Dual-Task Performance in Older Adults With and Without Idiopathic Normal Pressure Hydrocephalus

Abstract

Two of the main features of idiopathic normal pressure hydrocephalus (iNPH) are disturbed gait and cognition. These features are typically investigated separately, but here we combined walking with a cognitive task to investigate if older adults with iNPH were more susceptible to dual-task interference on walking than those without iNPH. In total, 95 individuals from the general population participated in our study. Of these, 20 were classified as Possible iNPH (median [interquartile range, IQR] 80 years [75–82.5]) and 75 as Unlikely iNPH (74 years [72–78]). Conversation, 10-m walking, semantic and phonemic verbal fluency were performed either combined or independently. “Stopping walking while talking” was noted. Pairwise comparisons and multiple logistic regression analyses were used. We found that the Possible iNPH group was older, stopped walking more frequently during the conversation, and had a slower single-task pace. The dual-task pace was slower for both groups. Only single-task walking pace could predict Possible iNPH when adjusted for age. We could establish a dual-task cost on gait performance in this sample of older adults from the general population, but the cost was not exclusive for individuals with Possible iNPH. To further assess the value of dual-task testing in iNPH, including observations of stopping walking while talking, a study of a clinical iNPH material with more severe symptoms would be valuable.

Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus: a population–based study

“…Our results showing worsened declarative memory is in line with other studies highlighting poor declarative memory in iNPH [ 19 , 41 ]. One example of memory impairment in iNPH is having to stop walking while recalling a recent event [ 32 ]. It is conceivable that the reduced memory performance in iNPH is related to the widening of the temporal horns (TH).…”

Quantification of pathological gait parameter thresholds of idiopathic normal pressure hydrocephalus patients in clinical gait analysis

“…Previous studies emphasized the importance of examining dual task performance during evaluation of shunt candidacy in NPH during CSF tap test 16 , 27 , 28 . Other studies revealed that the evaluation of gait performance during single tasks is sufficient 15 , 29 . In line with this, the present results reveal a good to excellent classification accuracy across all examined conditions with highest mean AUC values for preferred walking and walking with a motoric dual tasking.…”

Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus: a population–based study

“…One example of memory impairment in iNPH is having to stop walking while recalling a recent event [32].…”

“…The participants were recruited from an epidemiological study on iNPH among inhabitants 65 years or older in a northern region of Sweden [4,7,[29][30][31][32][33]. Out of the original 168 participants at baseline in 2014/15, 127 participated at follow-up in 2016/17, of which 104 in the present study.…”