PMID- 37845603 OWN - NLM STAT- MEDLINE DCOM- 20231026 LR - 20231121 IS - 1471-2318 (Electronic) IS - 1471-2318 (Linking) VI - 23 IP - 1 DP - 2023 Oct 16 TI - Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates. PG - 663 LID - 10.1186/s12877-023-04390-3 [doi] LID - 663 AB - BACKGROUND: Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS: A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment >/= 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS: In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS: Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION: NCT04689776, 30/12/2020. CI - (c) 2023. BioMed Central Ltd., part of Springer Nature. FAU - Chen, I-Chen AU - Chen IC AD - Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan. FAU - Chuang, I-Ching AU - Chuang IC AD - Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan. ichin@mail.cgu.edu.tw. AD - Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. ichin@mail.cgu.edu.tw. FAU - Chang, Ku-Chou AU - Chang KC AD - Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. AD - Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Chang, Chih-Hung AU - Chang CH AD - Program in Occupational Therapy, School of Medicine, Washington University , St. Louis, MO, USA. AD - Department of Medicine, School of Medicine, Washington University , St. Louis, MO, USA. AD - Department of Orthopedic Surgery, School of Medicine, Washington University , St. Louis, MO, USA. FAU - Wu, Ching-Yi AU - Wu CY AD - Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan. AD - Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. AD - Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. LA - eng SI - ClinicalTrials.gov/NCT04689776 PT - Clinical Trial PT - Journal Article DEP - 20231016 PL - England TA - BMC Geriatr JT - BMC geriatrics JID - 100968548 SB - IM MH - Aged MH - Humans MH - Cognition/physiology MH - *Cognitive Dysfunction/diagnosis/therapy MH - Exercise/psychology MH - *Minimal Clinically Important Difference MH - Task Performance and Analysis PMC - PMC10580601 OTO - NOTNLM OT - Cognitive impairment OT - Dual task performance OT - Minimal clinically important difference OT - Older adults OT - Responsiveness OT - Simultaneous cognitive-exercise training COIS- The authors declare no competing interests. EDAT- 2023/10/17 00:42 MHDA- 2023/10/23 01:18 PMCR- 2023/10/16 CRDT- 2023/10/16 23:44 PHST- 2023/02/09 00:00 [received] PHST- 2023/10/06 00:00 [accepted] PHST- 2023/10/23 01:18 [medline] PHST- 2023/10/17 00:42 [pubmed] PHST- 2023/10/16 23:44 [entrez] PHST- 2023/10/16 00:00 [pmc-release] AID - 10.1186/s12877-023-04390-3 [pii] AID - 4390 [pii] AID - 10.1186/s12877-023-04390-3 [doi] PST - epublish SO - BMC Geriatr. 2023 Oct 16;23(1):663. doi: 10.1186/s12877-023-04390-3.