Tasks matter

A cross-sectional study of the relationship of cognition and dual-task performance in older adults

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Dual-task (DT) performance, the ability to divide one's attention between motor and secondary tasks, is required in daily life. Adults with cognitive impairment (CI) experience more difficulty with DTs than healthy older adults, but it is unclear how the degree of CI relates to DT performance, particularly with tasks of varying levels of difficulty. Purpose: The purposes of this cross-sectional study were to (1) explore the relationship between cognitive level and DT performance and (2) determine how the difficulty of the combined tasks impacts this relationship. Methods: Twenty-three older adults with Mini-Mental State Examination (MMSE) scores ranging from 7 to 30 performed 2 single tasks (ST): the Timed Up and Go (TUG) and a 6-m walk for which self-selected walking speed (SSWS) was calculated. Each ST was repeated under 2 DT conditions: counting forward by 1's (TUG1 and SSWS1) and counting backward by 3's (TUG3 and SSWS3). Dual-task cost (DTC) was calculated for each DT as follows: [(difference between DT and ST motor performance)/ST motor performance] = 100. Spearman rank correlation coefficients were used to determine the relationship between DTC and the MMSE. The Friedman 2-way ANOVA on ranks was used to compare the magnitude of DTC among the 4 DTs. Results: Significant correlations between the MMSE and DTC were found for SSWS3, TUG1, and TUG3 (r = 0.43-0.57). SSWS1 had a weaker and nonsignificant correlation between MMSE and DTC (r = 0.36). The TUG3 was the most difficult DT, while the SSWS1 was the easiest DT. All participants, regardless of MMSE score, were able to engage in all DTs. Discussion and Conclusions: A linear relationship exists between cognition and DTC in older adults with varying cognitive levels. The strength of this relationship is greater for more challenging tasks. We also suggest that patients with CI may be able to engage in more challenging tasks than might be assumed. The impact of task difficulty has implications in the design of future studies of DT training for individuals both with and without CI.

Original languageEnglish (US)
Pages (from-to)115-122
Number of pages8
JournalJournal of Geriatric Physical Therapy
Volume36
Issue number3
DOIs
StatePublished - Jul 1 2013

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Task Performance and Analysis
Cognition
Cross-Sectional Studies
Costs and Cost Analysis
Aptitude
Nonparametric Statistics
Analysis of Variance
Cognitive Dysfunction

Keywords

  • Cognitive impairment
  • Dual task cost
  • Self-selected walking speed
  • Timed up and go

ASJC Scopus subject areas

  • Rehabilitation
  • Geriatrics and Gerontology

Cite this

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title = "Tasks matter: A cross-sectional study of the relationship of cognition and dual-task performance in older adults",
abstract = "Background: Dual-task (DT) performance, the ability to divide one's attention between motor and secondary tasks, is required in daily life. Adults with cognitive impairment (CI) experience more difficulty with DTs than healthy older adults, but it is unclear how the degree of CI relates to DT performance, particularly with tasks of varying levels of difficulty. Purpose: The purposes of this cross-sectional study were to (1) explore the relationship between cognitive level and DT performance and (2) determine how the difficulty of the combined tasks impacts this relationship. Methods: Twenty-three older adults with Mini-Mental State Examination (MMSE) scores ranging from 7 to 30 performed 2 single tasks (ST): the Timed Up and Go (TUG) and a 6-m walk for which self-selected walking speed (SSWS) was calculated. Each ST was repeated under 2 DT conditions: counting forward by 1's (TUG1 and SSWS1) and counting backward by 3's (TUG3 and SSWS3). Dual-task cost (DTC) was calculated for each DT as follows: [(difference between DT and ST motor performance)/ST motor performance] = 100. Spearman rank correlation coefficients were used to determine the relationship between DTC and the MMSE. The Friedman 2-way ANOVA on ranks was used to compare the magnitude of DTC among the 4 DTs. Results: Significant correlations between the MMSE and DTC were found for SSWS3, TUG1, and TUG3 (r = 0.43-0.57). SSWS1 had a weaker and nonsignificant correlation between MMSE and DTC (r = 0.36). The TUG3 was the most difficult DT, while the SSWS1 was the easiest DT. All participants, regardless of MMSE score, were able to engage in all DTs. Discussion and Conclusions: A linear relationship exists between cognition and DTC in older adults with varying cognitive levels. The strength of this relationship is greater for more challenging tasks. We also suggest that patients with CI may be able to engage in more challenging tasks than might be assumed. The impact of task difficulty has implications in the design of future studies of DT training for individuals both with and without CI.",
keywords = "Cognitive impairment, Dual task cost, Self-selected walking speed, Timed up and go",
author = "Dawn Venema and Emily Bartels and Siu, {Joseph Ka-Chun}",
year = "2013",
month = "7",
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doi = "10.1519/JPT.0b013e31827bc36f",
language = "English (US)",
volume = "36",
pages = "115--122",
journal = "Journal of Geriatric Physical Therapy",
issn = "1539-8412",
publisher = "Lippincott Williams and Wilkins",
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T1 - Tasks matter

T2 - A cross-sectional study of the relationship of cognition and dual-task performance in older adults

AU - Venema, Dawn

AU - Bartels, Emily

AU - Siu, Joseph Ka-Chun

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background: Dual-task (DT) performance, the ability to divide one's attention between motor and secondary tasks, is required in daily life. Adults with cognitive impairment (CI) experience more difficulty with DTs than healthy older adults, but it is unclear how the degree of CI relates to DT performance, particularly with tasks of varying levels of difficulty. Purpose: The purposes of this cross-sectional study were to (1) explore the relationship between cognitive level and DT performance and (2) determine how the difficulty of the combined tasks impacts this relationship. Methods: Twenty-three older adults with Mini-Mental State Examination (MMSE) scores ranging from 7 to 30 performed 2 single tasks (ST): the Timed Up and Go (TUG) and a 6-m walk for which self-selected walking speed (SSWS) was calculated. Each ST was repeated under 2 DT conditions: counting forward by 1's (TUG1 and SSWS1) and counting backward by 3's (TUG3 and SSWS3). Dual-task cost (DTC) was calculated for each DT as follows: [(difference between DT and ST motor performance)/ST motor performance] = 100. Spearman rank correlation coefficients were used to determine the relationship between DTC and the MMSE. The Friedman 2-way ANOVA on ranks was used to compare the magnitude of DTC among the 4 DTs. Results: Significant correlations between the MMSE and DTC were found for SSWS3, TUG1, and TUG3 (r = 0.43-0.57). SSWS1 had a weaker and nonsignificant correlation between MMSE and DTC (r = 0.36). The TUG3 was the most difficult DT, while the SSWS1 was the easiest DT. All participants, regardless of MMSE score, were able to engage in all DTs. Discussion and Conclusions: A linear relationship exists between cognition and DTC in older adults with varying cognitive levels. The strength of this relationship is greater for more challenging tasks. We also suggest that patients with CI may be able to engage in more challenging tasks than might be assumed. The impact of task difficulty has implications in the design of future studies of DT training for individuals both with and without CI.

AB - Background: Dual-task (DT) performance, the ability to divide one's attention between motor and secondary tasks, is required in daily life. Adults with cognitive impairment (CI) experience more difficulty with DTs than healthy older adults, but it is unclear how the degree of CI relates to DT performance, particularly with tasks of varying levels of difficulty. Purpose: The purposes of this cross-sectional study were to (1) explore the relationship between cognitive level and DT performance and (2) determine how the difficulty of the combined tasks impacts this relationship. Methods: Twenty-three older adults with Mini-Mental State Examination (MMSE) scores ranging from 7 to 30 performed 2 single tasks (ST): the Timed Up and Go (TUG) and a 6-m walk for which self-selected walking speed (SSWS) was calculated. Each ST was repeated under 2 DT conditions: counting forward by 1's (TUG1 and SSWS1) and counting backward by 3's (TUG3 and SSWS3). Dual-task cost (DTC) was calculated for each DT as follows: [(difference between DT and ST motor performance)/ST motor performance] = 100. Spearman rank correlation coefficients were used to determine the relationship between DTC and the MMSE. The Friedman 2-way ANOVA on ranks was used to compare the magnitude of DTC among the 4 DTs. Results: Significant correlations between the MMSE and DTC were found for SSWS3, TUG1, and TUG3 (r = 0.43-0.57). SSWS1 had a weaker and nonsignificant correlation between MMSE and DTC (r = 0.36). The TUG3 was the most difficult DT, while the SSWS1 was the easiest DT. All participants, regardless of MMSE score, were able to engage in all DTs. Discussion and Conclusions: A linear relationship exists between cognition and DTC in older adults with varying cognitive levels. The strength of this relationship is greater for more challenging tasks. We also suggest that patients with CI may be able to engage in more challenging tasks than might be assumed. The impact of task difficulty has implications in the design of future studies of DT training for individuals both with and without CI.

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