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Functional mobility under cognitive load in fibrosing interstitial lung disease: a motor-cognitive dual-task study
Dacian Mihart1, Alexandru Florian Crișan2,3, Vlad Cărunta3
1Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Background:
Fibrosing interstitial lung diseases (F-ILD) are associated with reduced exercise capacity and functional limitations. Motor-cognitive dual-task performance refers to the ability to perform a mobility task while simultaneously completing a cognitive task, reflecting the motor-cognitive demands of everyday multitasking. Dual-task performance has not been systematically compared between patients with F-ILD and healthy individuals.
Objectives:
To compare motor-cognitive dual-task performance between patients with fibrosing interstitial lung disease and healthy controls, and to examine associations with clinical parameters.
Design:
Cross-sectional comparative study.
Methods:
Forty-five patients with F-ILD and 45 age-matched healthy controls completed the Timed Up and Go (TUG) test under single-task and dual-task (serial subtraction) conditions. Dual-task interference (DTI) was computed as the percentage change from single-task performance. Pulmonary function tests, the six-minute walk distance (6MWT), and the Montreal cognitive assessment (MoCA) were administered. Between-group differences were assessed with the Mann-Whitney U test. Associations were examined using Spearman's correlation and multivariable regression adjusted for age, body mass index, and comorbidity count.
Results:
Compared to controls, patients with F-ILD demonstrated slower TUG dual-task performance (12.35 vs 10.21 s; p = 0.0016), reduced dual-task accuracy (66.7% vs 77.8%; p < 0.001), and increased cognitive interference (36.6% vs 10.9%; p < 0.001). Physical interference was also elevated (p = 0.0328). In ILD patients, a shorter 6MWT distance was associated with longer TUG dual-task time (ρ = -0.42, p = 0.004) and greater cognitive interference (ρ = -0.38, p = 0.009). No correlations were found with FVC, FEV1, or MoCA. After adjusting for confounders, ILD status independently correlated with longer TUG dual-task time (p = 0.029), lower accuracy (p = 0.0003), and increased cognitive DTI (p < 0.001).
Conclusion:
Patients with F-ILD show significant motor and cognitive dual-task impairments compared with healthy controls, partly independent of conventional lung function measures.
Trial Registration:
Not applicable.
