The relationship between dual-task and cognitive performance among elderly participants who exercise regularly

BACKGROUND: The dual-task performance is associated with the functionality of the elderly and it becomes more complex with age. OBJECTIVE: To investigate the relationship between the Timed Up and Go dual task (TUG-DT) and cognitive tests among elderly participants who exercise regularly. METHOD: This study examined 98 non-institutionalized people over 60 years old who exercised regularly. Participants were assessed using the TUG-DT (i.e. doing the TUG while listing the days of the week in reverse order), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Mini Mental State Examination (MMSE). The motor (i.e. time and number of steps) and cognitive (i.e. number of correct words) data were collected from TUG-DT . We used a significance level of α=0.05 and SPSS 17.0 for all data analyses. RESULTS: This current elderly sample featured a predominance of women (69.4%) who were highly educated (median=10 years of education) compared to Brazilian population and mostly non-fallers (86.7%). The volunteers showed a good performance on the TUG-DT and the other cognitive tests, except the MoCA, with scores below the cutoff of 26 points. Significant and weak correlations were observed between the TUG-DT (time) and the visuo-spatial/executive domain of the MoCA and the MMSE. The cognitive component of the TUG-DT showed strong correlations between the total MoCA performance score and its visuo-spatial/executive domain. CONCLUSIONS: The use of the TUG-DT to assess cognition is promising; however, the use of more challenging cognitive tasks should be considered when the study population has a high level of education. .

Longitudinal cognitive screening study in community-dwelling individuals / Estudo longitudinal de rastreio cognitivo em sujeitos da comunidade

Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression. Objectives: To evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study. Methods: 168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon's test for intra-group comparison, and the Spearman's correlation coefficient test for comparing cognitive and functionality scores. Results: After three years, the Wilcoxon's test showed a discreet yet significant cognitive decline (MMSE: -0.7 points; p=0.02; Z= -2.29; and global score on the BCB: +3.6 points; p=0.02; Z= -2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= -3.38). Conclusions: After three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.

Mudanças cognitivas no envelhecimento normal podem se assemelhar às alterações nos períodos iniciais de um processo demencial. Estudos longitudinais possibilitam um entendimento melhor desta progressão. Objetivos: Avaliar, em um estudo longitudinal de três anos, a evolução cognitiva e funcional de sujeitos sem demência da comunidade. Métodos: Após três anos de uma primeira avaliação de 168 sujeitos, em 2006, 73 sujeitos foram reavaliados em 2009 quanto à cognição e funcionalidade, através do Mini-Exame do Estado Mental (Mini-Mental), Bateria Breve de Rastreio Cognitivo (BBRC) e Questionário de Atividades Instrumentais (Pfeffer). A análise estatística constou de medidas descritivas, teste de Wilcoxon para comparação intragrupo e coeficiente de correlação de Spearman para comparação entre escores cognitivos e de funcionalidade. Resultados: Após três anos, o teste de Wilcoxon evidenciou declínio cognitivo discreto, porém significativo (Mini Mental: -0.7 pontos; p=0.02; Z= -2.29; e escore global da BBRC: +3.6 pontos; p=0.02; Z= -2.29), além de declínio funcional (Peffer: +0.7 pontos; p= 0.001; Z= -3,38). Conclusões: Após três anos de seguimento, observou-se discreto, porém significativo, declínio cognitivo e funcional dos sujeitos. A BBRC e o Mini-Mental mostraram-se eficazes para o screening cognitivo. O seguimento cognitivo longitudinal representa uma estratégia importante para a identificação precoce de possível evolução de uma condição de normalidade para um processo demencial.