Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Abstract

BackgroundMild cognitive impairment (MCI) is considered a transitional stage between cognitive normality and dementia among the elderly, and its associated risk of developing Alzheimer’s disease (AD) is 10–15 times higher than that of the general population. MCI is an important threshold for the prevention and control of AD, and intervention in the MCI stage may be the most effective strategy to delay the occurrence of AD.Materials and methodsIn this study, 68 subjects who met the inclusion criteria were divided into an MCI group (38 subjects) and normal elderly (NE) group (30 subjects). Both groups underwent clinical function assessments (cognitive function, walking function, and activities of daily living) and dual-task three-dimensional gait analysis (walking motor task and walking calculation task). Spatial-temporal parameters were obtained and reduced by principal component analysis, and the key biomechanical indexes were selected. The dual-task cost (DTC) was calculated for intra-group (task factor) and inter-group (group factor) comparisons.ResultsThe results of the principal component analysis showed that the cadence parameter had the highest weight in all three walking tasks. In addition, there were significant differences in the cadence both walking motor task (WMT) vs. walking task (WT) and walking calculation task (WCT) vs. WT in the MCI group. The cadence in the NE group only showed a significant difference between WMT and WT. The only differences between the MCI group and NE group was DTC cadence in WCT, and no differences were found for cadence in any of the three walking tasks.ConclusionThe results show that dual tasks based on cognitive-motor gait analysis of DTCcadence in MCI have potential value for application in early identification and provide theoretical support to improve the clinical diagnosis of MCI.

A novel dual-task paradigm with story recall shows significant differences in the gait kinematics in older adults with cognitive impairment: A cross-sectional study

“…Our results are in line with previous studies that DTC under DTs cannot distinguish MCI from normal elderly (Åhman et al, 2020;Jayakody et al, 2020). While others found significant differences of DTC between MCI and normal group (Zak et al, 2021;Zheng et al, 2022). The conflict of findings may due to the different inclusion criteria of MCI participants and different cognitive tasks, which may have different interferences in walking performance.…”

Effects of Multi-Task Mode on Cognition and Lower Limb Function in Frail Older Adults: A Systematic Search and Review

“…All studies [23][24][25][26][27][28][29] reporting MT testing in the frail elderly population used the DT mode; with seven studies using the cognitive-motor DT mode, including a walking task while performing a counting task, walking while talking or naming an animal, etc. ; and one study [29] additionally selecting the moto-motor DT mode (walking while holding a glass of water).…”

“…All studies [23][24][25][26][27][28][29] reporting MT testing in the frail elderly population used the DT mode; with seven studies using the cognitive-motor DT mode, including a walking task while performing a counting task, walking while talking or naming an animal, etc. ; and one study [29] additionally selecting the moto-motor DT mode (walking while holding a glass of water). All included studies reported results for lower limb functional indicators, such as gait speed, turn duration, step length and step frequency; and two of the studies [24,29] presented gait indicator results by reporting dual-task costs (DTCs).…”

“…; and one study [29] additionally selecting the moto-motor DT mode (walking while holding a glass of water). All included studies reported results for lower limb functional indicators, such as gait speed, turn duration, step length and step frequency; and two of the studies [24,29] presented gait indicator results by reporting dual-task costs (DTCs). The results of four studies [23,25,27,28] showed that DT testing significantly worsens gait performance in frail older adults; and both the studies by Piche et al and Zheng et al showed that the DTC of gait was significantly higher in the frail population [24,29].…”

“…The seven DT test studies contained a total of 489 subjects, 105 males and 289 females (one study did not report the gender of the subjects [23]), with female subjects dominating the studies. Six studies involved participants over the age of 70, two of whom were over the age of 80 [27,28], and one involved participants under the age of 70 [29]. Regarding the publication year of the studies, all six studies were published within the decade, and four of them [23,24,28,29] were published in the past 5 years, which suggests that the use of DT testing in frail populations has gradually been attracting attention in recent years (Table 1).…”