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01-02-2013 | Original Communication

Characterization of cognitive and motor performance during dual-tasking in healthy older adults and patients with Parkinson’s disease

Authors: Lucia Bartmann Wild, Daiane Borba de Lima, Joana Bisol Balardin, Luana Rizzi, Bruno Lima Giacobbo, Henrique Bianchi Oliveira, Irani Iracema de Lima Argimon, Leonardo Alexandre Peyré-Tartaruga, Carlos R. M. Rieder, Elke Bromberg

Published in: Journal of Neurology | Issue 2/2013

Abstract

The primary purpose of this study was to investigate the effect of dual-tasking on cognitive performance and gait parameters in patients with idiopathic Parkinson’s disease (PD) without dementia. The impact of cognitive task complexity on cognition and walking was also examined. Eighteen patients with PD (ages 53–88, 10 women; Hoehn and Yahr stage I-II) and 18 older adults (ages 61–84; 10 women) completed two neuropsychological measures of executive function/attention (the Stroop Test and Wisconsin Card Sorting Test). Cognitive performance and gait parameters related to functional mobility of stride were measured under single (cognitive task only) and dual-task (cognitive task during walking) conditions with different levels of difficulty and different types of stimuli. In addition, dual-task cognitive costs were calculated. Although cognitive performance showed no significant difference between controls and PD patients during single or dual-tasking conditions, only the patients had a decrease in cognitive performance during walking. Gait parameters of patients differed significantly from controls at single and dual-task conditions, indicating that patients gave priority to gait while cognitive performance suffered. Dual-task cognitive costs of patients increased with task complexity, reaching significantly higher values then controls in the arithmetic task, which was correlated with scores on executive function/attention (Stroop Color-Word Page). Baseline motor functioning and task executive/attentional load affect the performance of cognitive tasks of PD patients while walking. These findings provide insight into the functional strategies used by PD patients in the initial phases of the disease to manage dual-task interference.

Muslimovic D, Post B, Speelman JD, Schmand B (2005) Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65:1239–1245PubMedCrossRef

Foltynie T, Brayne CE, Robbins TW, Barker RA (2004) The cognitive ability of an incident cohort of Parkinson’s patients in the UK: the CamPaIGN study. Brain 127:550–560PubMedCrossRef

Dubois B, Pillon B (1997) Cognitive deficits in Parkinson’s disease. J Neurol 244:2–8PubMedCrossRef

Lord S, Rochester L, Hetherington V, Allcock LM, Burn D (2010) Executive dysfunction and attention contribute to gait interference in ‘off’ state Parkinson’s Disease. Gait Posture 31:169–174PubMedCrossRef

Plotnik M, Dagan Y, Gurevich T, Giladi N, Hausdorff JM (2011) Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson’s disease suffering from motor response fluctuations. Exp Brain Res 208:169–179PubMedCrossRef

Rochester L, Hetherington V, Jones D, Nieuwboer A, Willems AM, Kwakkel G et al (2004) Attending to the task: interference effects of functional tasks on walking in Parkinson’s disease and the roles of cognition, depression, fatigue, and balance. Arch Phys Med Rehabil 85:1578–1585PubMedCrossRef

Yogev-Seligmann G, Hausdrff JM, Giladi N (2008) The role of executive function and attention in gait. Mov Disord 23(3):329–342PubMedCrossRef

Marchese R, Bove M, Abbruzzese G (2003) Effect of cognitive and motor tasks on postural stability in Parkinson’s disease: a posturographic study. Mov Disord 18:652–658PubMedCrossRef

Morris ME, Iansek R, Smithson F, Huxham F (2000) Postural instability in Parkinson’s disease: a comparison with and without an added task. Gait Posture 12:205–216PubMedCrossRef

10.

Hackney ME, Earhart GM (2010) The effects of a secondary task on forward and backward walking in Parkinson’s disease. Neurorehabil Neural Repair 24:88–96CrossRef

11.

Kelly VE, Eusterbrock AJ, Shumway-Cook A (2012) A review of dual-task walking deficits in people with Parkinson’s disease: motor and cognitive contributions, mechanisms, and clinical implications. Parkinsons Dis. doi:10.1155/2012/918719

12.

Gibb WR, Lees AJ (1988) A comparison of clinical and pathological features of young and old onset Parkinson’s disease. Neurology 38:1402–1406PubMedCrossRef

13.

Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442PubMedCrossRef

14.

Folstein MF, Folstein SE, Mchugh PR (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef

15.

Gorestein C, Andrade L (1998) Inventário de depressão de Beck: propriedades psicométricas da versão em português. Rev Psiquiatr Clín 25:245–250

16.

Fahn S, Elton RL, Members of the UPDRS Development Committee (1987) The Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB, Goldstein M (eds) Recent developments in Parkinson’s disease. Macmillan Healthcare Information, Florham Park pp 153–163, 293–304

17.

Kongs SK, Thompson LL, Iverson GL, Heaton RK (2000) Wisconsin Card Sorting Test-64 Card Version. Psychological Assessment Resources, Lutz

18.

Strauss E, Sherman EMS, Spreen O (2006) A compendium of neuropsychological tests: administration, norms and commentary. Oxford University Press, New York

19.

Bisiacchi PS, Borella E, Bergamaschi S, Carretti B, Mondini S (2008) Interplay between memory and executive functions in normal and pathological aging. J Clin Exp Neuropsychol 30:723–733PubMedCrossRef

20.

Yogev G, Giladi N, Peretz C, Springer S, Simon ES, Hausdorff JM (2005) Dual tasking, gait rhythmicity, and Parkinson’s disease: which aspects of gait are attention demanding? Eur J Neurosci 22:1248–1256PubMedCrossRef

21.

Rhodes MG (2004) Age-related differences in performance on the Wisconsin Card Sorting Test: a meta-analytic review. Psychol Aging 19:482–494PubMedCrossRef

22.

Glisky EL, Polster MR, Routhieaux BC (1995) Double dissociation between item and source memory. Neuropsychology 9:229–235CrossRef

23.

Paolo AM, Tröster AI, Axelrod BN, Koller WC (1995) Construct validity of the WCST in normal elderly and persons with Parkinson’s disease. Arch Clin Neuropsych 10:463–473

24.

Laiacona M, Inzaghi MG, Tanti A, Capitani E (2000) Wisconsin card sorting test: a new global score, with Italian norms, and its relationship with the Weigl sorting test. Neurol Sci 21:279–291PubMedCrossRef

25.

MacLeod CM (1991) Half a century of research on the Stroop effect: an integrative review. Psychol Bull 109:163–203PubMedCrossRef

26.

Kelly VE, Janke AA, Shumway-Cook A (2010) Effects of instructed focus and difficulty on concurrent walking and cognitive task performance in healthy young adults. Exp Brain Res 207:65–73PubMedCrossRef

27.

O’Shea S, Morris ME, Iansek R (2002) Dual task interference during gait in people with Parkinson disease: effects of motor versus cognitive secondary tasks. Phys Ther 82:888–897PubMed

28.

Hollman JH, Kovash FM, Kubik JJ, Linbo RA (2007) Age-related differences in spatiotemporal markers of gait stability during dual task walking. Gait Posture 26:113–119PubMedCrossRef

29.

Cho C, Kunin M, Kudo K, Osaki Y, Olanow CW, Cohen B, Raphan T (2010) Frequency velocity mismatch: a fundamental abnormality in Parkinsonian gait. J Neurophysiol 103:1478–1489PubMedCrossRef

30.

Sabatini AM, Martelloni C, Scapellato S, Cavallo F (2005) Assessment of walking features from foot inertial sensing. IEEE Trans Biomed Eng 52(3):486–494PubMedCrossRef

31.

Hausdorff JM, Rios D, Edelberg HK (2001) Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 82:1050–1056PubMedCrossRef

32.

Hausdorff JM (2005) Gait variability: methods, modeling and meaning. J Neuroeng Rehabil 2(19)

33.

Maylor EA, Wing AM (1996) Age differences in postural stability are increased by additional cognitive demands. J Gerontol Psychol Sci 51(B):143–154CrossRef

34.

Lindenberger U, Marsiske M, Baltes PB (2000) Memorizing while walking: increase in dual-task costs from young adulthood to old age. Psychol Aging 15:417–436PubMedCrossRef

35.

Woollacott M, Shumway-cook A (2002) Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 16:1–14PubMedCrossRef

36.

Franzén E, Paquette C, Gurfinkel VS, Cordo PJ, Nutt JG, Horak FB (2009) Reduced performance in balance, walking and turning tasks is associated with increased neck tone in Parkinson’s disease. Exp Neurol 219:430–438PubMedCrossRef

37.

Morris M, Iansek R, McGinley J, Matyas T, Huxham F (2005) Three-dimensional gait biomechanics in Parkinson’s disease: evidence for a centrally mediated amplitude regulation disorder. Mov Disord 20:40–50PubMedCrossRef

38.

Hausdorff JM, Schweiger A, Herman T, Yogev-Seligmann G, Giladi N (2008) Dual-task decrements in gait: contributing factors among healthy older adults. J Gerontol A Biol Sci Med Sci 63:1335–1343PubMedCrossRef

39.

Springer S, Giladi N, Peretz C, Yogev G, Simon ES, Hausdorff JM (2006) Dual-tasking effects on gait variability: the role of aging, falls, and executive function. Mov Disord 21:950–957PubMedCrossRef

40.

Morris ME, Iansek R, Matyas TA, Summers JJ (1996) Stride length regulation in Parkinson’s disease: normalization strategies and underlying mechanisms. Brain 119(Pt 2):551–568PubMedCrossRef

41.

Bond JM, Morris M (2000) Goal-directed secondary motor tasks: their effects on gait in subjects with Parkinson disease. Arch Phys Med Rehabil 81:110–116PubMed

42.

Yogev G, Plotnik M, Peretz C, Giladi N, Hausdorff JM (2007) Gait asymmetry in patients with Parkinson’s disease and elderly fallers: when does the bilateral coordination of gait require attention? Exp Brain Res 177:336–346PubMedCrossRef

43.

Spildooren J, Vercruysse S, Desloovere K, Vandenberghe W, Kerckhofs E, Nieuwboer A (2010) Freezing of gait in Parkinson’s disease: the impact of dual tasking and turning. Mov Disord 25:2563–2570PubMedCrossRef

44.

Tombu M, Jolicoaeur P (2003) A central capacity sharing model of dual-task performance. J Exp Psychol Hum Percept Perform 29:3–18PubMedCrossRef

45.

Ruthruff E, Pashler HE, Klaassen A (2001) Processing bottlenecks in dual-task performance: structural limitation or strategic postponement? Psychon Bull Rev 8:73–80PubMedCrossRef

46.

Bloem BR, Grimbergen YA, Van Dijk JG, Munneke M (2006) The “posture second” strategy: a review of wrong priorities in Parkinson’s disease. J Neurol Sci 248:196–204PubMedCrossRef

47.

Beauchet O, Dubost V, Gonthier R, Kressig RW (2005) Dual-task-related gait changes in transitionally frail older adults: the type of the walking-associated cognitive task matters. Gerontology 51:48–52PubMedCrossRef

48.

Galletly R, Brauer SG (2005) Does the type of concurrent task affect preferred and cued gait in people with Parkinson’s disease? Aust J Physiother 51:175–180PubMedCrossRef

49.

Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement disorder society task force guidelines. Mov Disord 27:349–356PubMedCrossRef

50.

Poletti M, Frosini D, Pagni C et al (2012) Mild cognitive impairment and cognitive-motor relationships in newly diagnosed drug-naive patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 83(6):601–606PubMedCrossRef

51.

Gleason CE, Gangnon RE, Fischer BL, Mahoney JE (2009) Increased risk for falling associated with subtle cognitive impairment: secondary analysis of a randomized clinical trial. Dement Geriatr Cogn Disord 27:557–563PubMedCrossRef

52.

Klepac N, Trkulja V, Relja M, Babić T (2008) Is quality of life in non-demented Parkinson’s disease patients related to cognitive performance? A clinic-based cross-sectional study. Eur J Neurol 15:128–133PubMedCrossRef

53.

Canning CG, Ada L, Woodhouse E (2008) Multiple-task walking training in people with mild to moderate Parkinson’s disease: a pilot study. Clin Rehabil 22:226–233PubMedCrossRef

54.

Yogev-Seligmann G, Giladi N, Brozgol M, Hausdorff JM (2012) A training program to improve gait while dual tasking in patients with Parkinson’s disease: a pilot study. Arch Phys Med Rehabil 93(1):176–181PubMedCrossRef

55.

Brauer SG, Morris ME (2010) Can people with Parkinson’s disease improve dual tasking when walking? Gait Posture 31:229–233PubMedCrossRef

56.

Brauer SG, Woollacott MH, Lamont R, Clewett S, O’Sullivan J, Silburn P, Mellick GD, Morris ME (2011) Single and dual task gait training in people with Parkinson’s disease: a protocol for a randomised controlled trial. BMC Neurol 11(90)

Title: Characterization of cognitive and motor performance during dual-tasking in healthy older adults and patients with Parkinson’s disease
Authors: Lucia Bartmann Wild
Daiane Borba de Lima
Joana Bisol Balardin
Luana Rizzi
Bruno Lima Giacobbo
Henrique Bianchi Oliveira
Irani Iracema de Lima Argimon
Leonardo Alexandre Peyré-Tartaruga
Carlos R. M. Rieder
Elke Bromberg
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Journal of Neurology / Issue 2/2013
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-012-6683-3

ACC 2024 Congress

Springer Medicine

Characterization of cognitive and motor performance during dual-tasking in healthy older adults and patients with Parkinson’s disease

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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