Spatial navigation and dual-task performance in patients with Dementia that present partial dependence in instrumental activity of daily living

Abstract

Background: Instrumental activities of daily living (IADLs) ability impairments are clearly related to cognitive and motor decline, as well as to the progression of Dementia. However, more low-cost assessments are necessary to better understand the process of IADL in patients with Dementia. Objective: To compare cognitive, motor and cognitive-motor performance at different stages of dependence on IADL in patients with Dementia. Methods: Dementia patients (n = 53, age range: 63–94) and healthy older adults (n = 39, age range: 62–97) were included, and those with Dementia were separated into IADL 1 (n = 18), IADL 2 (n = 17), IADL 3 (n = 18). All groups performed cognitive (Trail making test A, semantic verbal fluency, and Stroop test), motor (sit to stand, aerobic steps, and 8-foot up-and-go), and cognitive-motor tests (dual-task, and spatial navigation). One-way ANOVA, Kruskal-Wallis, and Bonferroni post-hoc tests were used to compare groups. Also, an effect size (ES) has been applied to evaluate differences among the dementia groups while the healthy older adults were used as a reference group. Results: Only cognitive-motor and cognitive tests showed significant differences among groups (IADL 1 x IADL 2 x IADL 3). Compared with the healthy group, the ES analysis exposed that patients in different stages of IADL showed the worst performance on tests combining motor and cognitive demand, but not for motor and cognitive function separately. Conclusion: Poor dual-task and spatial navigation abilities are present in partial dependence in IADL, and these tasks should be considered as a functionality screening tool in patients with Dementia.

Keywords

• Alzheimer’s disease
• Mild cognitive impairment
• Cognition
• Mobility
• Dual-task
• Spatial navigation