Article

The important relationship between cognition and gait in people with dementia has
been explored with dual-task studies using added cognitive tasks. Effects of less
commonly studied but also attention-dividing motor dual-tasks are important to
assess in this group as they are common in everyday function and may affect gait
differently from cognitive dual-tasks. They may also be easier to comprehend
allowing their application with more severe cognitive impairment. The aim of this
study was to evaluate the effects and feasibility of a motor dual-task (MDT) on
gait measures in people with Alzheimer's disease (AD). Thirty people (15 men,
mean age +/- SD, 80.2 +/- 5.8 years) with a diagnosis of probable AD (MMSE range
8-28) walked on an electronic walkway (i) at self-selected comfortable pace and
(ii) at self-selected comfortable pace while carrying a tray and glasses. The MDT
produced significant decreases in velocity (Baseline=111.5 +/- 26.5 cm/s,
MDT=96.8 +/- 25.7 cm/s, p<0.001) and stride length (Baseline=121.4 +/- 21.6 cm,
MDT=108.1 +/- 21.0 cm, p<0.001) with medium effect sizes, and increased stride
time (Baseline=1.11 +/- 0.11s, MDT=1.14 +/- 0.12s, p=0.001) with small effect
size. Measures of spatial (Baseline=3.2 +/- 1.0%, MDT=3.9 +/- 1.5%, p=0.006) and
temporal (Baseline=2.4 +/- 0.8%, MDT=2.8 +/- 0.8%, p=0.008) variability increased
with the motor dual-task, with medium effect sizes. A trend for motor dual-task
changes in gait measures to increase with greater disease severity did not reach
significance. The tray-carrying task was feasible, even for participants with
severe cognitive decline. Further comparison of different types of motor and
cognitive dual-tasks may contribute to development of a framework for clinical
intervention to improve reduced dual-task walking capacity in people with AD.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS