Dual-task, single challenge: functionality as an early marker of cognitive decline

Early detection of possible cognitive decline (PwCD) is crucial for preserving function and independence in aging.

To examine whether dual-task and functional assessment tools can help detect cognitive impairment in older adults without prior diagnosis of neurocognitive disorders.

A cross-sectional study was conducted with healthy older adults (≥60 years). The following exclusion criteria were adopted: neurological diseases with motor deficits, severe functional limitations, mobility aid use, and inability to walk six meters unaided. Assessments included the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Drawing Test (CDT), Verbal Fluency (VF), Pfeffer Functional Activities Questionnaire, Timed Up and Go (TUG), Sit-to-Stand Test (STS), Berg Balance Scale (BBS), Step Test, and dual-task TUG (TUGdt) using animal naming (TUGdt-NA) and serial subtraction (TUGdt-S7). Statistical analyses included t-tests, Mann-Whitney U, ꭓ² tests, and logistic regression (p≤0.05).

Among 144 participants, 89 were classified as healthy and 55 as PwCD. Most were female (90.9%), black (57.7%), with an average of 11.04 years of education. Groups did not differ in age, gender, or comorbidities. The PwCD group had lower education (p=0.01), more black individuals (p=0.03), and scored significantly worse on all cognitive tests (p<0.0001) and TUGdt (NA: p=0.040; S7: time p=0.027; accuracy p<0.001). No differences were found in STS, Step Test, BBS, or total Pfeffer scores; however, the PwCD group showed greater instrumental activities of daily living (IADL) impairment.

The ability to perform dual tasks appears to be associated with functional capacity.