Objective: To evaluate mobility and linguistic metrics during a dual-task (DT) in people with PD and mild cognitive impairment (PD-MCI).

Background: People with PD (PwPD) experience difficulty performing complex mobility tasks such as DT activities. Cognitive impairment has been proposed to impact mobility in PwPD under DT conditions. However, previous work has been limited to simple mobility metrics in cohorts characterized by limited cognitive assessments. We investigated mobility and linguistic measures in single and DT conditions in PD-MCI.

Method: Nine people with PD-MCI diagnosed by MDS Tier II criteria and 20 people with normal cognition (NC, including PD without MCI (n=11) and controls (n=9)), completed the mobility assessment, Timed Up and Go (TUG), in single-task (ST) and DT (concurrent letter-guided verbal fluency tasks) conditions. Inertial measurement units (IMUs) were used to obtain TUG duration, and sit-to-stand and stand-to-sit lean angles. Cognitive-linguistic measures included MoCA, total words listed, and words/second rate. Sign rank tests were used to compare ST and DT variable distributions. Wilcoxon rank-sum tests were used to compare TUG and linguistic measures between groups for ST and DT TUG. Spearman’s correlations were used to assess associations between MoCA and the MDS-UPDRS III with mobility metrics.

Results: The PD-MCI group had fewer correct words on the verbal fluency task compared to the NC group in the DT TUG condition (mean diff=3.3, p=0.02). The DT TUG duration was significantly longer than the ST condition for both groups (p=0.001 for NC, p=0.04 for MCI). The difference in TUG duration between the ST and DT condition was not statistically different between groups. Stand-to-sit lean angle in the DT was significantly smaller in the PD-MCI group compared to NC group (mean difference=7.8s (SE 3.2),p=0.03). Stand-to-sit lean angle was borderline significantly correlated with MoCA but not correlated with UPDRS in the PD-MCI group (rho=0.81, p=0.05).

Conclusion: We identified DT impairments in transition angles in PD-MCI during a DT TUG and verbal fluency tasks. Smaller lean angles have been shown in older adult populations as a compensatory strategy for stability, at the cost of momentum to start walking. Additional larger studies are needed to further establish and understand the impact of PD-MCI on this relevant mobility metric.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-cognitive-impairment-on-mobility-and-linguistic-metrics-during-a-dual-task-in-pd/