4.7 Article

Dual-task tests discriminate between dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls - a cross-sectional cohort study

Journal

BMC GERIATRICS
Volume 20, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12877-020-01645-1

Keywords

Dual-task; Dementia; Mild cognitive impairment; Subjective cognitive impairment; Gait

Funding

  1. Swedish Research Council
  2. Alzheimer Foundation Sweden
  3. Swedish Society of Medicine
  4. Promobilia Foundation
  5. Uppsala-Orebro Regional Research Council
  6. County Council of Uppsala
  7. Geriatric Research Foundation
  8. Thureus Fund for Geriatric Research
  9. Commemorative Foundation of Ragnhild & Einar Lundstrom

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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 71years, 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 10s, and number of months per 10s. Logistic regression models examined associations between TUG outcomes pairwise between groups.ResultsThe TUGdt outcomes animals/10s and months/10s 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/10s 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/10s and months/10s, 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.

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