UDDGait™: Uppsala-Dalarna Dementia and Gait Project

UDDGait™ is a multidisciplinary research project with the overreaching goal of providing an aid for early identification of cognitive impairment and risk of dementia development, thereby providing a basis for adequate symptom relieving and health promoting interventions.

  • Funder: Swedish Research Council,Stiftelsen Promobilia, Konung Gustaf V:s och Drottning Victorias frimurarestiftelse, Demensfonden, UU innovation, Geriatriska fonden, Alzheimerfonden, Regionala forskningsrådet i Uppsala-Örebroregionen, Region Uppsala, Svenska läkaresällskapet och Stiftelsen Ragnhild och Einar Lundströms minne

The overall aim is to investigate if TUGdt is useful as an aid for prediction of dementia disease. To ensure the results, the aim is also to evaluate the test’s measurement properties and to generate normative reference values of healthy control persons.

Approach

We use the TUG, which is an uncomplicated and quickly administrated test of a one movement sequence starting from a sitting position in an armchair, standing up and walking 3 meters, turning around, walking back to the chair and sitting down again. For TUGdt, TUG is combined with a verbal task of e.g. naming different animals (Fig. 1).

Figure 1. Schematic illustration of the set-up with registration by two video cameras.

Figure 1. Schematic illustration of the set-up with registration by two video cameras.

This type of dual-task requires divided attention, which affects persons with dementia more than healthy persons in the same age-group. For example, gait disturbances caused by dual-tasking have been shown early in the course of dementia development. Thus, TUGdt can constitute a useful clinical tool for diagnosis and treatment planning for individuals with cognitive difficulties.

Execution

A pilot study was initially carried out to develop the methodology and the study protocol. In the next step the TUGdt was utilized for base line investigations of persons attending a specialist clinic at the Akademiska hospital in Uppsala or the hospital Falu Lasarett in Falun. Those patients who at baseline went through a lumbar puncture for investigation of biomarkers of Alzheimer’s disease in spinal fluid were additionally included in a study on the correlation between these markers and TUGdt parameters. Longitudinal follow-ups of the baseline investigations have been performed and are ongoing in several steps. We have additionally included and tested healthy controls by TUGdt to generate reference values and evaluate the test-retest reliability. Data collection for evaluation of test-retest reliability for patients undergoing memory assessments is ongoing. We have additionally developed a side project focused on analysis of gait parameters extracted from video recordings of TUG and TUGdt.

For this purpose, we have collected data at the Biomechanics and Motor Control laboratory at the Swedish School of Sport and Health Sciences (GIH) in Stockholm to evaluate the measurement properties for the use of video recordings in the evaluation of TUGdt step gait parameters. We have developed and used specific methodology for semi-automated extraction of gait parameters from video.

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