Associations between finger-dexterity dual task and neuropsychological tests in middle-aged and older adults

Despite the importance of early cognitive impairment detection, standard screening tools have limitations. Motor-cognitive dual tasks such as the Digital Trail Making Peg Test (DTMP) are feasible objective alternatives. Nonetheless, most studies have focused on older adults, and whether these tasks are associated with cognitive performance in midlife remains unclear. This study investigated associations between DTMP performance and neuropsychological test performance in middle-aged and older adults.

We analyzed 171 middle-aged (54.5 years; female, 61.4%) and 173 older (73.7 years; female, 41.6%) adults from the Tsukuba Happiness Life Study. Finger-dexterity dual-task performance was assessed using DTMP-A, requiring peg insertion in ascending numerical order, and DTMP-B, requiring alternating peg insertion between numbers and hiragana characters. Neuropsychological test performance was assessed using standardized measures of attention, executive function, memory, and language. Associations were examined using age-stratified multiple linear regression models after adjusting for covariates, with supportive domain-level models additionally adjusted for the Digit Symbol Substitution Test (DSST).

In age-stratified models, faster DTMP-B performance was significantly associated with better performance across attention, executive, memory, and language measures in both age groups, with standardized β coefficients ranging in absolute value from 0.22 to 0.64. Compared with DTMP-A, DTMP-B showed a broader and more consistent pattern of associations. In supportive DSST-adjusted models, DTMP-B remained associated with executive, memory, and language domains.

The finger-dexterity dual task, particularly DTMP-B, showed consistent associations with neuropsychological test performance across cognitive domains, suggesting its potential as a practical performance-based indicator in middle-aged and older adults.