Dataset Information

The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old.

ABSTRACT: Introduction: Dual tasking is common in activities of daily living (ADLs) and the ability to perform them usually declines with age. While cognitive aspects influence dual task (DT) performance, most DT-cost (DT-C) related metrics include only time- or speed- delta without weighting the accuracy of cognitive replies involved in the task. Objectives: The primary study goal was to weight the accuracy of cognitive replies as a contributing factor when estimating DT-C using a new index of DT-C that considers the accuracy of cognitive replies (P-index) in the instrumented timed up and go test (iTUG). Secondarily, to correlate the novel P-index with domains of the Mini-Mental State Examination (MMSE). Methods: Sixty-three participants (≥85 years old) took part in this study. The single task (ST) and DT iTUG tests were performed in a semi-random order. Both the time taken to complete the task measured utilizing an inertial measurement unit (IMU), and the accuracy of the cognitive replies were used to create the novel P-index. Clinical and sociodemographic data were collected. Results: The accuracy of the cognitive replies changed across the iTUG phases, particularly between the walk 1 and walk 2 phases. Moreover, weighting 0.6 for delta-time (W₁) and 0.4 for cognitive replies (W₂) into the P-index enhanced the prediction of the MMSE score. The novel P-index was able to explain 37% of the scores obtained by the fallers in the "spatial orientation" and "attention" domains of the MMSE. The ability of the P-index to predict MMSE scores was not significantly influenced by age, schooling, and number of medicines in use. The Bland-Altman analysis indicated a substantial difference between the time-delta-based DT-C and P-index methods, which was within the limits of agreement. Conclusions: The P-index incorporates the accuracy of cognitive replies when calculating the DT-C and better reflects the variance of the MMSE in comparison with the traditional time- or speed-delta approaches, thus providing an improved method to estimate the DT-C.

SUBMITTER: Brauner FO

PROVIDER: S-EPMC8514992 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old.

Brauner Fabiane Oliveira FO Balbinot Gustavo G Figueiredo Anelise Ineu AI Hausen Daiane Oliveira DO Schiavo Aniuska A Mestriner Régis Gemerasca RG

Frontiers in human neuroscience 20210930

<b>Introduction:</b> Dual tasking is common in activities of daily living (ADLs) and the ability to perform them usually declines with age. While cognitive aspects influence dual task (DT) performance, most DT-cost (DT-C) related metrics include only time- or speed- delta without weighting the accuracy of cognitive replies involved in the task. <b>Objectives:</b> The primary study goal was to weight the accuracy of cognitive replies as a contributing factor when estimating DT-C using a new index ...[more]

PMID: 34658817

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Project description:Background:Simple, easy-to-perform, safe and cost-effective methods for the prediction of adverse outcomes in older adults are essential for the identification of patients who are most likely to benefit from early preventive interventions. Methods:The study included 160 community-dwelling individuals aged 60-74 years, with 44.4% women. A comprehensive geriatric assessment was performed in all participants. Bioimpedance body composition analysis included 149 subjects. Among other tests, functional assessment included the Barthel Index of Activities of Daily Living (Barthel Index), Mini-Mental State Examination (MMSE), Timed Up and Go (TUG) and Fried frailty phenotype. Follow-up by telephone was made after at least 365 days. The composite endpoint (CE) included fall, hospitalization, institutionalization and death. Results:Cohort characteristics: age 66.8±4.2 years (mean±SD), 3.81±2.23 diseases, 4.29±3.60 medications or supplements, and good functional status (MMSE 29.0±1.5, Barthel Index 98.1±8.2, prevalence of Fried frailty phenotype 2.5%). During one-year follow-up, 34 subjects (21.3%; 95% confidence interval [CI] =14.9-27.6%) experienced CE: hospitalizations (13.8%; 95% CI=8.41-19.1), falls (9.38%; 95% CI=4.86-13.9), death (0.63%; 95% CI=0-1.85) and no institutionalization. A higher probability of CE was associated with age ?70 years (P=0.018), taking any medication or supplements (P=0.007), usual pace gait speed ?0.8 m/s (P=0.028) and TUG >9 s (P<0.002). TUG was the only independent measure predicting one-year CE occurrence (OR=1.22, 95% CI=1.07-1.40, P=0.003) in multivariate logistic regression. However, its predictive power was poor; the area under the receiver operating characteristic curve was 0.659 (95% CI 0.551-0.766, P=0.004) and Youden's J statistic for a TUG cut-off of 9.0 s was 0.261 (sensitivity 0.618 and specificity 0.643). Conclusion:The TUG test was superior to frailty phenotype measures in predicting one-year incidence of a CE consisting of fall, hospitalization, institutionalization and death in a cohort of healthy-aging community-dwelling early-old adults, although its value as a stand-alone test was limited.

Project description:BackgroundDual-task walking is used as a treatment, for gait assessment, and as an outcome measure in Parkinson's disease (PD). Movement smoothness, i.e. its non-intermittency, is a movement cardinal feature. This study assesses whether dual-tasking reduces gait smoothness in PD alongside reducing speed, one of its well-known effects.MethodsThe Timed Up and Go (TUG) test, instrumented with an inertial sensor fixed to the back, was administered to 33 PD patients (15 females; age: median = 71 years; IQR = 10) to assess two walking types: straight-walking and turning-while-walking. The TUG test was completed in single-task and two dual-task modalities: cognitive (doing successive subtractions) and motor (holding a water glass). The angular speed spectral arc length metric (SPARC) and the Ln-DimensionLess Jerk (LDLJ), two smoothness measures quantifying the peaks and dips in the speed profile, were measured, along with the trunk angular velocity and the foot strikes number. ANOVA was used for hypothesis testing and estimated marginal means for post-hoc tests and effect sizes (ES).ResultsIn straight-walking and turning, cognitive and motor dual tasks decreased gait speed (ES range = [0.476, 1.379]; p < 0.01) and increased the step number (ES = [0.402, 0.927]; p < 0.05). SPARC (ES = [0.221, 0.493]; p < 0.05) and angular LDLJ (ES = [0.451, 0.929]; p < 0.01) were lower in the two dual-task conditions in both phases, indicating reduced gait smoothness than in single-task. This worsening of gait smoothness was partially confirmed after ruling out the dual-task effect on speed and step number. In particular, anterior-posterior SPARC during turning was still low in cognitive (ES = 0.351; p < 0.01) and motor (ES = 0.283; p < 0.05) dual tasks.ConclusionsIn PD, dual-tasking decreases gait speed and increases the step number when walking straight and turning while walking. Independently of these effects, dual-tasking also reduces gait smoothness. As an independent feature of movement, when dual-task walking is the outcome measure, improving smoothness may represent a novel treatment aim in PD. As long as it is instrumented with an inertial sensor, the TUG test is valuable for studying different walking types.Trial registrationNCT05904171 (ClinicalTrials.gov; date registration: 2023-06-06).

Dataset Information

The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old.

Publications

The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old.

Similar Datasets

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