Do frailty and cognitive impairment affect dual-task cost during walking in the oldest old institutionalized patients?
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The objective of this study was to investigate dual-task costs in several elderly populations, including robust oldest old, frail oldest old with MCI, frail oldest old without MCI, and frail elderly with dementia. Sixty-four elderly men and women categorized into frail without MCI (age 93.4 ± 3.2 years, n = 20), frail with MCI (age 92.4 ± 4.2 years, n = 13), robust (age 88.2 ± 4.1 years, n = 10), and patients with dementia (age 88.1 ± 5.1 years, n = 21). Five-meter gait ability and timed-up-and-go (TUG) tests with single and dual-task performance were assessed in the groups. Dual-task cost in both 5-m habitual gait velocity test and TUG test was calculated by the time differences between single and dual-task performance. The robust group exhibited better 5-m gait and TUG test performances in the single and dual-task conditions compared with the other three groups (P < 0.001), and the frail and frail + MCI groups exhibited better performances than the dementia group (P < 0.001). No significant differences were observed between the frail and frail + MCI groups. However, all groups exhibited lower gait velocities in the verbal and arithmetic task conditions, but the dual-task cost of the groups were similar. Robust individuals exhibited superior single and dual-task walking performances than the other three groups, and the frail and frail + MCI individuals exhibited performances that were superior to those of the patients with dementia. However, the dual-task costs, i.e., the changes in gait performance when elderly participants switch from a single to a dual task, were similar among all four of the investigated groups. Therefore, these results demonstrated that the magnitude of the impairment in gait pattern is independent of frailty and cognitive impairment status.
KeywordsFrailty Oldest old Cognitive impairment Dual-task walking Dementia
This work was supported in part by the Spanish Department of Health and Institute Carlos III of the Government of Spain [Spanish Net on Aging and frailty; (RETICEF)] under grant numbered RD12/043/0002].
Compliance with ethical standards
All subjects or their legal guardians agreed to participate in the trial and completed an ethical consent form. The study was conducted according to the Declaration of Helsinki and was approved by the Ethics Committee of the Public University of Navarra, Spain.
Conflict of interest
The authors declare that they have no competing interests.
- Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Idoate F, Millor N, Gómez M, Rodriguez-Mañas L, Izquierdo M (2014a) Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age (Dordr) 36:773–785CrossRefGoogle Scholar
- Casas-Herrero A, Cadore EL, Zambom-Ferraresi F, Idoate F, Millor N, Martínez-Ramírez A, Gómez M, Rodríguez-Mañas L, Marcellan T, Ruiz de Gordoa A, Marques MC, Izquierdo M (2013) Functional capacity, muscle fat infiltration, power output and cognitive impairment in institutionalized frail oldest-old. Rejuvenation Res 16:396–403PubMedPubMedCentralCrossRefGoogle Scholar
- Freiberger E, Häberle L, Spirduso WW, Rixt Zijlstra GA (2012) Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial. J Am Geriatr Soc 60:437–446PubMedCrossRefGoogle Scholar
- Fried LP, Tangen CM, Waltson J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group (2001) Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:146–155CrossRefGoogle Scholar
- Garcia-Garcia FJ, Gutierrez Avila G, Alfaro-Acha A, Amor Andres MS, De Los Angeles De La Torre Lanza M, Escribano Aparicio MV, Humanes Aparicio S, Larrion Zugasti JL, Gomez-Serranillo Reus M, Rodriguez-Artalejo F, Rodriguez-Mañas L, Toledo Study Group (2011) The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging. Aging J Nutr Health Aging 15:852–865PubMedCrossRefGoogle Scholar
- Maquet D, Lekeu F, Warzee E, Gillain S, Wojtsik V, Salmon E, Petermans J, Croisier JL (2010) Gait analysis in elderly adult patients with mild cognitive impairment and patients with mild Alzheimer’s disease: simple versus dual task: a preliminary report. Clin Physiol Funct Imaging 30:51–56PubMedCrossRefGoogle Scholar
- McGough EL, Kelly VE, Logsdon RG, McCurry SM, Cochrane BB, Engel JM, Teri L (2011) Associations between physical performance and executive function in older adults with mild cognitive impairment: gait speed and the timed “up & go” test. Phys Teraphy 91:1198–1207Google Scholar
- Rodríguez-Mañas L, Féart C, Mann G, Viña J, Chatterji S, Chodzko-Zajko W, Gonzalez-Colaço Harmand M, Bergman H, Carcaillon L, Nicholson C, Scuteri A, Sinclair A, Pelaez M, Van der Cammen T, Beland F, Bickenbach J, Delamarche P, Ferrucci L, Fried LP, Gutiérrez-Robledo LM, Rockwood K, Rodríguez Artalejo F, Serviddio G, Vega E, on behalf of the FOD-CC group (Appendix 1) (2012) Searching for an operational definition of frailty: a Delphi method based consensus statement. The frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci 68:62–67PubMedPubMedCentralCrossRefGoogle Scholar
- Windblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Bäckman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Dujin C, Visser P, Petersen RC (2004) Mild cognitive impairment beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 256:240–246CrossRefGoogle Scholar
- Zwijsen SA, Smalbrugge M, Zuidema SU, Koopmans RTCM, Bosmans JE, van Tulder MW, Eefsting JA, Gerritsen DL, Pot A-M (2011) Grip on challenging behaviour: a multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol. BMC Health Serv Res 11:41–47PubMedPubMedCentralCrossRefGoogle Scholar