Abstract
Objective To investigate the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks. Methods This was a cross-sectional study involving 126 subjects divided into three groups: Parkinson group (n = 43), Alzheimer group (n = 38), and control group (n = 45). The subjects were evaluated using the Timed Up and Go test administered with motor and cognitive distracters. Gait analyses consisted of cadence and speed measurements, with cognitive functions being assessed by the Brief Cognitive Screening Battery and the Clock Drawing Test. Statistical procedures included mixed-design analyses of variance to observe the gait patterns between groups and tasks and the linear regression model to investigate the influence of cognitive functions in this process. A 5% significant level was adopted. Results Regarding the subjects’ speed, the data show a significant difference between group vs task interaction (p = 0.009), with worse performance of subjects with PD in motor dual task and of subjects with AD in cognitive dual task. With respect to cadence, no statistical differences was seen between group vs task interaction (p = 0.105), showing low interference of the clinical conditions on such parameter. The linear regression model showed that up to 45.79%, of the variance in gait can be explained by the interference of cognitive processes. Conclusion Dual task activities affect gait pattern in subjects with PD and AD. Differences between groups reflect peculiarities of each disease and show a direct interference of cognitive processes on complex tasks.
Highlights
Humans are bipeds and either move with unipodal support phases, during no contact or remain in orthostatism
In this study we investigated the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks
Cross-sectional analyses revealed a significant difference in age between the Parkinson’s group (PG) and the Alzheimer’s group (AG) (p = 0.003) and between the AG and the control group (CG) (p = 0.001) but not between the PG and the CG (p = 0.845)
Summary
Humans are bipeds and either move with unipodal support phases (deambulation), during no contact (running) or remain in orthostatism. This represents an adaptive challenge to the systems that control balance and reinforces the need of transmission of continuous information regarding the position and movement of the body in space[1,2]. Balance and gait dysfunctions co-exist in healthy older adults[8,9]. This is due to cognitive and mobility decline inherent of aging[10,11]. Recent studies have demonstrated that the influence of superior cortical areas opposes the concept of locomotion as a reflexive automatic task, once the cognitive apparatus interfere constantly on human motricity[8,9,10,11]
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