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      Dual-Task Performance and Neurodegeneration: Correlations Between Timed Up-and-Go Dual-Task Test Outcomes and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers

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          Abstract

          Background:

          Tools to identify individuals at preclinical stages of dementia disorders are needed to enable early interventions. Alterations in dual-task performance have been detected early in progressive neurodegenerative disorders. Hence, dual-task testing may have the potential to screen for cognitive impairment caused by neurodegeneration. Exploring correlations between dual-task performance and biomarkers of neurodegeneration is therefore of interest.

          Objective:

          To investigate correlations between Timed Up-and-Go dual-task (TUGdt) outcomes and Alzheimer’s disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-β 42 (Aβ 42), total tau (t-tau), and phosphorylated tau (p-tau).

          Methods:

          This cross-sectional cohort study included 90 participants (age range 49–84 years) undergoing memory assessment, who were subsequently diagnosed with AD, other dementia disorders, mild cognitive impairment, or subjective cognitive impairment. TUG combined with “Naming Animals” (TUGdt NA) and “Months Backwards” (TUGdt MB), respectively, were used to assess dual-task performance. The number of correct words and time taken to complete the tests were measured. The CSF biomarkers were analysed by ELISA. Spearman’s rank correlation was used for analyses between TUGdt outcomes (TUGdt NA and TUGdt MB), and CSF biomarkers, adjusted for age, gender, and educational level.

          Results:

          The number of correct words, as well as the number of correct words/10 s during TUGdt NA correlated negatively to CSF t-tau and p-tau. No correlations were found between any time scores and CSF biomarkers.

          Conclusion:

          The correlations between TUGdt NA and t-tau and p-tau may indicate that neurodegeneration affects dual-task performance. Longitudinal studies are needed to further explore dual-task testing in screening for cognitive impairment due to neurodegeneration.

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          Most cited references35

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          The role of executive function and attention in gait.

          Until recently, gait was generally viewed as a largely automated motor task, requiring minimal higher-level cognitive input. Increasing evidence, however, links alterations in executive function and attention to gait disturbances. This review discusses the role of executive function and attention in healthy walking and gait disorders while summarizing the relevant, recent literature. We describe the variety of gait disorders that may be associated with different aspects of executive function, and discuss the changes occurring in executive function as a result of aging and disease as well the potential impact of these changes on gait. The attentional demands of gait are often tested using dual tasking methodologies. Relevant studies in healthy adults and patients are presented, as are the possible mechanisms responsible for the deterioration of gait during dual tasking. Lastly, we suggest how assessments of executive function and attention could be applied in the clinical setting as part of the process of identifying and understanding gait disorders and fall risk. 2007 Movement Disorder Society
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            "Stops walking when talking" as a predictor of falls in elderly people.

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              • Article: not found

              The Impact of Mild Cognitive Impairment on Gait and Balance: A Systematic Review and Meta-Analysis of Studies Using Instrumented Assessment.

              In addition to cognitive deficits, people with mild cognitive impairment (MCI) can experience motor dysfunction, including deficits in gait and balance. Objective, instrumented motor performance assessment may allow the detection of subtle MCI-related motor deficits, allowing early diagnosis and intervention. Motor assessment under dual-task conditions may increase diagnostic accuracy; however, the sensitivity of different cognitive tasks is unclear.
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                Author and article information

                Journal
                J Alzheimers Dis
                J. Alzheimers Dis
                JAD
                Journal of Alzheimer's Disease
                IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )
                1387-2877
                1875-8908
                16 May 2019
                19 September 2019
                2019
                : 71
                : Suppl 1 , Gait Disorders in Alzheimer’s Disease and Other Dementias
                : S75-S83
                Affiliations
                [a ]Department of Public Health and Caring Sciences, Geriatrics, Uppsala University , Sweden
                [b ]Department of Geriatric and Rehabilitation Medicine, Falu Lasarett, Falun, Sweden
                [c ]School of Education, Health and Social Studies, Dalarna University , Falun, Sweden
                [d ]Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Sweden
                Author notes
                [* ]Correspondence to: Hanna Bozkurt Åhman, Uppsala University, Department of Public Health and Caring Sciences, Box 564, SE-75122, Sweden. Tel.: +46 729 234 096; E-mail: hanna.bozkurt.ahman@ 123456pubcare.uu.se .
                Article
                JAD181265
                10.3233/JAD-181265
                6839487
                31104024
                d52fef1d-1cd5-43eb-8d15-0ceb8f2e99ef
                © 2019 – IOS Press and the authors. All rights reserved

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 April 2019
                Categories
                Research Article

                alzheimer’s disease,attention,biomarkers,cerebrospinal fluid,dementia,executive function,gait,mild cognitive impairment,subjective cognitive impairment

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