The Effects of Cognitive Load on Gait in Dementia of the Alzheimer's Type: A Longitudinal Study
As dementia grows at an increasingly faster rate around the world, it has become imperative to identify its symptoms at an early stage. Dementia of the Alzheimer’s type (DAT) mainly disrupts cognitive functioning, but behavioral changes such as slow walking also occur. In an aging world with a growi...
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Format: | Others |
Language: | English English |
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Florida State University
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Online Access: | http://purl.flvc.org/fsu/fd/2018_Su_Oh_fsu_0071E_14612 |
Summary: | As dementia grows at an increasingly faster rate around the world, it has become imperative to identify its symptoms at an early stage. Dementia of the Alzheimer’s type (DAT) mainly disrupts cognitive functioning, but behavioral changes such as slow walking also occur. In an aging world with a growing dementia population, early identification has come to play an important role in the management and treatment of the disease. A simultaneous assessment of the behavioral and cognitive changes is recommended to be used to assist with early identification of dementia. A dual task of walking and talking is especially practical to identify early signs of dementia since individuals usually walk while doing something else such as talking on the phone or with another person. This study was an investigation into longitudinal changes in gait under different levels of cognitive load conditions: 1) the baseline condition was defined as normal walking with no simultaneous cognitive load, 2) the low cognitive load condition was defined as walking and counting numbers from a random number assigned, and finally 3) the high cognitive load condition was defined as walking and simultaneously completing a categorical naming task (generating as many words in a specific category as possible). Fourteen individuals with a mean age of 78 years who in the early (mild or moderate) stage of DAT (Mean DRS-2 score = 88.14, SD = 12.6) participated. For the walking task, the GAITRite© Portable Walkway system incorporating a 580-cm mat with embedded sensors to measure spatiotemporal parameters of gait and the accompanying software was employed. Once a month over a one-year period, participants walked across the GAITRite© Walkway mat. The gait analyses included Functional Ambulation Profile (FAP), stride length (SL), velocity, and double support time (DST). To more precisely examine the effects of concurrent cognitive load, participants completed the low and high cognitive load tasks while seated. Values in FAP, SL, and velocity decreased as tasks became more complex and as the disease progressed, while DST increased at the same rate. The comparison of walking and seated conditions indicated that participants’ performance on both number-counting and categorical naming tasks was poorer when they were walking rather than when they were seated. The results imply effectiveness of gait assessment during multitasking conditions for early diagnosis of DAT. Identifying DAT at an earlier stage is beneficial for the person with the disease, family members and caregivers, as well as health professionals. In this regard, the findings of this current investigation may establish a bridgehead for advances in the early identification of DAT. === A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. === Summer Semester 2018. === May 15, 2018. === Cognitive Load, Dementia, Early Identification, Gait === Includes bibliographical references. === Richard J. Morris, Professor Co-Directing Dissertation; Leonard L. LaPointe, Professor Co-Directing Dissertation; Colleen M. Kelley, University Representative; Katlin L. Lansford, Committee Member; Charles G. Maitland, Committee Member. |
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