Objective: To investigate whether motor and cognitive dual-task (DT) gait costs differ between early and intermediate stages of Parkinson’s disease (PD).

Background: In PD, reduced gait automaticity leads to greater reliance on attentional control. Consequently, DT paradigms are widely used to examine cognitive-motor interference during walking. However, whether DT-related gait costs change with disease progression remains unclear.

Method: A cross-sectional observational study was conducted according to STROBE guidelines and included 49 individuals with PD classified in Hoehn and Yahr (H&Y) stages 1 (n=18), 2 (n=20), and 3 (n=11). Participants had a confirmed PD diagnosis, used dopaminergic medication, and were able to walk independently without assistive devices. Exclusion criteria included other neurological disorders, uncorrected sensory deficits, or orthopedic, cardiac, or respiratory conditions affecting testing. Assessments were performed in a single session during the ON medication state by trained physiotherapists, and included the Geriatric Depression Scale (GDS) for depressive symptoms, the Balance Evaluation Systems Test (BESTest) for balance performance, sections II and III of the Unified Parkinson’s Disease Rating Scale (UPDRS) for disease severity, and the Montreal Cognitive Assessment (MoCA) for global cognition. Spatiotemporal gait parameters were collected with the GAITRite system under three experimental conditions: usual walking, a cognitive task performed while standing (verbal fluency), and simultaneous performance of walking and the cognitive task. Group comparisons of DT-related changes were performed using the Kruskal-Wallis test, with control for multiple testing through the Benjamini-Hochberg procedure.

Results: No significant differences in motor or cognitive DT gait costs were observed across disease stages after correction for multiple comparisons (p > 0.05). Substantial interindividual variability was observed across all stages, and regression analyses did not reveal significant associations between DT costs and clinical variables.

Conclusion: DT-related gait costs did not increase between early and intermediate PD stages. These findings suggest that difficulties in regulating gait under cognitive load may emerge early in the disease course, highlighting the importance of early identification and management.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dual-task-gait-costs-do-not-increase-across-stages-of-parkinsons-disease/