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Zhao HY, Zhang ZQ, Huang YH, Li H, Wei FY. Performance of the walking trail making test in older adults with white matter hyperintensities. World J Psychiatry 2024; 14:102-110. [PMID: 38327891 PMCID: PMC10845218 DOI: 10.5498/wjp.v14.i1.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Several studies have reported that the walking trail making test (WTMT) completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments. We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities (WMH). AIM To explore the performance in the WTMT in older people with WMH. METHODS In this single-center, observational study, 25 elderly WMH patients admitted to our hospital from June 2019 to June 2020 served as the WMH group and 20 participants matched for age, gender, and educational level who were undergoing physical examination in our hospital during the same period served as the control group. The participants completed the WTMT-A and WTMT-B to obtain their gait parameters, including WTMT-A completion time, WTMT-B completion time, speed, step length, cadence, and stance phase percent. White matter lesions were scored according to the Fazekas scale. Multiple neuropsychological assessments were carried out to assess cognitive function. The relationships between WTMT performance and cognition and motion in elderly patients with WMH were analyzed by partial Pearson correlation analysis. RESULTS Patients with WMH performed significantly worse on the choice reaction test (CRT) (0.51 ± 0.09 s vs 0.44 ± 0.06 s, P = 0.007), verbal fluency test (VFT, 14.2 ± 2.75 vs 16.65 ± 3.54, P = 0.012), and digit symbol substitution test (16.00 ± 2.75 vs 18.40 ± 3.27, P = 0.010) than participants in the control group. The WMH group also required significantly more time to complete the WTMT-A (93.00 ± 10.76 s vs 70.55 ± 11.28 s, P < 0.001) and WTMT-B (109.72 ± 12.26 s vs 82.85 ± 7.90 s, P < 0.001). WTMT-A completion time was positively correlated with CRT time (r = 0.460, P = 0.001), while WTMT-B completion time was negatively correlated with VFT (r = -0.391, P = 0.008). On the WTMT-A, only speed was found to statistically differ between the WMH and control groups (0.803 ± 0.096 vs 0.975 ± 0.050 m/s, P < 0.001), whereas on the WTMT-B, the WMH group exhibited a significantly lower speed (0.778 ± 0.111 vs 0.970 ± 0.053 m/s, P < 0.001) and cadence (82.600 ± 4.140 vs 85.500 ± 5.020 steps/m, P = 0.039), as well as a higher stance phase percentage (65.061 ± 1.813% vs 63.513 ± 2.465%, P = 0.019) relative to controls. CONCLUSION Older adults with WMH showed obviously poorer WTMT performance. WTMT could be a potential indicator for cognitive and motor deficits in patients with WMH.
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Affiliation(s)
- Hong-Yi Zhao
- Department of Neurology, No. 984 Hospital of PLA, Beijing 100094, China
- Department of Neurology, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - Zhi-Qiang Zhang
- Mental Health Institute of Inner Mongolia Autonomous Region, The Third Hospital of Inner Mongolia Autonomous Region, Hohhot 010010, Inner Mongolia Autonomous Region, China
| | - Yong-Hua Huang
- Department of Neurology, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - Hong Li
- Department of Neurosurgery, No. 984 Hospital of PLA, Beijing 100094, China
| | - Fang-Yuan Wei
- Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
- Engineering Research Center of Chinese Orthopaedic and Sports Rehabilitation Artificial Intelligent, Ministry of Education, Beijing 100029, China
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Kim H, Osuka Y, Kojima N, Sasai H, Nakamura K, Oba C, Sasaki M, Suzuki T. Inverse Association between Cheese Consumption and Lower Cognitive Function in Japanese Community-Dwelling Older Adults Based on a Cross-Sectional Study. Nutrients 2023; 15:3181. [PMID: 37513598 PMCID: PMC10384548 DOI: 10.3390/nu15143181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Diet modification may contribute to the prevention of age-related cognitive decline. The association between dairy product consumption and cognitive function in older people remains unknown. We investigated whether cheese intake is associated with lower cognitive function (LCF) in community-dwelling older adults. This cross-sectional study included 1503 adults aged over 65 years. The analyzed data were obtained through face-to-face interviews and functional ability measurement. Cognitive function was assessed using the mini-mental state examination (MMSE), and a score ≤23 was defined as LCF. The prevalence of LCF was 4.6%, and this group had smaller calf circumference, slower usual walking speed, and a more frequent history of anemia than subjects with MMSE scores >23. After adjusting for confounding factors, logistic regression analysis revealed cheese intake (odds ratio (OR) = 0.404, 95% confidence interval (CI) = 0.198-0.824), age (OR = 1.170, 95% CI = 1.089-1.256), usual walking speed (OR = 0.171, 95% CI = 0.062-0.472) and calf circumference (OR = 0.823, 95% CI = 0.747-0.908) to be significant factors associated with LCF. Although the present study was an analysis of cross-sectional data of Japanese community-dwelling older adults, the results suggest that cheese intake is inversely associated with LCF.
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Affiliation(s)
- Hunkyung Kim
- Gaon Research Center, 402 Pangyo Medical Tower, Seongnam-shi 13466, Republic of Korea
| | - Yosuke Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu 474-8511, Aichi, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi 173-0015, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi 173-0015, Tokyo, Japan
| | - Kentaro Nakamura
- Nutrition and Food Function Research Department, R&D Division, Meiji Co. Ltd., Hachioji 192-0919, Tokyo, Japan
| | - Chisato Oba
- Nutrition and Food Function Research Department, R&D Division, Meiji Co. Ltd., Hachioji 192-0919, Tokyo, Japan
| | - Mayuki Sasaki
- Nutrition and Food Function Research Department, R&D Division, Meiji Co. Ltd., Hachioji 192-0919, Tokyo, Japan
| | - Takao Suzuki
- Institute of Gerontology, J. F. Oberlin University, Machida 194-0294, Tokyo, Japan
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Research progress in the application of motor-cognitive dual task training in rehabilitation of walking function in stroke patients. JOURNAL OF NEURORESTORATOLOGY 2022. [DOI: 10.1016/j.jnrt.2022.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Thiel C, Günther L, Osterhoff A, Sommer S, Grüneberg C. Feasibility of smartphone-supported, combined physical and cognitive activities in the Neighbourhood for stimulating social participation of the elderly. BMC Geriatr 2022; 22:629. [PMID: 35907804 PMCID: PMC9338648 DOI: 10.1186/s12877-022-03303-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Combining smartphone-assisted group activities in the neighbourhood and training in physical and cognitive skills may offer the potential to promote social participation and connectedness of older adults. This non-controlled proof-of-concept, retrospectively registered study aimed to determine the feasibility of such an intervention approach, including its evaluation. Methods In two consecutive six-month intervention cycles, 39 community-dwelling adults were provided with weekly smartphone, physical and cognitive training by two tutors. Using a specifically designed app, the participants were also encouraged to join and later self-organise physically and cognitively stimulating activities related to hot spots in their Bochum neighbourhood. Indicators of feasibility were documented. Results The recruitment and assessments took 3 hours per participant. Excluding smartphone support, the preparation and the implementation of the intervention amounted to nine person-hours per week. Six participants dropped out, and 13 did not complete one or more assessments. The participants attended 76 ± 15% of the weekly training sessions. The instructors deemed the programme feasible, but familiarisation with the smartphone and the app was very time-consuming. Twenty-seven of 29 participants reported high overall satisfaction, and 22 agreed that the programme helped them to establish social contacts. The smartphones attracted substantial interest and were used frequently, despite mixed satisfaction with the project-specific app. From baseline to follow-up, the six-minute walking distance, lower extremity strength and moderate to vigorous physical activity, as well as quality of life, were preserved at a high level, while balance performance was significantly improved. Of the 11 tests related to cognitive functioning, 4 tests (a memory test, the Stroop test and 2 tests of verbal fluency) indicated significant improvement. No moderate or serious adverse events occurred in relation to the assessments or the intervention. Conclusions The multimodal approach seems safe and feasible and offers the potential to promote social connectedness, bonds in the residential neighbourhood and smartphone competency, as well as to preserve or improve physical and cognitive functions. Adaptations of the intervention and of the outcome assessments may contribute to better assessment and exploitation of the potential of this approach in a future study involving socially, physically and cognitively less active elderly persons.
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Affiliation(s)
- Christian Thiel
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany. .,Faculty of Sports Science, Training and Exercise Science, Ruhr-University, Bochum, Germany.
| | - Liane Günther
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Anke Osterhoff
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Speech and Language Therapy Program, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Sascha Sommer
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Speech and Language Therapy Program, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Christian Grüneberg
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany
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Ramírez F, Gutiérrez M. Dual-Task Gait as a Predictive Tool for Cognitive Impairment in Older Adults: A Systematic Review. Front Aging Neurosci 2021; 13:769462. [PMID: 35002676 PMCID: PMC8740025 DOI: 10.3389/fnagi.2021.769462] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/06/2021] [Indexed: 01/21/2023] Open
Abstract
The use of the dual-task model as a cognitive-motor interface has been extensively investigated in cross-sectional studies as a training task in cognitive impairment. However, few existing longitudinal studies prove the usefulness of this tool as a clinical marker of cognitive impairment in older people. What is the evidence in prospective studies about dual-task gait as a predictor of cognitive impairment in older adults? This study aims to review and discuss the current state of knowledge in prospective studies on the use of dual-task gait as a predictive tool for cognitive impairment in older adults. The methodology used was a systematic review, according to the PRISMA criteria for the search, summarize and report. A search in 3 databases (Pubmed, Web of Science, and Scopus) was carried out until April 2021. The search terms used were: "(gait OR walking) AND (cognitive decline) AND (dual-task) AND (follow-up OR longitudinal OR long-term OR prospective OR cohort OR predict)." We included prospective research articles with older people with cognitive evaluation at the beginning and the end of the follow-up and dual-task gait paradigm as initial evaluation associated with the presentation of cognitive impairment prediction using any dual-task gait parameters. After exclusion criteria, 12 studies were reviewed. The results indicate that eight studies consider dual-task gait parameters a useful cognitive-motor tool, finding that some of the evaluated parameters of dual-task gait significantly correlate with cognitive impairment over time. The most promising DT parameters associated with cognitive impairment prediction seem to be gait speed, speed cost, DT time, numbers of words during DT, among others. In sum, this study reviews the variety of dual-task gait parameters and their relevance as a simple tool for early cognitive impairment screening, opening a diagnostic window for the screening of cognitive impairment in older people.
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Affiliation(s)
- Felipe Ramírez
- Programa Magíster en Kinesiología Gerontológica, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Myriam Gutiérrez
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Santiago, Chile
- Centro de Estudio del Movimiento Humano, Escuela de Kinesiología, Facultad de Odontología y Salud, Universidad Diego Portales, Santiago, Chile
- Unidad de Cerebro Saludable, Hospital Clínico Universidad de Chile, Santiago, Chile
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A combined stepping and visual tracking task predicts cognitive decline in older adults better than gait or visual tracking tasks alone: a prospective study. Aging Clin Exp Res 2021; 33:1865-1873. [PMID: 32965610 DOI: 10.1007/s40520-020-01714-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/09/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND It is unclear whether motor-cognitive dual tasks predict cognitive decline better than either motor or cognitive tasks alone. AIMS To examine the utility of the novel motor-cognitive dual-task test [Stepping Trail Making Test (S-TMT)], as a predictor of cognitive decline, and compare its predictive performance with single motor or cognitive tests. METHODS This 2-year population-based prospective study included 626 adults aged ≥ 70 years from Takashimadaira, Itabashi, Tokyo. The S-TMT measured the time taken to step on 16 numbers in order. Gait speed and TMT-A were assessed with standardized methods as single motor and cognitive tasks, respectively. A decline in the Mini-Mental State Examination score by ≥ 3 points over 2 years was defined as a significant cognitive decline. RESULTS Over 2 years, 97 (15.5%) experienced cognitive decline. After adjusting for confounders, binary logistic regression models showed no significant associations between gait speed, TMT-A time tertiles, and risk of cognitive decline, but participants in the longest tertile of S-TMT time were more likely to develop cognitive decline than those of the shortest tertile (odds ratio 2.14; 95% confidence interval 1.17-3.90). Only the addition of the S-TMT time to the covariates model significantly improved the reclassification indices for predicting cognitive decline (net reclassification improvement: 0.31, P < 0.01; integrated discrimination improvement: 0.01, P = 0.02). DISCUSSION AND CONCLUSION Only the S-TMT was significantly associated with cognitive decline and improved reclassification indices, indicating that it is more useful for predicting cognitive decline than individual gait speed or visual tracking tests alone.
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Osuka Y, Kim H, Watanabe Y, Taniguchi Y, Kojima N, Seino S, Kawai H, Sakurai R, Inagaki H, Awata S, Shinkai S. A Stepping Trail Making Test as an Indicator of Cognitive Impairment in Older Adults. J Clin Med 2020; 9:jcm9092835. [PMID: 32887235 PMCID: PMC7563673 DOI: 10.3390/jcm9092835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/27/2022] Open
Abstract
This study aimed to examine the concurrent validity of a novel motor-cognitive dual-task test, the Stepping Trail Making Test (S-TMT), as an indicator of cognitive impairment (CI), and compare its screening performance to that of motor or cognitive tests alone. This was a population-based cross-sectional study including 965 Japanese adults aged ≥ 70 years. To measure the time taken to perform the S-TMT, the participants were instructed to step on 16 numbers in sequence as quickly and accurately as possible. Motor and cognitive functions were assessed by gait speed and TMT part A (TMT-A), respectively. Participants were classified into CI (< 24 points), mild CI (MCI, 24-27 points), and intact cognition (> 27 points) categories based on their Mini-Mental State Examination score. Binary logistic regression models showed that the addition of the S-TMT to the covariates model gave the highest discrimination index (c-statistics), and significantly improved reclassification indices (net reclassification improvement and integrated discrimination improvement) for screening both CI and MCI compared to those of gait speed or TMT-A alone. These results show that S-TMT has a concurrent validity as a dual-task test for screening CI and MCI and better discrimination and reclassification performance than motor or cognitive tests alone in older adults.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (H.K.); (N.K.); (H.I.); (S.A.)
- Correspondence: ; Tel.: +81-3-3964-3241
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (H.K.); (N.K.); (H.I.); (S.A.)
| | - Yutaka Watanabe
- Faculty of Dental Medicine, Hokkaido University, Hokkaido 060-8586, Japan;
| | - Yu Taniguchi
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Ibaraki 305-0053, Japan;
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (H.K.); (N.K.); (H.I.); (S.A.)
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (S.S.); (R.S.)
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan;
| | - Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (S.S.); (R.S.)
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (H.K.); (N.K.); (H.I.); (S.A.)
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (H.K.); (N.K.); (H.I.); (S.A.)
| | - Shoji Shinkai
- Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Saitama 350-0288, Japan;
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