Abstract
BackgroundDiscrimination between early-stage dementia and other cognitive impairment diagnoses is central to enable appropriate interventions. Previous studies indicate that dual-task testing may be useful in such differentiation. The objective of this study was to investigate whether dual-task test outcomes discriminate between groups of individuals with dementia disorder, mild cognitive impairment, subjective cognitive impairment, and healthy controls.MethodsA total of 464 individuals (mean age 71 years, 47% women) were included in the study, of which 298 were patients undergoing memory assessment and 166 were cognitively healthy controls. Patients were grouped according to the diagnosis received: dementia disorder, mild cognitive impairment, or subjective cognitive impairment. Data collection included participants’ demographic characteristics. The patients’ cognitive test results and diagnoses were collected from their medical records. Healthy controls underwent the same cognitive tests as the patients. The mobility test Timed Up-and-Go (TUG single-task) and two dual-task tests including TUG (TUGdt) were carried out: TUGdt naming animals and TUGdt months backwards. The outcomes registered were: time scores for TUG single-task and both TUGdt tests, TUGdt costs (relative time difference between TUG single-task and TUGdt), number of different animals named, number of months recited in correct order, number of animals per 10 s, and number of months per 10 s. Logistic regression models examined associations between TUG outcomes pairwise between groups.ResultsThe TUGdt outcomes “animals/10 s” and “months/10 s” discriminated significantly (p < 0.001) between individuals with an early-stage dementia diagnosis, mild cognitive impairment, subjective cognitive impairment, and healthy controls. The TUGdt outcome “animals/10 s” showed an odds ratio of 3.3 (95% confidence interval 2.0–5.4) for the groups dementia disorders vs. mild cognitive impairment. TUGdt cost outcomes, however, did not discriminate between any of the groups.ConclusionsThe novel TUGdt outcomes “words per time unit”, i.e. “animals/10 s” and “months/10 s”, demonstrate high levels of discrimination between all investigated groups. Thus, the TUGdt tests in the current study could be useful as complementary tools in diagnostic assessments. Future studies will be focused on the predictive value of TUGdt outcomes concerning dementia risk for individuals with mild cognitive impairment or subjective cognitive impairment.
Highlights
Dementia disorders are the leading cause of disability and dependency among older adults [1], and as the proportion of older adults in the population increases, so does the global prevalence of dementia disorders [2]
Future studies will be focused on the predictive value of TUG dual-task (TUGdt) outcomes concerning dementia risk for individuals with mild cognitive impairment or subjective cognitive impairment
Our results show that the TUGdt test outcomes “animals/ 10 s” and “months/10 s” demonstrated a high level of discrimination between dementia disorders, Mild cognitive impairment (MCI), subjective cognitive impairment (SCI), and healthy controls
Summary
Dementia disorders are the leading cause of disability and dependency among older adults [1], and as the proportion of older adults in the population increases, so does the global prevalence of dementia disorders [2]. Mild cognitive impairment (MCI), which signifies a decline in cognitive function beyond typical aging but without having an impact on functional activities [4], and subjective cognitive impairment (SCI), which involves only a subjective reduction of cognitive function [5], are possible early manifestations of dementia disorders [5, 6]. Non-invasive and less time-consuming methods that can enhance discrimination between these diagnoses have been called for [9]. Such methods could be useful either as frontline screening tools or as diagnostic tools aimed at facilitating early and potentially more effective interventions. The objective of this study was to investigate whether dual-task test outcomes discriminate between groups of individuals with dementia disorder, mild cognitive impairment, subjective cognitive impairment, and healthy controls
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