Motor cognitive dual tasking: early detection of gait impairment, fall risk and cognitive decline

Gait and cognition are closely associated. Older adults with gait deficits have an increased risk of developing cognitive deficits and cognitive deficits are associated with worsened gait. Both gait and cognitive impairments are risk factors for falls in older adults.

The aims of this article are (1) to highlight the association between gait and cognition, particularly executive function, (2) to present motor cognitive dual tasking test paradigms and (3) to provide an algorithm for standardized mobility tests that can quickly and easily be performed in a private practice or on a hospital ward.

A Pubmed review of current literature on the topic as well as the personal experience and recommendations of the authors are presented. Assessments summarized: clock drawing test, stops walking when talking test, normal walking speed, timed up and go test, regular, as a dual task and imagined.

It is recommended that at least two of the presented assessments should be performed at each clinical visit in all patients age 65 years or older. If one of the assessments presented provides abnormal results, patients should be referred to a gait specialist for an in-depth quantitative gait analysis.

Assessments of functional mobility, fall risk and cognition should be an integral part of every comprehensive geriatric assessment. Quantitative gait analysis allows not only the early detection of gait deficits and fall risk, but also of cognitive deficits. Early detection allows for timely implementation of targeted interventions to improve gait and/or cognition.