Dividing attention during the Timed Up and Go enhances associations of several subtask performances with MCI and cognition

Victoria N. Poole*, Robert J. Dawe, Melissa Lamar, Michael Esterman, Lisa Barnes, Sue E. Leurgans, David A. Bennett, Jeffrey M. Hausdorff, Aron S. Buchman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We tested the hypothesis that dividing attention would strengthen the ability to detect mild cognitive impairment (MCI) and specific cognitive abilities from Timed Up and Go (TUG) performance in the community setting. While wearing a belt-worn sensor, 757 dementiafree older adults completed TUG during two conditions, with and without a concurrent verbal serial subtraction task. We segmented TUG into its four subtasks (i.e., walking, turning, and two postural transitions), and extracted 18 measures that were summarized into nine validated sensor metrics. Participants also underwent a detailed cognitive assessment during the same visit. We then employed a series of regression models to determine the combinations of subtask sensor metrics most strongly associated with MCI and specific cognitive abilities for each condition. We also compared subtask performances with and without dividing attention to determine whether the costs of divided attention were associated with cognition. While slower TUG walking and turning were associated with higher odds of MCI under normal conditions, these and other subtask associations became more strongly linked to MCI when TUG was performed under divided attention. Walking and turns were also most strongly associated with executive function and attention, particularly under divided attention. These differential associations with cognition were mirrored by performance costs. However, since several TUG subtasks were more strongly associated with MCI and cognitive abilities when performed under divided attention, future work is needed to determine how instrumented dual-task TUG testing can more accurately estimate risk for late-life cognitive impairment in older adults.

Original languageEnglish
Article numbere0269398
JournalPLoS ONE
Volume17
Issue number8 August
DOIs
StatePublished - Aug 2022

Funding

FundersFunder number
National Institute on AgingK25AG061254

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