• Michael Schwenk, Tania Zieschang, Peter Oster, and Klaus Hauer.
• Department of Geriatric Research, Bethanien-Krankenhaus/Geriatric Centre at the University of Heidelberg, Heidelberg, Germany.
• Neurology. 2010 Jun 15; 74 (24): 1961-8.

BackgroundDeficits in attention-related cognitive performance measured as dual-task performance represent early markers of dementia and are associated with motor deficits and increased risk of falling. The purpose of this study was to examine the effect of a specific dual-task training in patients with mild to moderate dementia.MethodsSixty-one geriatric patients with confirmed dementia took part in a 12-week randomized, controlled trial. Subjects in the intervention group (IG) underwent dual-task-based exercise training. The control group (CG) performed unspecific low-intensity exercise. Motor performance (gait speed, cadence, stride length, stride time, single support) and cognitive performance (serial 2 forward calculation [S2], serial 3 backward calculation [S3]) were examined as single and dual tasks. Decrease in performance during dual tasks compared to single task expressed as motor, cognitive, and combined motor/cognitive dual-task cost (DTC) was calculated before and after intervention. Primary outcome was defined as DTC for gait speed under complex S3 conditions.ResultsSpecific training significantly improved dual-task performance under complex S3 conditions compared to the CG (reduction of DTC: gait speed 21.7% IG, 2.6% CG, p < 0.001; other gait variables: 8.7% to 41.1% IG, -0.9% to 8.1% CG, p ConclusionsThe specific exercise program was effective to improve dual-task performance in patients with dementia.Classification Of EvidenceThis study provides Class II evidence that specific dual-task training improves dual-task performance during walking under complex S3 conditions in geriatric patients with mild to moderate dementia.

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