Department of Geriatric Research, Bethanien-Krankenhaus/Geriatric Centre at the University of Heidelberg, Heidelberg, Germany.
Neurology. 2010 Jun 15;74(24):1961-8. doi: 10.1212/WNL.0b013e3181e39696. Epub 2010 May 5.
Deficits in attention-related cognitive performance measured as dual-task performance represent early markers of dementia and are associated with motor deficits and increased risk of falling. The purpose of this study was to examine the effect of a specific dual-task training in patients with mild to moderate dementia.
Sixty-one geriatric patients with confirmed dementia took part in a 12-week randomized, controlled trial. Subjects in the intervention group (IG) underwent dual-task-based exercise training. The control group (CG) performed unspecific low-intensity exercise. Motor performance (gait speed, cadence, stride length, stride time, single support) and cognitive performance (serial 2 forward calculation [S2], serial 3 backward calculation [S3]) were examined as single and dual tasks. Decrease in performance during dual tasks compared to single task expressed as motor, cognitive, and combined motor/cognitive dual-task cost (DTC) was calculated before and after intervention. Primary outcome was defined as DTC for gait speed under complex S3 conditions.
Specific training significantly improved dual-task performance under complex S3 conditions compared to the CG (reduction of DTC: gait speed 21.7% IG, 2.6% CG, p < 0.001; other gait variables: 8.7% to 41.1% IG, -0.9% to 8.1% CG, p <or= 0.001 to 0.056; combined motor/cognitive: 20.6% IG, 2.2% CG, p = 0.026). No significant effects were found under less challenging dual-task S2 conditions or for cognitive dual-task S3 performance.
The specific exercise program was effective to improve dual-task performance in patients with dementia.
This study provides Class II evidence that specific dual-task training improves dual-task performance during walking under complex S3 conditions in geriatric patients with mild to moderate dementia.
注意力相关认知表现的双重任务表现缺陷代表了痴呆的早期标志物，与运动缺陷和跌倒风险增加有关。本研究的目的是检验轻度至中度痴呆患者的特定双重任务训练的效果。
61 名经确诊患有痴呆的老年患者参加了一项为期 12 周的随机对照试验。干预组（IG）接受基于双重任务的运动训练，对照组（CG）进行非特异性低强度运动。以单任务和双重任务的方式检测运动表现（步态速度、步频、步长、步时、单支撑）和认知表现（连续 2 向前计算[ S2 ]、连续 3 向后计算[ S3 ]）。在干预前后，通过计算与单任务相比，双重任务中的表现下降（表示为运动、认知和综合运动/认知双重任务成本[ DTC ]）来评估双重任务表现。主要结果定义为复杂 S3 条件下步态速度的 DTC。
与 CG 相比，特定训练显著改善了复杂 S3 条件下的双重任务表现（DTC 降低：步态速度 21.7%IG，2.6%CG，p<0.001；其他步态变量：8.7%至 41.1%IG，-0.9%至 8.1%CG，p<0.001 至 0.056；综合运动/认知：20.6%IG，2.2%CG，p=0.026）。在挑战性较小的双重任务 S2 条件下或认知双重任务 S3 表现下，未发现显著效果。
特定的运动方案能有效改善痴呆患者的双重任务表现。
本研究提供了 II 级证据，表明特定的双重任务训练可改善轻度至中度痴呆老年患者在复杂 S3 条件下行走时的双重任务表现。
