Marta Gonçalves-Montera

Background: Age-related cognitive decline is linked to reduced gait complexity and higher fall risk. Traditional linear gait measures may miss subtle motor-cognitive deficits in older adults with dementia. This study examined whether an 8-week motor-cognitive exercise program could improve gait adaptability in institutionalized older adults with cognitive impairment. Gait complexity, measured using Sample Entropy, was the primary outcome. Methods: Forty-two institutionalized older adults completed follow-up assessments, including 26 with cognitive impairment and 16 controls. Gait was assessed during normal walking (single-task) and while performing cognitive tasks (dual-task), such as naming animals or counting backward. Inertial sensors recorded stride intervals, and Sample Entropy was calculated to evaluate gait regularity and adaptability, (gait complexity). The intervention included 24 structured sessions combining physical and cognitive exercises targeting balance, coordination, and executive function. Non-parametric tests (Wilcoxon) were used, with Bonferroni correction for multiple comparisons. Results: Participants with cognitive impairment showed increased gait complexity, especially during dual-task walking. Significant improvements were found in both limbs under dual-task conditions (left: p = 0.015, effect size = 0.34; right: p = 0.030, effect size = 0.31). During single-task walking, a significant improvement was observed in the left limb (p = 0.006, effect size = 0.39). Conclusions: Motor-cognitive exercise may enhance non-linear gait complexity in institutionalized older adults with cognitive impairment. The use of dual-task training in rehabilitation and highlight the value of entropy-based gait assessment for detecting subtle functional changes. However, the lack of a randomized non-exercising cognitive impairment control group limits definitive conclusions about causality.

Background/Objectives: Gait performance in aging relies heavily on cognitive resources, yet the extent to which short-term interventions can mitigate dual-task costs in institutionalized populations remains understudied. This study aimed to compare single and dual-task gait performance between older adults with and without suspected cognitive impairment and to evaluate the effects of an 8-week multicomponent exercise program on functional mobility. Methods: Institutionalized older adults (n = 42) were stratified into two groups: suspected cognitive impairment (n = 26) and no suspected impairment (n = 16), based on MMSE and Clock Drawing Test screening. Participants performed the Timed Up and Go (TUG) and Dual-Task TUG (TUG-DT) at baseline and post-intervention. Results: At baseline, the suspected impairment group exhibited significantly poorer performance on both tests (p < 0.001) compared to the non-impaired group. Following the 8-week intervention, the suspected impairment group demonstrated large, significant improvements in both TUG (r = −0.73) and TUG-DT (r = −0.59), whereas the non-impaired group remained stable. Notably, while the single-task TUG showed the greatest responsiveness to the exercise program, the TUG-DT continued to reveal a significant cognitive-motor load. Conclusions: Multicomponent exercise effectively enhances functional mobility in cognitively vulnerable older adults, reversing declines in both single and dual-task conditions. Significance: These findings support the implementation of dual-task screening to unmask latent functional deficits and validate the use of accessible, short-term multicomponent exercise programs as a vital strategy to preserve autonomy in institutionalized older adults.

This study aimed to investigate the presence of a Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) cognitive profile in a Portuguese neurologic injured sample. The Portuguese WAIS-III was administered to 81 mixed neurologic patients and 81 healthy matched controls selected from the Portuguese standardization sample. Although the mixed neurologic injury group performed significantly lower than the healthy controls for the majority of the WAIS-III scores (i.e., composite measures, discrepancies, and subtests), the mean scores were within the normal range and, therefore, at risk of being unobserved in a clinical evaluation. ROC curves analysis showed poor to acceptable diagnostic accuracy for the WAIS-III composite measures and subtests (Working Memory Index and Digit Span revealed the highest accuracy for discriminating between participants, respectively). Multiple regression analysis showed that both literacy and the presence of brain injury were significant predictors for all of the composite measures. In addition, multiple regression analysis also showed that literacy, age of injury onset, and years of survival predicted all seven composite measures for the mixed neurologic injured group. Despite the failure to find a WAIS-III cognitive profile for mixed neurologic patients, the results showed a significant influence of brain lesion and literacy in the performance of the WAIS-III.

The literature lacks information on the performance of patients with brain tumors on the Wechsler Intelligence Scales. This study aimed to explore the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) performance profile of 23 consecutive patients with brain tumors and 23 matched controls selected from the Portuguese WAIS-III standardization sample, using the technical manual steps recommended for score interpretation. The control group was demographically matched to the tumor group regarding gender, age, education, profession, and geographic region. The technical manual steps recommended for score interpretation were applied. Patients with brain tumors had significantly lower performances on the Performance IQ, Full-Scale IQ, Perceptual Organization Index, Working Memory Index, Processing Speed Index, Arithmetic, Object Assembly, and Picture Arrangement, though all scaled scores were within the normal range according to the manual tables. Only Vocabulary and Comprehension scatter scores were statistically different between groups. No strengths or weaknesses were found for either group. The mean discrepancy scores do not appear to have clinical value for this population. In conclusion, the study results did not reveal a specific profile for patients with brain tumors on the WAIS-III.