Dual-task gait and mild behavioral impairment: The interface between non-cognitive dementia markers

Dylan X Guan; Hung-Yu Chen; Richard Camicioli; Manuel Montero-Odasso; Eric E Smith; Zahinoor Ismail

doi:10.1016/j.exger.2022.111743

Dual-task gait and mild behavioral impairment: The interface between non-cognitive dementia markers

Exp Gerontol. 2022 Jun 1:162:111743. doi: 10.1016/j.exger.2022.111743. Epub 2022 Feb 16.

Authors

Dylan X Guan¹, Hung-Yu Chen², Richard Camicioli³, Manuel Montero-Odasso⁴, Eric E Smith⁵, Zahinoor Ismail⁶

Affiliations

¹ University of Toronto, Toronto, ON, Canada.
² University of Calgary, Calgary, AB, Canada.
³ University of Alberta, Edmonton, AB, Canada.
⁴ Schulich School of Medicine& Dentistry, Division of Geriatric Medicine, Western University, London, ON, Canada.
⁵ Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
⁶ Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. Electronic address: ismailz@ucalgary.ca.

PMID: 35182610
DOI: 10.1016/j.exger.2022.111743

Abstract

Background: Mild behavioral impairment (MBI) and dual-task gait cost (DTGC) are two non-cognitive markers of dementia that capture behavioral and motor symptoms. We investigated the relationship between MBI and DTGC in a sample of non-demented older adults.

Methods: This was a cross-sectional observational study of 193 participants (10 cognitively normal, 48 subjective cognitive decline (SCD), 135 mild cognitive impairment (MCI); 52.8% female) from 13 Canadian sites from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. The Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to define MBI severity using a published algorithm. DTGC, the percentage difference between dual-task and preferred walking speeds, was assessed under three cognitive tasks: animal naming, counting backwards, and serial seven subtractions. Associations were tested in the entire cohort and in the MCI subgroup using multivariable linear regression adjusted for age, sex, education, and diagnosis. The role of global cognition, executive function, verbal and working memory in the association were investigated using tests of mediation and moderation.

Results: MBI symptoms were present in 46.6% of participants (mean age = 72.4 years). Greater overall MBI burden was associated with lower gait speed across all conditions. Furthermore, a one-point increase in global MBI symptom severity was associated with a 0.8% increase in DTGC in the animal fluency condition, a 0.9% increase in the counting backwards condition and a 1.1% increase in the serial sevens condition. These associations were strongest in the subgroup of MCI participants. Executive function but not global cognition or verbal and working memory mediated the association between MBI and DTGC in all three conditions.

Conclusions: MBI is associated with gait speed and DTGC in this group of non-demented individuals, independent of the presence or absence of MCI. These findings provide evidence of the relationship between these non-cognitive dementia markers of behavior and gait beyond cognitive impairment.

Keywords: Dementia; Dual-task gait; Mild behavioral impairment; Neuropsychiatric symptoms; Non-cognitive dementia markers.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Canada / epidemiology
Cognitive Dysfunction*
Cross-Sectional Studies
Dementia*
Female
Gait
Humans
Male
Neuropsychological Tests