Dual-task versus single-task walking within an Otago Exercise Program for older adults with dementia: a 24-week cluster randomized controlled trial

BACKGROUND AND OBJECTIVE: Dementia is associated with impairments in both cognitive and motor function, including gait disturbances and reduced mobility. Although dual‐task walking may improve cognitive‐motor integration, evidence in dementia remains limited. This study examined whether replacing single‐task walking with dual‐task walking within an Otago Exercise Program (OEP) provides additional benefits for cognitive function and gait performance in older adults with dementia. METHODS: This cluster randomized controlled trial randomized 100 older adults with dementia from 11 dementia care centers to a control group (CG; n = 50) or experimental group (EG; n = 50). Both groups completed a 24‐week OEP‐based program three times weekly; the EG additionally performed 10 min of dual‐task walking per session. Primary outcomes were a composite cognitive score and gait speed. Secondary outcomes included static balance, dynamic balance, and lower‐extremity function (knee extensor strength and five‐times sit‐to‐stand test [FTSTS]). RESULTS: Significant group × time interactions were observed for the composite cognitive score and gait speed (both p < .001), with the experimental group demonstrating significantly greater improvements than the control group at both 12 and 24 weeks. No significant group × time interactions were observed for the secondary outcomes; static balance, dynamic balance, knee extensor strength, and FTSTS improved similarly in both groups, indicating no additional benefit of dual‐task walking. CONCLUSION: Adding dual‐task walking to OEP was associated with greater improvements in cognitive performance and gait speed than OEP alone. Incorporating dual‐task walking into such programs may provide additional benefits for older adults with dementia. CLINICAL TRIAL REGISTRATION: KCT0010602.