Abstract
Background
Gait and cognition are closely associated. Older adults with gait deficits have an increased risk of developing cognitive deficits and cognitive deficits are associated with worsened gait. Both gait and cognitive impairments are risk factors for falls in older adults.
Objectives
The aims of this article are (1) to highlight the association between gait and cognition, particularly executive function, (2) to present motor cognitive dual tasking test paradigms and (3) to provide an algorithm for standardized mobility tests that can quickly and easily be performed in a private practice or on a hospital ward.
Materials and methods
A Pubmed review of current literature on the topic as well as the personal experience and recommendations of the authors are presented. Assessments summarized: clock drawing test, stops walking when talking test, normal walking speed, timed up and go test, regular, as a dual task and imagined.
Results
It is recommended that at least two of the presented assessments should be performed at each clinical visit in all patients age 65 years or older. If one of the assessments presented provides abnormal results, patients should be referred to a gait specialist for an in-depth quantitative gait analysis.
Conclusion
Assessments of functional mobility, fall risk and cognition should be an integral part of every comprehensive geriatric assessment. Quantitative gait analysis allows not only the early detection of gait deficits and fall risk, but also of cognitive deficits. Early detection allows for timely implementation of targeted interventions to improve gait and/or cognition.
Zusammenfassung
Hintergrund
Gang und Kognition sind eng assoziiert. Ältere Erwachsene mit Gangdefiziten haben ein erhöhtes Risiko, kognitive Defizite zu entwickeln. Kognitive Defizite sind mit einer Gangverschlechterung assoziiert. Sowohl Gang- als auch kognitive Beeinträchtigungen sind Sturzrisikofaktoren bei älteren Menschen.
Ziele
1) Die Assoziation zwischen Gang und Kognition, insbesondere Exekutivfunktionen, zu beleuchten, 2) motorisch-kognitive Dual-task-Testparadigmen darzustellen und 3) einen Algorithmus für standardisierte Mobilitätsuntersuchungen zu präsentieren, die sich schnell und einfach in Praxis oder Klinik durchführen lassen.
Material und Methoden
Vorgestellt werden die Ergebnisse einer Sichtung der aktuellen Literatur in PubMed sowie persönliche Erfahrungen und Empfehlungen der Autoren. Zusammengefasste Assessment-Verfahren: Uhrentest, SWWT(„stops walking when talking“)-Test, normale Gehgeschwindigkeit, Timed-up-and-Go-Test (normal, als eine doppelte Aufgabe und imaginär).
Ergebnisse
Empfohlen wird, bei jedem klinischen Besuch mit allen Patienten, die 65 Jahre alt oder älter sind, mindestens 2 der erwähnten Untersuchungen durchzuführen. Falls sich bei mindestens einem Test Auffälligkeiten ergeben, sollten Patienten einem Spezialisten für eine gründliche quantitative Ganganalyse zugewiesen werden.
Diskussion
Untersuchungen zu funktioneller Mobilität, Sturzrisiko und Kognition sollten in jedes umfassende geriatrische Assessment integriert sein. Quantitative Ganganalysen erlauben nicht nur eine Früherkennung von Gangdefiziten und Sturzrisiko, sondern auch von kognitiven Defiziten. Eine Früherkennung ermöglicht den zeitgerechten Einsatz gezielter Interventionen, um Gang und/oder Kognition zu verbessern.
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S.A. Bridenbaugh and R.W. Kressig have no conflicts of interest to declare.
This article is a literature review and does not include studies on humans or animals.
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Bridenbaugh, S., Kressig, R. Motor cognitive dual tasking. Z Gerontol Geriat 48, 15–21 (2015). https://doi.org/10.1007/s00391-014-0845-0
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DOI: https://doi.org/10.1007/s00391-014-0845-0