The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Dual-Task Training Effect on Cognitive and Body Function, β-amyloid Levels in Alzheimer's Dementia Patients: A Randomized Controlled Trial

  • Received : 2021.05.14
  • Accepted : 2021.06.03
  • Published : 2021.06.30
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Abstract

Purpose: Dementia is a disease in which cognitive function declines, leading to deterioration of body functions and activities of daily living. The purpose of this study is to explore the effects of dual-task training, including cognitive tasks, on cognitive and body function and β-amyloid levels in Alzheimer's dementia patients. Methods: 34 inpatients diagnosed with Alzheimer's dementia at a nursing hospital located in South Korea. The patients were randomly divided into a dual-task group (n=16) and a single-task group (n=18). Each group was trained for 30 minutes three times a week for eight weeks. The MMSE-K was used to measure the patients' cognitive function. To assess the patients' static balance ability, their LOS was measured using BioRescue. while dynamic balance was measured using the BBS. The 10MWT were conducted to evaluate the patients' walking ability. Blood analysis was performed to measure levels of β-amyloid. Results: Both groups exhibited statistically significant improvements in gait function after the training (p<0.05). The dual-task group exhibited statistically significant differences in cognitive function, static and dynamic balance function, and β-amyloid levels after training (p<0.05). A significant difference was observed between the two groups (p<0.05). Conclusion: Dual-task training were found to be effective in improving cognitive and bodily functioning and reducing β-amyloid levels in Alzheimer's dementia patients. Thus, this may be suggested as an effective exercise method for the treatment and early prevention of Alzheimer's dementia.

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References

  1. Livingston G, Sommerlad A, Orgeta V et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-734. https://doi.org/10.1016/S0140-6736(17)31363-6
  2. Ritchie K, Lovestone S. The dementias. Lancet. 2002;360(9347):1759-66. https://doi.org/10.1016/S0140-6736(02)11667-9
  3. Borroni B, Colciaghi F, Archetti S et al. Predicting cognitive decline in Alzheimer disease: role of platelet amyloid precursor protein. Alz Dis Assoc Dis. 2004;18(1):32-4. https://doi.org/10.1097/00002093-200401000-00006
  4. Pietrzik C, Behl C. Concepts for the treatment of Alzheimer's disease: molecular mechanisms and clinical application. Int J Exp Pathol. 2005;86(3):173-85. https://doi.org/10.1111/j.0959-9673.2005.00435.x
  5. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychoger. 2002;14(1):17-23. https://doi.org/10.1017/S1041610202008244
  6. Jia RX, Liang JH, Xu Y et al. Effects of physical activity and exercise on the cognitive function of patients with Alzheimer disease: a meta-analysis. BMC Geriatr. 2019;19(1):1-14. https://doi.org/10.1186/s12877-018-1019-5
  7. Hanseeuw BJ, Betensky RA, Jacobs HI et al. Association of amyloid and tau with cognition in preclinical Alzheimer disease: a longitudinal study. JAMA Neurol. 2019;76(8):915-24. https://doi.org/10.1001/jamaneurol.2019.1424
  8. Brasure M, Desai P, Davila H et al. Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review. Ann Intern Medi. 2018;168(1):30-8. https://doi.org/10.7326/m17-1528
  9. Ogawa Y, Kaneko Y, Sato T et al. Sarcopenia and muscle functions at various stages of Alzheimer disease. Front Neurol. 2018;9:710. https://doi.org/10.3389/fneur.2018.00710
  10. Miller PA, Butin D. The role of occupational therapy in dementia-COPE (Caregiver Options for Practical Experiences). Int J Geriatr Psychiatry. 2000;15(1):86-9. https://doi.org/10.1002/(SICI)1099-1166(200001)15:1<86::AID-GPS124>3.0.CO;2-8
  11. Olazaran J, Reisberg B, Clare L et al. Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dement Geriatr Cogn Disord. 2010;30(2):161-78. https://doi.org/10.1159/000316119
  12. Verhaeghen P, Steitz DW, Sliwinski MJ et al. Aging and dual-task performance: a meta-analysis. Psychol Aging. 2003;18(3):443. https://doi.org/10.1037/0882-7974.18.3.443
  13. Ahman HB, Giedraitis V, Cedervall Y et al. Dual-task performance and neurodegeneration: correlations between timed up-and-go dual-task test outcomes and Alzheimer's disease cerebrospinal fluid biomarkers. J Alzheimers Dis. 2019;71(S1):75-83.
  14. Takakusaki K. Functional neuroanatomy for posture and gait control. J Mov Disord. 2017;10(1):1. https://doi.org/10.14802/jmd.16062
  15. McCulloch KL, Mercer V, Giuliani C et al. Development of a clinical measure of dual task performance in walking: reliability and preliminary validity of the walking and remembering test. J Geriatr Phys Ther. 2009;32(1):2-9. https://doi.org/10.1519/00139143-200932010-00002
  16. O'Shea S, Morris ME, Iansek R. Dual task interference during gait in people with Parkinson disease: effects of motor versus cognitive secondary tasks. Phys Ther. 2002;82(9):888-97. https://doi.org/10.1093/ptj/82.9.888
  17. Dennis A, Dawes H, Elsworth C et al. Fast walking under cognitive-motor interference conditions in chronic stroke. Brain Res. 2009;1287:104-10. https://doi.org/10.1016/j.brainres.2009.06.023
  18. Ansai JH, Andrade LP, Rossi PG et al. Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease. Braz J Phys Ther. 2017;21(2):144-51. https://doi.org/10.1016/j.bjpt.2017.03.010
  19. Hollman JH, Kovash FM, Kubik JJ et al. Age-related differences in spatiotemporal markers of gait stability during dual task walking. Gait Posture. 2007;26(1):113-9. https://doi.org/10.1016/j.gaitpost.2006.08.005
  20. Toulotte C, Thevenon A, Watelain E et al. Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions. Clin Rehabil. 2006;20(3):269-76. https://doi.org/10.1191/0269215506cr929oa
  21. You JH, Shetty A, Jones T et al. Effects of dual-task cognitive-gait intervention on memory and gait dynamics in older adults with a history of falls: a preliminary investigation. Neuro Rehabil. 2009;24(2):193-8.
  22. Silsupadol P, Siu KC, Shumway-Cook A et al. Training of balance under single-and dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86(2):269-81. https://doi.org/10.1093/ptj/86.2.269
  23. Michel JA, Mateer CA. Attention rehabilitation following stroke and traumatic brain injury: a review. Eur J Phys Rehabil Med. 2006;42(1):59.
  24. Pellecchia GL. Dual-task training reduces impact of cognitive task on postural sway. J Mot Behav. 2005;37(3):239-46. https://doi.org/10.3200/JMBR.37.3.239-246
  25. Montero-Odasso MM, Sarquis-Adamson Y, Speechley M et al. Association of dual-task gait with incident dementia in mild cognitive impairment: results from the gait and brain study. JAMA Neurol. 2017;74(7):857-65. https://doi.org/10.1001/jamaneurol.2017.0643
  26. Kemoun G, Thibaud M, Roumagne N et al. Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord. 2010;29(2):109-14. https://doi.org/10.1159/000272435
  27. Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Arch Phys Med Rehabil. 2004;85(10):1694-704. https://doi.org/10.1016/j.apmr.2004.03.019
  28. Yokoyama H, Okazaki K, Imai D et al. The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial. BMC Geriatr. 2015;15(1):60. https://doi.org/10.1186/s12877-015-0058-4
  29. Malcolm BR, Foxe JJ, Butler JS et al. The aging brain shows less flexible reallocation of cognitive resources during dual-task walking: a mobile brain/body imaging (MoBI) study. Neuroimage. 2015;117:230-42. https://doi.org/10.1016/j.neuroimage.2015.05.028
  30. Erickson KI, Colcombe SJ, Wadhwa R et al. Training-induced functional activation changes in dual-task processing: an fMRI study. Cereb Cortex. 2006;17(1):192-204. https://doi.org/10.1093/cercor/bhj137
  31. Xu W, Qiu C, Gatz M et al. Mid-and late-life diabetes in relation to the risk of dementia. Diabetes. 2009;58(1):71-7. https://doi.org/10.2337/db08-0586