Abstract
Objectives1) To measure and compare the time required to perform (pTUG) and the time required to imagine (iTUG) the Timed Up & Go (TUG), and the time difference between these two tasks (i.e., TUG delta time) in older adults with cognitive decline (i.e., mild cognitive impairment (MCI) and mild-to-moderate Alzheimer disease and related disorders (ADRD)) and in cognitively healthy individuals (CHI); and 2) to examine any association between the TUG delta time and a cognitive status.MethodsSixty-six participants (24 CHI, 23 individuals with MCI, and 19 individuals with ADRD) were recruited in this cross-sectional study. The mean and standard deviation of the pTUG and iTUG completion times and the TUG delta time, as well as age, gender, and Mini-Mental State Examination (MMSE) scores were used as outcomes. Participants were separated into three groups based on the tertilization of TUG delta time: lowest (<13.6%; n = 22; best performance), intermediate (13.6-52.2%; n = 22), and highest tertile (>52.2%; n = 22, worst performance).ResultsFewer CHI were in the group exhibiting the highest tertile of TUG delta time compared to individuals with lowest and intermediate TUG delta times (p = 0.013). Being in the highest tertile of the TUG delta time was associated with cognitive decline in the unadjusted model (p = 0.012 for MCI, and p = 0.021 for mild-to-moderate ADRD). In the multivariate models, this association remained significant only for individuals with MCI (p = 0.019 while adjusting for age and gender; p = 0.047 while adjusting for age, gender, and MMSE score; p = 0.012 for the stepwise backward model).ConclusionsOur results provide the first evidence that motor imagery of gait may be used as a biomarker of MCI in older adults.
Highlights
There is growing evidence that cognitive decline results in the deterioration of gait patterns [1,2,3]
Adjusted models showed that this association remained significant only with the mild cognitive impairment (MCI) status (p = 0.019 while adjusting for age and gender; p = 0.047 for the fully adjusted model; p = 0.012 for the stepwise backward model)
The Mini-Mental State Examination (MMSE) score was associated with the highest tertile of TUG delta time in the stepwise backward logistic regression (p = 0.009)
Summary
There is growing evidence that cognitive decline results in the deterioration of gait patterns [1,2,3] Though it is commonly associated with the later stages of dementia, a decline in gait performance may be detected much earlier. If a clear link can be established between spatio-temporal gait parameters and the motor disorders of early-stage dementia, an alternative, noninvasive biomarker could be implemented. Such a biomarker could be more assessed in clinical practice and could serve to improve the prediction accuracy of these screening procedures, those related to AD [10]
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