two healthy community-dwelling older adults (age 60-89) with a MMSE ≥27 were enrolled in this study. Gait analyses using 10-meter walk test (10MWT) and GAITRite-instrument were performed under single and dual-task conditions. Performance on MMSE, CDT, MoCA, TMT-A, TMT-B, Digit Span Forward and Digit Span Backward were registered. Based on the tertiles of dual-task costs (DTC), subjects were categorized as “poor walkers” or “good walkers”. Comparative and predictive statistical analyses were conducted.RESULTS During both types of dual-task 10MWT “poor walkers” performed significantly worse on CDT, MMSECDT, TMT-A and Digit Span Backward compared to “good walkers”. Spatiotemporal gait analysis revealed that temporal DTC resulted in poorer performance on MMSE, CDT, MMSECDT and MoCA orientation whereas spatial DTC showed significantly lower scores on MoCA language, TMT-B and ΔTMT for “poor walkers” compared to “good walkers”. The effort it took to perform either the verbal fluency or the arithmetic dual-task during 10MWT predicted TMT-A and Digit Span Backward outcome. Regarding spatiotemporal dual-task gait analysis, performance on MMSE could be predicted by DTC stride velocity and performance on MoCA language could be predicted by DTC step and stride length.CONCLUSIONS Poor walking abilities can be associated with early cognitive decrements, even in a very early stage when cognitive performance is still more or less intact. Poor walking performance might therefore be considered a clinical precursor or warning signal for beginning cognitive decline. The subtle cognitive and gait decrements can be identified using inexpensive tools, which are easy applicable in all clinical settings.Trial registration Not applicable |
