Dual task in healthy elderly, depressive and Alzheimer’s disease patients

The assessment of executive function abilities in healthy and neurodegenerative aging-A selective literature review

Numerous studies have examined executive function (EF) abilities in cognitively healthy older adults and those living with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Currently, there are no standard accepted protocols for testing specific EFs; thus, researchers have used their preferred tool, which leads to variability in assessments of decline in a particular ability across studies. Therefore, there is a need for guidance as to the most sensitive tests for assessing EF decline. A search of the most current literature published between 2000 and 2022 on EF studies assessing cognitively healthy older adults and individuals living with MCI and AD was conducted using PubMed/Medline, PsycINFO, Embase, Web of Science, and Google Scholar. Emphasis was placed on the EF's dual-tasking, inhibition, shifting or switching, and working memory updating. Many tasks and their outcomes were reviewed. Of particular importance was the difference in outcomes for tasks applied to the same group of participants. These various EF assessment tools demonstrate differences in effectively identifying decline in EF ability due to the aging process and neurodegenerative conditions, such as MCI and AD. This review identifies various factors to consider in using particular EF tasks in particular populations, including task demand and stimuli factors, and also when comparing differing results across studies.

Dual-Task Performance, Balance and Aerobic Capacity as Predictors of Falls in Older Adults with Cardiovascular Disease: A Comparative Study

Cardiovascular diseases (CVD) are highly prevalent and strongly associated with the risk of falls in the elderly. Falls are associated with impairments in cognition and functional or gait performance; however, little is known about these associations in the elderly population with CVD. In this study, we aimed to clarify the possible associations of physical capacity and functional and cognitive outcomes with the incidence of falls in older adults with CVD. In this comparative study, 72 elderly patients were divided into fallers (n = 24 cases) and non-fallers (n = 48 controls) according to the occurrence of falls within one year. Machine learning techniques were adopted to formulate a classification model and identify the most important variables associated with the risk of falls. Participants with the worst cardiac health classification, older age, the worst cognitive and functional performance, balance and aerobic capacity were prevalent in the case group. The variables of most importance for the machine learning model were VO_2max, dual-task in seconds and the Berg Scale. There was a significant association between cognitive-motor performance and the incidence of falls. Dual-task performance, balance, and aerobic capacity levels were associated with an increased risk of falls, in older adults with CVD, during a year of observation.

Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis

BACKGROUND

Psychomotor retardation has long been recognized as a major feature of depression, and anxiety disorders have been linked with freeze and flight motor responses. This systematic review and meta-analysis aimed a) to synthesize available evidence of motor alterations comparing individuals with depression and anxiety disorders to healthy individuals and b) to evaluate the effect of experimental manipulations of motor displays within these clinical groups.

METHOD

The databases PubMed and PsycINFO were searched for studies either assessing motor differences between clinical and healthy control groups or manipulating the motor system within a clinical group.

RESULTS

The literature search yielded 87 relevant papers, comprising 82 studies comparing a clinical group to a healthy group and 5 studies investigating motor manipulations within a clinical sample. The results of the meta-analysis (K = 71) indicated a statistically significant combined estimate of differences between healthy and clinical groups (g = 0.38 [0.31, 0.45], adjusted for publication bias g = 0.26 [0.19, 0.33]) of a small size. This effect did not vary according to type of disorder (anxiety vs. depression, p = .468). From a narrative review of experimental studies within clinical groups, four out of five studies reported statistically significant effects of manipulating the motor system on affective outcomes.

DISCUSSION

This synthesis adds to the accumulating empirical evidence of motor alterations in depression and anxiety disorders. Future research will need to investigate how individuals suffering from depression or anxiety disorders could benefit from psychological, behavioral, and physical interventions directly aimed at the motor system.

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

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.

The effect of dual-task training on cognition of people with different clinical conditions: An overview of systematic reviews

BACKGROUND

The number of patients with cognitive impairment increases as the population becomes older. This perspective may persist a burden on health care systems unless considered new options of prevention and treatment. The aim of this meta-synthesis is to analyze different systematic reviews on the effectiveness of dual-task training (DTT) on cognition and motor function of different people.

METHODS

A systematic search of systematic reviews published until October 2019 was conducted in PubMed/Medline, Scopus and Cochrane databases addressing studies which investigated the effect of DTT compared to control or other intervention on cognitive functions of healthy or unhealthy individuals. Three steps were followed to retrieve studies: reading title, abstract and full text. Checklist Assessing the Methodological Quality of Systematic Reviews (AMSTAR) was used to assess the quality of selected articles.

RESULTS

In terms of quality of evidence, according to AMSTAR, 62.5 % of the reviews were rated as being "low" and 37.5 % were graded as "moderate" quality. Two main themes were identified among the studies' outcomes: Improvement on mobility performance or postural stability; and beneficial effect on cognitive function. In terms of effect size, there were reported an important variation, having more significant results for findings involving mobility and modest effect for findings regarding cognitive function.

CONCLUSION

People with different clinical conditions could benefit from dual-task training. The benefits may encompass general cognitive functions, memory, physical performance, gait and balance, to name a few aspects.