Desempenho da dupla tarefa em idosos com comprometimento cognitivo leve e doença de Alzheimer: um estudo longitudinal

Abstract

Background: Motor performance in older adults with cognitive impairment is worse under dual-task conditions, increasing the risk of falls. However, the trajectory of behavior over time in the dual task (TD) in elderly people without cognitive impairment, with mild cognitive impairment (MCI) and Alzheimer's disease (AD) is still debatable. Objectives: To compare, over time, the performance of an isolated and dual task in elderly people with cognitive preservation, MCI and mild AD. Methods: This is a longitudinal study data collection at two evaluation times (M1) and after 32 months (M2). Of these, 51 participated in the assessment at M2 (22 elderly people with cognitive preservation, 19 with MCI and 10 with mild AD. As variables of cognitive and motor performance were analyzed in three situations: (1) isolated motor task - Timed up and go test (TUGT); (2) isolated cognitive test – dialing numbers on a phone; (3) dual-task - associating the previous two. To compare the performance of dual-task between groups delta (Δ = M2-M1) was calculated and the ANCOVA test was applied considering age as a confounding variable. Results: The cost of the dual task was not significantly different over time in any group analyzed. On the other hand, elderly people with AD showed significant differences in time (p <0.00) and in cadence (p = 0.01) in isolated motor task and in time (p = 0.02) in the number of steps (p <0.00) and cadence (p <0.00) in dual task. Conclusion: The group of elderly people with AD had a significant impact on their dual-task performance, differently from the elderly with MCI and with cognitive preservation. It is assumed that a special look will be given to interventions that contemplate the dual task as an alternative to non-pharmacological exercise for these elderly people. In addition, that dual task assessments, especially involving more functional tasks, such as walking and talking on the phone, in elderly people with AD, can be considered in physical therapy assessment protocols. In addition, the performance of the dual task does not seem to interfere with motor performance over time in elderly in prodromal stages, such as MCI and in with cognitive preservation.