Objective: The aim of this investigation is to relate cholinergic activity (CA) to objective measures of balance, gait, and attention in a MCI and control group. We hypothesize that people with Mild cognitive impairment (MCI) will have low CA, which will reduce attention and relate to worse gait and balance dysfunction, compared to controls.

Background: MCI is defined as cognitive decline greater than expected for age and education. Although MCI refers to cognitive impairments, gait and balance dysfunction has also been observed in MCI populations. Emerging literature suggests that cognitive information is critical for motor performance, particularly for complex tasks.

Methods: 3 MCI and 6 non-MCI subjects have been tested (80 will be recruited). Each subject completed a quiet standing and walk test, both with and without a secondary task. Balance variables: 95% ellipse sway area, jerk, and RMS sway. Gait: gait speed, percent of time in double support, and number of steps in a turn. Gait and balance measures were recorded via 6 inertial sensors. Dual task cost (DTC) was calculated for each gait and balance variable. A computerized test of attention, The Attention Network Test (ANT), was also completed. ANT variables: alerting efficiency, orienting efficiency, and conflict resolution efficiency. Short-latency afferent inhibition (SAI), a transcranial magnetic stimulation modality, assessed CA.

Results: Preliminary data yield large Cohen’s d effect sizes for MCI and greater DTC of the 95% ellipse sway area (MCI: 0.47±0.50; Control: -0.10±0.21; d = 2.00), DTC of the percent of time in double support (MCI: 0.07±0.01; Control: 0.03±0.02; d = 2.58), and worse SAI (MCI: 88.94±33.65; Control: 62.98±13.32; d = 1.25) for the MCI group. Spearman’s correlations indicate a significant correlation between worse SAI and greater DTC on jerk (ρ = 0.73; p = 0.03) and RMS sway (ρ = 0.68; p = 0.04). The ANT yielded weak effect sizes between MCI groups.

Conclusions: Effect size analyses of these data yield preliminary support for the hypothesis that MCI is associated with impaired balance and gait, especially in dual task conditions. Further, significant correlations between SAI and DTC on jerk and RMS sway indicate that CA may be a factor in balance dysfunction. The MCI group shows a trend of lower CA and greater DTC in balance and gait tasks. MCI patients with low CA could be at greater risk of gait and balance dysfunction in dual task conditions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cholinergic-activity-mobility-and-attention-in-mild-cognitive-impairment/