Validity, test-retest reliability, sensitivity to change and feasibility of motor-cognitive dual task assessments in patients with dementia. (May 2017)

• Record Type: Journal Article
• Authors: Lemke, Nele C.; Wiloth, Stefanie; Werner, Christian; Hauer, Klaus
• Is Part Of: Archives of gerontology and geriatrics. Volume 70(2017)
• Page Start: 169
• Page End: 179
• Publication Date: 2017-05
• Subjects: AD Alzheimer's disease -- CERAD Consortium to Establish a Registry for Alzheimer's Disease -- CG control group -- CI confidence interval -- CIRS Cumulative Illness Rating Scale -- cm centimeter -- EF executive functions -- DT dual task -- DTC dual task costs -- GDS Geriatric Depression Scale -- ICC Intra-Class Correlation Coefficient -- IG intervention group -- min. minutes -- MMSE Mini-Mental State Examination -- NAI Nürnberger-Alters-Inventar -- N Newton -- OR odds ratio -- POMA Performance Orientated Mobility Assessment -- s seconds -- SF-12 short form (12) -- ST single task -- TUG Timed up and Go-test -- WWT walking while talking -- ZN-G Zahlen-Nachsprechen-G (Repeating-Number-Test) -- ZVT-G Zahlen-Verbindungs-Test-G (age-adjusted Trail Making Test); Assessment validation -- Dementia -- Cognition -- Elderly -- Dual task; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2017.01.016
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: Evaluation of psychometric quality of DT-tests lacks in patients with dementia. Motor-cognitive tasks showed good-excellent psychometric quality in dementia. Gait-based DT-tests demonstrated best results. Relative DTCs which are recommended for DT assessment were less valid measures. Abstract: Objective: To investigate validity, test-retest reliability, sensitivity to change, and feasibility of dual task (DT) assessments in patients with dementia. Design: Validation study. Setting: Post ward-rehabilitation. Participants: Geriatric patients (n = 105) with dementia (age 82.7 ± 5.9, MMSE score 21.9). Main outcome measures: Psychometric quality of DT performance of different DT-tests. Analyses were performed for motor and cognitive performance, and relative DT costs (DTCs). Results: Spearman's rank correlations (rs ) between examined DT-tests were moderate-high for motor tasks (rs = 0.29–0.90), small-high for cognitive tasks (rs = 0.12–0.55) and small-high for relative DTCs (motor DTCs rs = 0.02-0.61, cognitive DTCs rs = −0.19 to 0.06, combined DTCs rs = −0.11 to 0.31). Correlations with external assessment were moderate-high for motor tasks (rs = 0.25–0.84), small-moderate for cognitive tasks (rs = −0.10 to 0.46) and small-moderate for relative DTCs (motor DTCs rs = −0.09 to 0.17, cognitive DTCs rs = −0.03 to 0.21, combined DTCs rs = −0.07 to 0.26). Test-retest reliability was excellent for motor tasks (ICC = 0.75–0.96), fair-excellent for cognitive tasks (ICC = 0.51–0.88) and poor-good for relative DTCs (motor DTCs ICC = 0.10–0.74, cognitive DTCs ICC = 0.05–0.65, combined DTCs ICC = 0.15–0.71). Sensitivity to change was acceptable-excellent for trained DT-tests ( p ≤ 0.01). Effect sizes were small-large for gait parameters (SRM = 0.30–1.12), large for cognitive tasks (SRM = 0.82–0.95) and small-large for relative DTCs (motor DTCs SRM = 0.15–0.77, cognitive DTCs SRM = 0.56-0.98, combined DTCs SRM = 0.40–1.10). Completion time ranged from 13.1 to 16.9 min. Conclusions: All DT-tests showed acceptable-excellent psychometric properties in patients with dementia with highest quality for the gait-based tests 'Walking & Counting' and 'Walking & reciting ABC'.