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J Alzheimers Dis. 2018;64(4):1137-1148. doi: 10.3233/JAD-180016.

Dual-Task Gait and Alzheimer's Disease Genetic Risk in Cognitively Normal Adults: A Pilot Study.

Author information

1
Department of Medicine (Geriatrics), Duke University School of Medicine, Durham, NC, USA.
2
Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA.
3
Durham VA Geriatrics Research Education and Clinical Center (GRECC), Durham, NC, USA.
4
Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University School of Medicine, Durham, NC, USA.
5
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
6
Department of Orthopedic Surgery, Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC, USA.

Abstract

BACKGROUND:

Dual-task paradigms, in which an individual performs tasks separately and then concurrently, often demonstrate that people with neurodegenerative disorders experience more dual-task interference, defined as worse performance in the dual-task condition compared to the single-task condition.

OBJECTIVE:

To examine how gait-cognition dual-task performance differs between cognitively normal older adults with and without an APOE ɛ4 allele.

METHODS:

Twenty-nine individuals ages 60 to 72 with normal cognition completed a dual-task protocol in which walking and cognitive tasks (executive function, memory) were performed separately and concurrently. Fourteen participants carried APOE ɛ4 alleles (ɛ3/ɛ4 or ɛ2/ɛ4); fifteen had APOE genotypes (ɛ2/ɛ2, ɛ2/ɛ3, or ɛ3/ɛ3) associated with lower risk of Alzheimer's disease (AD).

RESULTS:

The two risk groups did not differ by age, sex, race, education, or gait or cognitive measures under single-task conditions. Compared to low risk participants, APOE ɛ4 carriers tended to exhibit greater dual-task interference. Both the memory and executive function tasks resulted in dual-task interference on gait, but effect sizes for a group difference were larger when the cognitive task was executive function. In the dual-task protocol that combined walking and the executive function task, effect sizes for group difference in gait interference were larger (0.62- 0.70) than for cognitive interference (0.45- 0.47).

DISCUSSION:

Dual-task paradigms may reveal subtle changes in brain function in asymptomatic individuals at heightened risk of AD.

KEYWORDS:

Aging brain; cognitive performance; cognitive reserve; dementia; diagnosis; early detection; motor interference; phenotype; risk; stress test

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