WALKING WHILE TALKING AND RISK OF INCIDENT DEMENTIA

BACKGROUND & OBJECTIVE

In today’s busy society it seems that everyone is attempting to dual/multi-task. However, research has identified that dual-tasking results in deterioration in the quality of task performance. As individual’s age and/or develop a cognitive impairment, the level of task deterioration increases. Part of this is secondary to decreased executive function which is the primary cognitive component involved in dual tasking. Additionally, they may have poor task prioritization, resulting in prioritization of the cognitive task over the gait and/or balance task. The other part is difficulty with primary motor tasks such as decreased postural control and/or gait deviations.

To examine an individual’s ability to dual task, a highly reliable and validated test, such as Walking While Talking (WWT) test, can be used. During this test the participants are asked to walk and recite alternate letters of the alphabet, a skill that is linked to executive function. Limitations identified during the WWT test is indicative of executive dysfunction, a prominent and early feature of non-Alzheimer Disease (AD) dementias. To further analyze this relationship the authors of this study examined if performance on WWT can predict incidents of all-cause dementia.

METHODS

Subjects: Individuals without severe auditory/visual loss, inability to ambulate, or institutionalized were recruited from the Bronx County Population list.

Baseline Assessment: In addition to the WWT, the following gait variables were examined: gait speed, cadence, step length, swing percent, stance percent, double limb support percent, step time variability, and swing time variability. The gait evaluation was completed using GAITRite.

Follow-Up Cognitive Assessment: Verbal IQ estimates, vocabulary assessment, and the Free and Cued Selective Reminding Test were completed by Neuropsychologists every 12-18 months. Dementia diagnosed was initially screened for by experts who attended a consensus case and was then confirmed by diagnosis neuroimaging and other laboratory tests as indicated to subtype the dementia.

RESULTS

This prospective cohort study identified that neither gait speed (p=0.39) nor gait rhythm (p=0.74) were associated with increased risk of developing dementia. When examining all gait variables together it was identified that a one unit increase in gait variability during

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