Objective: Evaluating DT situations in Parkinson Disease is helpful since cognitive functions and motor control—both often impaired in PD—are examined at the same time. However, it is unclear if DT gait performance is indicative for cognitive impairment. Therefore, the objective of this study is to find if cognitive deficits are reflected DT costs of spatiotemporal gait parameters using MoCA.

Background: As the Parkinson’s disease progresses the common symptoms like cognitive and gait deficits usually get worse. Motor-cognitive dual tasks (DTs) like (walking while talking) are used to explore the intersecting relation between gait and cognition.

Method: Cognitive function, single task (ST) and DT gait performance were investigated in 80 PD patients. Cognition was assessed by the Montreal Cognitive Assessment (MoCA) followed by a standardized, sensor-based gait test and the identical gait test. PD patients were stratified according to the established MoCA cutoff score <26 (cognitively impaired) and ≥26 (cognitively unimpaired). DT costs in gait parameters [(DT − ST)/ST × 100] were calculated as a measure of DT effect on gait. Correlation analysis was used to evaluate the association between MoCA performance and gait parameters. In a linear regression model, DT gait costs and clinical confounders (age, gender, disease duration, motor impairment, medication, and depression) were correlated to cognitive performance. In a subgroup analysis, we compared matched groups of cognitively impaired and unimpaired PD patients regarding differences in ST, DT, and DT gait costs.

Results: Correlation analysis revealed weak correlations between MoCA score and DT costs of gait parameters. DT costs of stride length, swing time variability, and maximum toe clearance were included in a regression analysis. The parameters only explain 10% of the cognitive variance. In combination with clinical confounders, regression analysis showed that these gait parameters explained 33% of MoCA performance. Group comparison revealed strong DT effects within both groups (large effect sizes), but significant between-group effects in DT gait costs were not observed.

Conclusion: These findings suggest that DT gait performance is not indicative for cognitive impairment in PD. DT effects on gait parameters were substantial in cognitively impaired and unimpaired patients, thereby potentially overlaying the effect of cognitive impairment on DT gait costs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognition-and-gait-in-parkinsons-disease/