Cognition and dual-task performance in older adults with Parkinson's and Alzheimer's disease

Abstract

Gustavo Christofoletti,1 Larissa Pires de Andrade,2 Fernanda Beinotti,3 Guilherme Borges3 1Federal University of Mato Grosso do Sul, Biological and Health Science Center, Campo Grande, MS, Brazil; 2State University of São Paulo, Bioscience Institute, Rio Claro, SP, Brazil; 3State University of Campinas, Faculty of Medical Sciences, Campinas, SP, Brazil Background: Patients with neurodegenerative diseases usually experience significant functional deficits. Older adults with Parkinson's disease (PD) and Alzheimer's disease (AD) may suffer from both motor and cognitive impairments, making them especially vulnerable to poor dual-task performance. Objective: To analyze the dual-task cost of walking in subjects with PD and AD exposed to motor and cognitive distracters. Methods: A cross-sectional study was conducted involving 126 older adults comprising three groups: PD (n=43), AD (n=38), and control (n=45). The subjects were evaluated using the Timed Up and Go (TUG) test administered with motor and cognitive distracters. Mixed-design analysis of variance (ANOVA) with cognition as a covariant factor was used to test the possible main effects of dual-task on motion. A 5% threshold for significance was set, with a 95% confidence interval (CI). The partial eta square (n2p) analysis was included to estimate the magnitude of effect. Results: Examining the effects for dual-task, ANOVA revealed the main effect for group×task interactions (F=13.09; P=0.001; n2p =0.178), for task (F=8.186; P=0.001; n2p =0.063) but not for group (F=2.954; P=0.056; n2p =0.047). Cognition applied as a covariant factor indicated interference on dual-tasks (F=30.43; P=0.001; n2p =0.201). Conclusion: The findings of this study suggest that dual-task interference is a particularly noticeable problem in PD and AD, affecting subjects' ability to appropriately adapt to environmental challenges. Keywords: Parkinson's disease, Alzheimer's disease, motion, task performance and analysis, cognition