Effect of dual task on balance in older adults with mild cognitive impairment

• Main Authors: Kedkanok Srimaloon, Patima Silsupadol, Somporn Sungkarat
• Format: Article
• Language: English
• Published: Chaing Mai University 2017-09-01
• Series: Journal of Associated Medical Sciences
• Subjects: Mild cognitive impairment; balance; dual task
• Online Access: https://www.tci-thaijo.org/index.php/bulletinAMS/article/view/88188
• ISSN: 2539-6056; 2539-6056

Background: Balance impairment is an important risk factor for falls and is associated with cognitive impairment. However, it is inconclusive whether older adults with mild cognitive impairment (MCI) have impaired balance. This may be due to the balance tests commonly used in clinical settings are not physically and/or cognitively challenged enough to identify balance impairment in this population. Objective: The aim of this study was to compare the balance ability between older adults with and without mild cognitive impairment (MCI and non–MCI) under different balance tests during single and dual task conditions. Materials and methods: Twenty one older adults with MCI (mean age 71.43±1.17 years) and 21 older adults with non-MCI (mean age 69.38±1.04 years) participated. Both groups were similar in gender, age, and education level. Postural sway while standing were measured using Lord’s sway meter under 4 conditions: 1) stand on firm surface with eyes open 2) stand on firm surface with eyes closed 3) stand on foam surface with eyes open 4) stand on foam surface with eyes closed. Timed Up and Go (TUG) and Tandem walk test at fastest speed was also administered to the participants. All balance tests were randomly administered under single (balance test only) and dual (balance test in concurrent with naming test) task. Outcome measures were sway area, time taken to complete TUG and Tandem, and error of tandem walk (% of total steps). Mixed model repeated measures ANOVAs were used to determine the difference of each outcome measure between groups and tasks. Significant level was set at p≤0.05. Results: For postural sway while standing, there was a significant group × condition × task interaction of sway area (p=0.03). Post hoc analysis (Bonferroni adjustment) identified a significant larger sway area in older adults with MCI compared to non-MCI while standing on firm surface with eyes closed under single task condition and standing on foam surface with eyes closed under dual task condition (p=0.02 and 0.03, respectively). Significant group × task interaction was found for TUG times (p=0.04). Post hoc analysis (Bonferroni adjustment) identified significant longer time taken to complete TUG in older adults with MCI compared to non-MCI for both single and dual tasks (p=0.04 and 0.01 respectively). There were no significant main effects of group, task, or group x task interaction of any outcome measures for Tandem walk test (p>0.05). Conclusion: Findings from this study suggest that older adults with MCI had balance impairment compared to controls. However, relative physically and/or cognitively challenged balance tests (e.g. having older adults with MCI perform secondary task while evaluating their balance) are required to reveal balance impairment, an important risk factor for falls. Journal of Associated Medical Sciences 2017; 50(3): 605-616