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Improving Sensitivity to Detect Mild Cognitive Impairment: Cognitive Load Dual-Task Gait Speed Assessment

Published online by Cambridge University Press:  17 April 2017

Rebecca K. MacAulay ,
Mark T. Wagner ,
Dana Szeles  and
Nicholas J. Milano
Rebecca K. MacAulay*
Affiliation:
Department of Psychology, University of Maine, Orono, Maine
Mark T. Wagner
Affiliation:
Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
Dana Szeles
Affiliation:
Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
Nicholas J. Milano
Affiliation:
Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
*
Correspondence and reprint requests to: Rebecca K. MacAulay, Department of Psychology, University of Maine, 301 Little Hall, Orono, ME 04469. E-mail: rebecca.macaulay@maine.edu.
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Abstract

Objectives: Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Methods: Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Results: Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, ps<.05. Follow-up analysis indicated that the MCI group had significantly slower dual-task gait speed but did not differ in simple-gait speed. Multivariate linear regression across groups found that executive attention performance accounted for 27.4% of the variance in dual-task gait speed beyond relevant demographic and health risk factors. Conclusions: The present study increases the external validity of dual-task gait assessment of MCI. Differences in dual-task gait speed appears to be largely attributable to executive attention processes. These findings have clinical implications as they demonstrate expected patterns of gait-brain behavior relationships in response to a cognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493–501)

Keywords

Cognitive agingDementiaAttentionCognitive reserveRiskSubjective Health complaint
Type
Special Section: Mild Cognitive Impairment
Information
Journal of the International Neuropsychological Society , Volume 23 , Issue 6 , July 2017 , pp. 493 - 501
Copyright
Copyright © The International Neuropsychological Society 2017 

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