Upper-Extremity Dual-Task Function: An Innovative Method to Assess Cognitive Impairment in Older Adults

Area of Science:

• Gerontology
• Neuroscience
• Biomedical Engineering

Background:

• Dual-tasking challenges are linked to cognitive decline in older adults.
• Gait tests are common for dual-tasking but impractical for some older adults.
• An upper-extremity function (UEF) test is explored as an alternative motor task for dual-task assessments.

Purpose of the Study:

• To assess the efficacy of an upper-extremity function (UEF) test for evaluating dual-task performance in older adults.
• To compare UEF and gait parameters between cognitively impaired and healthy older adults during dual-tasking.
• To investigate the correlation between UEF and gait performance in dual-task scenarios.

Main Methods:

• Older adults (≥65 years) performed single- and dual-task upper-extremity (elbow flexion) and gait tests.
• Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA).
• Three-dimensional kinematics of upper-extremity and lower-extremity were measured using wearable sensors.

Main Results:

• Cognitively impaired older adults exhibited significantly reduced arm flexion speed and range of motion during dual-tasking.
• The cognitively impaired group also showed higher arm speed variability in the dual-task condition.
• UEF speed parameters significantly correlated with gait stride velocity during dual-tasking and dual-task cost.

Conclusions:

• A novel, brief (20-second) upper-extremity function (UEF) test effectively assesses dual-task performance in older adults.
• UEF parameters (speed, range of motion, speed variability) are significantly associated with cognitive status (MoCA scores).
• The UEF test demonstrates significant links to gait performance within a dual-task context, offering a practical alternative.