Exploring Motor-Cognitive Interference Effects and the Influence of Self-Reported Physical Activity on Dual-Task Walking in Parkinson's Disease and Healthy Older Adults.

Abstract

Introduction: Parkinson's disease (PD) is characterized by motor and cognitive impairments that often manifest as distinct motor subtypes: Postural Instability Gait Difficulty (PIGD) and Tremor-Dominant (TD). Motor-cognitive interference, especially under dual-task (DT) walking conditions, may vary by subtype, providing insights into specific impairments. This study explored DT interference effects in PD subtypes, focusing on the potential impact of self-reported physical activity, which may help mitigate subtype-specific impairments and improve motor-cognitive function. Methods: PD patients classified as PIGD or TD and healthy controls completed single-task (ST) and DT walking assessments involving different cognitive tasks (Serial Subtraction, Auditory Stroop, and Clock Task). Physical activity levels were evaluated using the CHAMPS questionnaire, analyzing the self-reported frequency and duration of weekly exercise-related activities. Results: Interference effects were significantly different between PD patients and controls, with the PIGD group showing greater motor impairment under high cognitive load, primarily affecting gait, than the TD and control groups. Performance differences between groups diminished as cognitive load increased. Self-reported physical activity does not significantly moderate motor performance under DT conditions, suggesting that activity levels in this sample are insufficient to offset motor-cognitive interference. However, like group affiliation, physical activity directly influences motor performance during DT conditions, indicating that both factors independently impact motor-cognitive function in PD. Discussion: These findings suggest that DT assessments help differentiate PD motor subtypes, as group differences were minimal in ST conditions. While physical activity is associated with general improvements in motor ST and DT performance in PD and controls, the lack of a significant moderating effect from self-reported exercise-related physical activity indicates that current activity levels may not be high enough to counter motor-cognitive interference. More intensive or DT-specific exercise may be required to reduce interference effects. Future research should examine the role of structured physical activity programs, potentially incorporating DT training, to evaluate their impact on motor-cognitive interference in PD.