Influence of dual task and frailty on gait parameters of older community-dwelling individuals

Abstract

Background: Gait parameters such as gait speed (GS) are important indicators of functional capacity. Frailty Syndrome is closely related to GS and is also capable of predicting adverse outcomes. The cognitive demand of gait control is usually explored with dual-task (DT) methodology.

Objective: To investigate the effect of DT and frailty on the spatio-temporal parameters of gait in older people and identify which variables relate to GS.

Method: The presence of frailty was verified by Fried's Frailty Criteria. Cognitive function was evaluated with the Mini-Mental State Exam (MMSE) and gait parameters were analyzed through the GAITRite(®) system in the single-task and DT conditions. The Kolmogorov-Smirnov, ANOVA, and Pearson's Correlation tests were administered.

Results: The participants were assigned to the groups frail (FG), pre-frail (PFG), and non-frail (NFG). During the DT, the three groups showed a decrease in GS, cadence, and stride length and an increase in stride time (p<0.001). The reduction in the GS of the FG during the DT showed a positive correlation with the MMSE scores (r=730; p=0.001) and with grip strength (r=681; p=0.001).

Conclusions: Gait parameters are more affected by the DT, especially in the frail older subjects. The reduction in GS in the FG is associated with lower grip strength and lower scores in the MMSE. The GS was able to discriminate the older adults in the three levels of frailty, being an important measure of the functional capacity in this population.

Figure 1. Mean and standard deviation values for gait speed in both tasks (single and dual) for each group (frail, pre-frail, non-frail).

Figure 2. Mean and standard deviation values for cadence in both tasks (single and dual) for each group (frail, pre-frail, non-frail).

Figure 3. Mean and standard deviation values for stride length in both tasks (single and dual) for each group (frail, pre-frail, non-frail).