The associations between dual-task walking under three different interference conditions and cognitive function

Background & aims: Dual-task walking is an emerging marker of cognitive impairment. However, there is uncertainty regarding which dual-task test and measure to use. The aims of this study were to determine the association between three different dual-tasks and 1) global cognition and 2) individual cognitive domains.

Methods: Participants (n = 91) were adults aged between 56-83 years (mean 68.8, SD 6.7). Under single- and dual-task, gait speed was obtained using a computerized mat. For the dual-task there were three conditions: 1) reciting alternate letters of the alphabet (DT-alpha); 2) counting backwards in 3 s (DT-counting); and 3) recalling words from a shopping list (DT-recall). Dual-task interference in gait and cognition were calculated as: (dual task-single task)/single task×100 and summed to obtain total interference. The cognitive domains of executive function, processing speed, working memory, verbal fluency, visuospatial function and verbal memory (recall and recognition) were assessed using a battery of neuropsychological tests. Raw test scores were subjected to principal component analysis to derive a global cognition score. Partial correlations were used to determine the strength of associations between single- and dual-task measures and cognitive scores, adjusting for age, sex and education.

Results: The strongest significant associations for each cognitive outcome variable were between greater total interference under DT-alpha and lower global cognition (r = 0.25), working memory (r = 0.28) and verbal memory [recognition] (r = 0.21), greater gait interference under DT-alpha and slower processing speed (r = 0.43) and single-task gait speed and verbal fluency (r = 0.23). Associations between dual-task measures and cognition were generally weaker under the DT-counting and DT-recall.

Significance: Calculating total and gait interference during DT-alpha may be the most useful in order to identify adults with poorer cognition.