AUTHOR=Weng Wei-Han , Yang Yea-Ru , Yeh Nai-Chen , Ku Pei-Hsin , Wang Po-Shan , Liao Ying-Yi , Wang Ray-Yau 

TITLE=Gait performance and prefrontal cortex activation during single and dual task walking in older adults with different cognitive levels

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 15 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1177082

DOI=10.3389/fnagi.2023.1177082

ISSN=1663-4365

ABSTRACT=Background: Growing evidences show the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions.
Methods: Normal control (NC), mild cognitive impairment (MCI), and mild dementia (MD) were enrolled in this study. All participants experienced a compressive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. Cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. Motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW).     
Results: MD had worse SW, CDW and TUG performance as compared to MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in MCI (p=0.000), which was not demonstrated in the other two groups.
Conclusion: MD demonstrated decreased motor function as compared to NC and MCI. The increased PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults.