title: Do frailty and cognitive impairment affect dual-task cost during walking in the oldest old institutionalized patients?
abstract: The objective of this study was to investigate dual-task costs in several elderly populations, including robust oldest old, frail oldest old with MCI, frail oldest old without MCI, and frail elderly with dementia. Sixty-four elderly men and women categorized into frail without MCI (age 93.4 ± 3.2 years, n = 20), frail with MCI (age 92.4 ± 4.2 years, n = 13), robust (age 88.2 ± 4.1 years, n = 10), and patients with dementia (age 88.1 ± 5.1 years, n = 21). Five-meter gait ability and timed-up-and-go (TUG) tests with single and dual-task performance were assessed in the groups. Dual-task cost in both 5-m habitual gait velocity test and TUG test was calculated by the time differences between single and dual-task performance. The robust group exhibited better 5-m gait and TUG test performances in the single and dual-task conditions compared with the other three groups (P < 0.001), and the frail and frail + MCI groups exhibited better performances than the dementia group (P < 0.001). No significant differences were observed between the frail and frail + MCI groups. However, all groups exhibited lower gait velocities in the verbal and arithmetic task conditions, but the dual-task cost of the groups were similar. Robust individuals exhibited superior single and dual-task walking performances than the other three groups, and the frail and frail + MCI individuals exhibited performances that were superior to those of the patients with dementia. However, the dual-task costs, i.e., the changes in gait performance when elderly participants switch from a single to a dual task, were similar among all four of the investigated groups. Therefore, these results demonstrated that the magnitude of the impairment in gait pattern is independent of frailty and cognitive impairment status.
authors.affiliation: Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Cadore
authors.affiliation: Division of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Casas-Herrero
authors.affiliation: Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain.
authors.forename: Fabricio
authors.initials: F
authors.lastname: Zambom-Ferraresi
authors.affiliation: Mathematics Department, Public University of Navarra, Navarre, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Martínez-Ramírez
authors.affiliation: Mathematics Department, Public University of Navarra, Navarre, Spain.
authors.forename: Nora
authors.initials: N
authors.lastname: Millor
authors.affiliation: Mathematics Department, Public University of Navarra, Navarre, Spain.
authors.forename: Marisol
authors.initials: M
authors.lastname: Gómez
authors.affiliation: Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain.
authors.forename: Ana B Bays
authors.initials: AB
authors.lastname: Moneo
authors.affiliation: Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain. mikel.izquierdo@gmail.com.
authors.forename: Mikel
authors.initials: M
authors.lastname: Izquierdo
mesh_terms: D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D005260:Female; D016330:Frail Elderly; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D015577:Geriatric Assessment; D006801:Humans; D007326:Institutionalization; D008297:Male; D009483:Neuropsychological Tests; D013647:Task Performance and Analysis
keywords: Cognitive impairment; Dementia; Dual-task walking; Frailty; Oldest old