Gait abnormalities increase when walking is paired with cognitive task for patients with CKD
Patients with chronic kidney disease experienced more gait abnormalities when walking and talking compared with when doing one of these tasks alone, a finding possibly due to increased cognitive-motor interference, according to this study.
“Dual-task paradigms, such as the walking-while-talking test, involve the simultaneous performance of cognitive and motor tasks to study their interactions,” Jim Q. Ho, MD, of Albert Einstein School of Medicine, and colleagues wrote. “They can assess cognitive-motor interference, a phenomenon in which concurrently performing these two tasks may lead to a decline in either or both tasks. The walking-while talking test places high demands on the attention system, which may decrease gait performance because of interference and competition for the same brain resources.”
Researchers argued that while gait abnormalities and cognitive impairment are both common for patients with CKD, there remains a gap in knowledge as to whether gait abnormalities increase when dual tasks are being completed.
“Insight into dual-task function among patients with CKD may have major clinical implications in predicting adverse outcomes and developing novel therapeutic strategies,” they wrote.
To investigate this area, 330 patients aged at least 65 years (41% with CKD) underwent gait analysis, including when walking while talking. Performance by CKD status was considered.
Researchers found that, compared with those without the disease, participants with CKD had slower gait speed and various gait cycle abnormalities during walking while talking (eg, every 10 mL/min/1.73m2 lower eGFR was associated with slower gait speed, shorter step length and less time to swing phase). After comparing walking while talking to walking alone, each 10 mL/min/1.73m2 lower eGFR was associated with a 1.8% greater decrease in time in the swing phase and a 0.9% greater increase in time in the stance phase.
Researchers noted these findings are relevant to all stages of CKD and are worse for patients with poorer kidney function.
“This study is the first to link nondialysis-dependent CKD with gait abnormalities and increased cognitive-motor interference during walking while talking,” they concluded.
“Future studies should investigate whether the walking while talking test and dual-task cost can predict adverse outcomes, such as fall risk and cognitive dysfunction, and whether dual-task performance training may improve outcomes in CKD.” – by Melissa J. Webb
Disclosures: Ho reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.