背景:双重任务范式被认为提供了一种定量手段来评估认知储备和大脑在面对竞争的认知需求时分配资源的能力。最常见的双重任务范例检查步态或平衡控制与认知功能之间的相互作用。然而,步态和平衡任务对老年人来说可能具有身体挑战性,并可能带来跌倒的风险。
目的:我们介绍一部小说,结合电机控制任务的数字双任务评估(“球平衡”测试),挑战个人在指定区域内保持虚拟球,具有并发认知任务(向后数字跨度任务[BDST])。
方法:该任务是在触摸屏平板电脑上执行的,使用嵌入在平板电脑中的惯性传感器测量性能,在单任务和双任务条件下进行。该任务的临床使用是在375名老年参与者(n=210名女性;年龄73.0,SD6.5岁)的样本中进行评估的。
结果:所有老年人,包括轻度认知障碍(MCI)和阿尔茨海默病相关性痴呆(ADRD),那些因糖尿病而导致平衡和步态问题的人,骨关节炎,周围神经病变,和其他原因,能够在坐下时舒适安全地完成任务。不出所料,与单任务条件相比,双任务条件下的任务性能显着下降。我们表明,表现与认知障碍显著相关;在健康参与者中发现了显著差异,那些有MCI的,还有那些有ADRD的。任务结果与功能障碍显著相关,独立于诊断,认知障碍程度(如迷你精神状态检查[MMSE]评分所示),和年龄。最后,我们发现,使用一系列针对3种不同认知功能结果变量(共识临床判断,Rey听觉语言学习测试[RAVLT],和MMSE)。
结论:我们的结果表明,双重任务球平衡测试可以用作认知储备的数字认知评估。便携性,简单,这项任务的直观性表明,它可能适合于无监督的认知功能家庭评估。
BACKGROUND: Dual task paradigms are thought to offer a quantitative means to assess cognitive reserve and the brain\'s capacity to allocate resources in the face of competing cognitive demands. The most common dual task paradigms examine the interplay between gait or balance control and cognitive function. However, gait and balance tasks can be physically challenging for older adults and may pose a risk of falls.
OBJECTIVE: We introduce a novel, digital dual-task assessment that combines a motor-control task (the \"ball balancing\" test), which challenges an individual to maintain a virtual ball within a designated zone, with a concurrent cognitive task (the backward digit span task [BDST]).
METHODS: The task was administered on a touchscreen tablet, performance was measured using the inertial sensors embedded in the tablet, conducted under both single- and dual-task conditions. The clinical use of the task was evaluated on a sample of 375 older adult participants (n=210 female; aged 73.0, SD 6.5 years).
RESULTS: All older adults, including those with mild cognitive impairment (MCI) and Alzheimer disease-related dementia (ADRD), and those with poor balance and gait problems due to diabetes, osteoarthritis, peripheral neuropathy, and other causes, were able to complete the task comfortably and safely while seated. As expected, task performance significantly decreased under dual task conditions compared to single task conditions. We show that performance was significantly associated with cognitive impairment; significant differences were found among healthy participants, those with MCI, and those with ADRD. Task results were significantly associated with functional impairment, independent of diagnosis, degree of cognitive impairment (as indicated by the Mini Mental State Examination [MMSE] score), and age. Finally, we found that cognitive status could be classified with >70% accuracy using a range of classifier models trained on 3 different cognitive function outcome variables (consensus clinical judgment, Rey Auditory Verbal Learning Test [RAVLT], and MMSE).
CONCLUSIONS: Our results suggest that the dual task ball balancing test could be used as a digital cognitive assessment of cognitive reserve. The portability, simplicity, and intuitiveness of the task suggest that it may be suitable for unsupervised home assessment of cognitive function.