Perturbation-based dual task assessment in older adults with mild cognitive impairment.
Lakshmi Kannan, Jessica Pitts, Tony Szturm and 2 others
PMID 38813371WHAT IT FOUND
Older adults with mild cognitive impairment fell more often during reactive balance tests than cognitively intact peers, regardless of whether they performed a simultaneous visual task.
Adding the visual task did not worsen their balance recovery, suggesting they prioritized staying upright over the secondary task.
Key findings
01Participants with mild cognitive impairment had significantly higher fall rates than cognitively intact peers during single-task and dual-task perturbations.
02Performing a visual cognitive task simultaneously with balance recovery did not significantly worsen reactive balance stability or increase falls compared to the balance task alone.
03Both groups showed reduced performance on the visual tracking task during dual-tasking, indicating a trade-off where cognitive accuracy was sacrificed to maintain balance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had a small sample size (15 per group), which may limit the generalizability of the findings. The cognitively intact group was younger on average (though not significantly different) and had higher baseline balance scores, which may confound comparisons. The study focused only on visuomotor and visuospatial cognitive tasks; other domains like working memory or language were not tested under dual-task conditions. Fall risk was assessed in a controlled laboratory setting using a harness, which may not fully replicate real-world environmental complexities.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH grants.
The easy way to misread this
Do not conclude that dual-task training is ineffective for this population. While dual-tasking did not worsen balance *outcomes* compared to single-tasking, the impaired group had significantly worse baseline balance and fall rates. The lack of additional degradation may reflect a ceiling effect of instability or a 'posture first' strategy that masks cognitive deficits, rather than an absence of dual-task interference.