Objective: We investigated whether cognition and daily-life mobility are associated in people with mild-to-moderate Parkinson’s disease (PD).

Background: PD is responsible for more mobility disability and cognitive disability than most other neurological diseases. It is increasingly recognized that gait and turning are not pure motor tasks, but that cognition is also essential for safe mobility during daily life. In fact, recent laboratory studies are revealing important relationships between cognition and mobility in people with PD.

Method: A total of 48 individuals with idiopathic PD (age= 69.8 years, disease duration: 7.7, SD:5.8) participated in the study. Cognitive testing was performed with a Tablet-based Cognitive Assessment Tool (TabCAT) tests on an IPAD, developed by UCSF Memory and Aging Center. Specifically, visuospatial function was assessed with a Line Orientation task and executive function was assessed with a Set-Shifting task as well as Flankers task. At home, subjects were instructed to wear two instrumented socks with inertial sensors embedded, on each foot, and a sensor on the waist for a week of continuous monitoring. We analyzed measures of gait and turning quantity and quality.

Results: All participants were able to complete the TabCAT cognitive assessment and the week of home monitoring with an average of 7.2 (SD:1.05) days of recording and an average of 63.3 (SD:12.5) hours. Executive function was significantly associated with average gait, but not turning, metrics during daily life. Better set-shifting ability was associated with multiple domains of gait including faster gait speed (rho=0.32, p=0.03), larger angle at heel-strike (rho=0.29, p=0.04), shorter double-support time (rho=-0.39, p=0.005), shorter stride duration (rho=-0.32, p=0.03), and faster cadence (rho=0.29, p=0.05). Visuospatial function was not significantly associated with any gait or turning measures, and no association was present between quantity of gait and turning and cognitive function.

Conclusion: Our preliminary findings support a relation between executive function and multiple domains of gait during daily life. Specifically, better performance in set-shifting, the component of executive function related to cognitive flexibility, was related to better gait performance in daily life suggesting the importance of successfully shifting back and forth between multiple tasks for safe gait in daily life in people with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-cognitive-function-related-to-daily-life-gait-and-turning-in-people-with-parkinsons-disease/