Abstract

Background: Obesity is the over accumulation of fat in the body and represents a major priority for healthcare systems due to its social, clinical and economic burdens. The prevalence of obesity in India is 40.3% which is increasing faster than the world average and it is higher among middle aged adults over 40 than under 40, where as in Kerala the prevalence rate is about 40.7% with a female preponderance. Midlife obesity is associated with decrements in cognitive function as well as motor function, and this could potentially compromise a person’s memory, attention, concentration and decision-making abilities that impacts daily functioning. Dual task involves the simultaneous incorporation of cognitive as well as motor components and it is found to be affected in obese adults. So there may exist a scope of association between the cognition and dual task performance of obese patients, and thus this study aims to find out the association between cognition and dual task performance in sedentary middle aged obese adults. Objective: To find out the linear relationship between cognition and dual task performance in sedentary middle aged obese adults. Methods: Community dwelling sedentary middle aged obese individuals with MoCA score between 18 - 30 were recruited for the study. They were instructed to perform two single tasks: six-meter self-selected walking speed test and the timed up and go test. Each single task was then repeat under two dual task conditions: self-selected walking speed test and verbal fluency test, self-selected walking speed test and serial 3 subtraction test, timed up and go test and verbal fluency test, and timed up and go test and serial 3 subtraction test. Dual task cost was calculated for each dual task to explore the percentile decline in dual task performance. ((difference between dual task and single task motor erformance)/single task motor performance] ×100) Results and Discussion: Regression analysis was done and found a significant linear relationship of cognition with dual task performance and dual task cost in sedentary middle aged obese adults (p<0.05). Moderate linear relationship (β=0.65) was found for timed up and go serial 3 subtractions which was the most difficult task and a weak linear relationship (β=0.22) for self-selected walking speed verbal fluency the simplest one. The results concluded that as the task complexity increases dual task cost increases which indicates a direct relationship between cognition and dual task performance. The prefrontal cortex plays a major role during single and dual-task gait functions and this activation corresponds to the complexity of the task. Reduced brain volume, grey matter atrophy, impaired synaptic plasticity, all of which may contribute to changes in cognitive and motor domain. These evidence may correspond to the linear relationship exists between cognition with dual task performance and dual task cost in the current study. Conclusion: Findings of this study implies that there is a linear relationship between cognition and dual task performance in sedentary middle aged obese adults.

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