Association between the cost of dual-task and cognitive function in older people with Motoric Cognitive Risk Syndrome: a cross-sectional study

Authors

DOI:

https://doi.org/10.17267/2238-2704rpf.2025.e6367

Keywords:

Cognition, Dementia, Frailty, Risk Factors

Abstract

INTRODUCTION: Dual-task mobility tests are considered more sensitive than single-task assessments for detecting early cognitive impairment in older adults. However, their association with cognitive performance in individuals with Motoric Cognitive Risk syndrome (MCR) has not been well established. OBJECTIVE: To investigate the relationship between the cost of dual-task testing in the Timed Up and Go (TUG) test with different cognitive demands and cognitive function in older individuals with MCR. METHODOLOGY: Fifty-nine older individuals with MCR were included (89.8% women; mean age: 70 years). The cost of dual-task testing was assessed in two conditions: TUG with counting backwards and TUG with animal naming. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test Part A (TMT-A), Digit Span, and Verbal Fluency tests. Multiple linear regressions, adjusted for age, sex, and education, were conducted. RESULTS: The dual-task cost of the TUG with counting backwards correlated positively with performance in attention and processing speed (TMT-A; r = 0.52; β = 0.17 [0.05 to 0.29]) and negatively with global cognitive performance (MoCA; r = -0.48; β = -1.18 [-2.22 to -0.11]). The TUG with animal naming showed no significant associations with cognitive tests. CONCLUSION: The dual-task cost during the TUG with counting backwards was moderately associated with attention, processing speed, and global cognition in older adults with MCR. No significant associations were observed for the TUG with animal naming. These findings highlight that the type of cognitive demand used in dual-task testing may influence the degree of motor-cognitive interference.

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References

1. Verghese J, Annweiler C, Ayers E, Barzilai N, Beauchet O, Bennett DA, et al. Motoric cognitive risk syndrome: Multicountry prevalence and dementia risk. Neurology. 2014;83(8):718-26. https://doi.org/10.1212/WNL.0000000000000717

2. Xu W, Bai A, Liang Y, Lin Z. Motoric Cognitive Risk Syndrome and the Risk of Incident Dementia: A Systematic Review and Meta-Analysis of Cohort Studies. Gerontology. 2024;70(5):479–90. https://doi.org/10.1159/000535082

3. Callisaya ML, Ayers E, Barzilai N, Ferrucci L, Guralnik JM, Lipton RB, et al. Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study. J Alzheimers Dis. 2016;53(3):1043-52. https://doi.org/10.3233/JAD-160230

4. Cullen S, Montero-Odasso M, Bherer L, Almeida Q, Fraser S, Muir-Hunter S, et al. Guidelines for gait assessments in the canadian consortium on neurodegeneration in aging (CCNA). Can Geriatr J. 2018;21(2):157-65. https://doi.org/10.5770/cgj.21.298

5. Springer S, Giladi N, Peretz C, Yogev G, Simon ES, Hausdorff JM. Dual-tasking effects on gait variability: the role of aging, falls, and executive function. Mov Disord. 2006;21(7):950-7. https://doi.org/10.1002/mds.20848

6. Verghese J, Wang C, Bennett DA, Lipton RB, Katz MJ, Ayers E. Motoric cognitive risk syndrome and predictors of transition to dementia: A multicenter study. Alzheimer's Dement. 2019;15(7):870-7. https://doi.org/10.1016/j.jalz.2019.03.011

7. Montero-Odasso MM, Sarquis-Adamson Y, Speechley M, Borrie MJ, Hachinski VC, Wells J, et al. Association of dual-task gait with incident dementia in mild cognitive impairment: Results from the gait and brain study. JAMA Neurol. 2017;74(7):857-65. https://doi.org/10.1001/jamaneurol.2017.0643

8. Ward N, Menta A, Peach S, White SA, Jaffe S, Kowaleski C, et al. Cognitive Motor Dual Task Costs in Older Adults with Motoric Cognitive Risk Syndrome. J Frailty Aging. 2021;10(4):337-42. https://doi.org/10.14283/jfa.2021.27

9. Udina C, Ayers E, Inzitari M, Verghese J. Walking while Talking and Prefrontal Oxygenation in Motoric Cognitive Risk Syndrome: Clinical and Pathophysiological Aspects. J Alzheimers Dis. 2021;84(4):1585-96. https://doi.org/10.3233/JAD-210239

10. Montero-Odasso M, Camicioli R. Falls and Cognition in Older Persons. Cham: Springer; 2020. https://doi.org/10.1007/978-3-030-24233-6

11. Bishnoi A, Hernandez ME. Dual task walking costs in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health. 2021;25(9):1618-29. https://doi.org/10.1080/13607863.2020.1802576

12. Åberg AC, Larsson LE, Giedraitis V, Berglund L, Halvorsen K. Dual-Task Interference of Gait Parameters During Different Conditions of the Timed Up-and-Go Test Performed by Community-Dwelling Older Adults. J Aging Phys Act. 2023;31(5):823-32. https://doi.org/10.1123/japa.2022-0304

13. Vance RC, Healy DG, Galvin R, French HP. Dual tasking with the timed "up & go" test improves detection of risk of falls in people with Parkinson disease. Phys Ther. 2015;95(1):95-102. https://doi.org/10.2522/ptj.20130386

14. Herman T, Giladi N, Hausdorff JM. Properties of the ‘Timed Up and Go’ Test: More than Meets the Eye. Gerontology. 2011;57(3):203-10. https://doi.org/10.1159/000314963

15. Almeida OP, Almeida SA. CReliability of the Brazilian version of the geriatric depression scale (GDS) short form. Arq Neuropsiquiatr. 1999;57(2-B):421-6. https://doi.org/10.1590/S0004-282X1999000300013

16. Beauchet O, Sekhon H, Launay CP, Rolland Y, Schott AM, Allali G. Motoric cognitive risk syndrome and incident dementia: results from a population-based prospective and observational cohort study. Eur J Neurol. 2020;27(3):468-74. https://doi.org/10.1111/ene.14093

17. Pérez AC, Román PÁL, Jiménez MM, Zurita ML, Aguilera JAL, Montilla JAP, et al. Is the Xiaomi Mi Band 4 an Accuracy Tool for Measuring Health-Related Parameters in Adults and Older People? An Original Validation Study. Int J Environ Res Public Health. 2022;19(3):1593. https://doi.org/10.3390/ijerph19031593

18. Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, Bourdeaudhuij I, et al. How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011;8(1):80. https://doi.org/10.1186/1479-5868-8-80

19. Podsiadlo D, Richardson S. The Timed ”Up & Go”: A Test of Basic Functional Mobility for Frail Elderlv Persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

20. Hittmair-delazer M, Semenza C, Denes G. Concepts and facts in calculation. Brain. 1994;117(4):715-28. https://doi.org/10.1093/brain/117.4.715

21. Memória CM, Yassuda MS, Nakano EY, Forlenza OV. Brief screening for mild cognitive impairment: validation of the Brazilian version of the Montreal cognitive assessment. Int J Geriatr Psychiatry. 2013;28(1):34-40. https://doi.org/10.1002/gps.3787

22. Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, et al. Subjective cognitive decline, mild cognitive impairment, and dementia: syndromic approach: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol. 2022;16(3 suppl. 1):1-24. https://doi.org/10.1590/1980-5764-dn-2022-s101pt

23. Strauss E, Sherman EMS, Spreen O. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 3rd ed. Oxford: Oxford University Press; 2006.

24. Wechsler D. WAIS-R: Manual: Wechsler adult intelligence scale-revised. San Antonio, TX: Psychological Corporation; 1981.

25. Whiteside DM, Kealey T, Semla M, Luu H, Rice L, Basso MR, et al. Verbal Fluency: Language or Executive Function Measure? Appl Neuropsychol Adult. 2016;23(1):29-34. https://doi.org/10.1080/23279095.2015.1004574

26. Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 79.

27. Weiss EM, Siedentopf C, Hofer A, Deisenhammer EA, Hoptman MJ, Kremser C, et al. Brain activation pattern during a verbal fluency test in healthy male and female volunteers: a functional magnetic resonance imaging study. Neurosci Lett. 2003;352(3):191-4. https://doi.org/10.1016/j.neulet.2003.08.071

28. Åhman HB, Berglund L, Cedervall Y, Kilander L, Giedraitis V, McKee KJ, et al. Dual-Task Tests Predict Conversion to Dementia—A Prospective Memory-Clinic-Based Cohort Study. Int J Environ Res Public Health. 2020;17(21):8129. https://doi.org/10.3390/ijerph17218129

29. Cedervall Y, Stenberg AM, Åhman HB, Giedraitis V, Tinmark F, Berglund L, et al. Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function: A Mixed Methods Observational Study for Development of the UDDGait Protocol. Int J Environ Res Public Health. 2020;17(5):1715. https://doi.org/10.3390/ijerph17051715

30. Ali P, Renaud P, Montero-Odasso M, Gautier J, Dinomais M, Annweiler C. Gait performance in older adults across the cognitive spectrum: Results from the GAIT cohort. J Am Geriatr Soc. 2024;72(11):3437-47. https://doi.org/10.1111/jgs.19162

31. Ansai JH, Andrade LP, Nakagawa TH, Vale FAC, Caetano MJD, Lord SR, et al. Cognitive Correlates of Timed Up and Go Subtasks in Older People With Preserved Cognition, Mild Cognitive Impairment, and Alzheimer’s Disease. Am J Phys Med Rehabil. 2017;96(10):700-5. https://doi.org/10.1097/PHM.0000000000000722

32. Donoghue OA, Horgan NF, Savva GM, Cronin H, O’Regan C, Kenny RA. Association Between Timed Up-and-Go and Memory, Executive Function, and Processing Speed. J Am Geriatr Soc. 2012;60(9):1681-6. https://doi.org/10.1111/j.1532-5415.2012.04120.x

33. Menon V. Developmental cognitive neuroscience of arithmetic: implications for learning and education. ZDM. 2010;42(6):515-25. https://doi.org/10.1007/s11858-010-0242-0

34. Fehr T, Code C, Herrmann M. Common brain regions underlying different arithmetic operations as revealed by conjunct fMRI-BOLD activation. Brain Res. 2007;1172(1):93-102. https://doi.org/10.1016/j.brainres.2007.07.043

35. Beauchet O, Dubost V, Gonthier R, Kressig RW. Dual-task-related gait changes in transitionally frail older adults: The type of the walking-associated cognitive task matters. Gerontology. 2005;51(1):48-52. https://doi.org/10.1159/000081435

36. Muir SW, Gopaul K, Odasso MMM. The role of cognitive impairment in fall risk among older adults: A systematic review and meta-analysis. Age Ageing. 2012;41(3):299-308. https://doi.org/10.1093/ageing/afs012

37. Tomas-Carus P, Rosado H, Pereira C, Marmeleira J, Veiga G, Collado-Mateo D. Differences between two types of dual tasks according to the educational level in older adults. Arch Gerontol Geriatr. 2020;91:104216. https://doi.org/10.1016/j.archger.2020.104216

38. Hofheinz M, Mibs M. The Prognostic Validity of the Timed Up and Go Test With a Dual Task for Predicting the Risk of Falls in the Elderly. Gerontol Geriatr Med. 2016;2:e233372141663779. https://doi.org/10.1177/2333721416637798

Published

12/15/2025

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Original Articles

How to Cite

1.
Batista G de A, Calixtre LB, Cavalcante BR, Silva JD de A, Amaral KMS, Gonçalves RL da S, et al. Association between the cost of dual-task and cognitive function in older people with Motoric Cognitive Risk Syndrome: a cross-sectional study. Rev Pesq Fisio [Internet]. 2025 Dec. 15 [cited 2025 Dec. 16];15:e6367. Available from: https://www5.bahiana.edu.br/index.php/fisioterapia/article/view/6367