Identifying elderly people at risk for cognitive decline by using the 2-step test.
Kohei Maruya, Hiroaki Fujita, Tomoyuki Arai and 4 others
PMID 29410586WHAT IT FOUND
Elderly people with poorer 2-step test results were more likely to have cognitive decline, but many in those groups did not have decline and some with normal results did.
Do not use it alone to identify cognitive decline.
Key findings
01Cognitive decline was present in 13.2% of the Robust group, 38.5% of the <1.3 group, and 41.7% of the <1.1 group.
02In unadjusted comparisons, lower 2-step test groups had slower comfortable walking speed, slower Stroop test times, and lower word frequency, RDST-J, and JST-IC scores.
03After adjustment for age, BMI, walking frequency, and education years, walking speed remained lower in poorer 2-step groups, and memory retention was lower in the <1.3 group than in the Robust group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a cross-sectional study, so it cannot show whether poor 2-step test performance causes cognitive decline or the reverse. Participants were recruited only from a dementia prevention class, so they may not represent all community-dwelling older adults. The sample was relatively small, especially the <1.1 group, which included only 12 participants. The authors reported that the predicting rate of the 2-step test value was low and that caution is needed when using it to distinguish MCI. Several unadjusted cognitive differences were not confirmed after adjustment, and memory retention was significant only in the <1.3 group compared with the Robust group.
The easy way to misread this
Do not treat a poorer 2-step test result as a diagnosis of cognitive decline. The study showed an association, not a causal effect, and many participants with poorer results did not have cognitive decline.