Cognitive and motor dual-task performance in older adults with prediabetes and type 2 diabetes mellitus: A cross-sectional study

Type 2 diabetes mellitus (T2DM) and prediabetes (PreDM) are common among older adults and are associated with cognitive and physical impairments. Dual-task testing, which combines motor and cognitive tasks, reflects real-world functional ability. However, comparisons of dual-task performance between older adults with T2DM and PreDM are limited. This study aimed to compare cognitive and motor dual-task performance and related physical and cognitive parameters in older adults with T2DM and PreDM. This cross-sectional study included 46 older adults (23 T2DM and 23 PreDM), all aged ≥ 65 years. Dual-task performance was assessed using the timed up and go test under motor (TUG-Motor) and cognitive (TUG-Cog) conditions. Fatigue was measured by a Visual Analogue Scale; handgrip strength was measured with a dynamometer; physical performance was evaluated via the Short Physical Performance Battery (SPPB); and cognitive function was assessed with the Mini-Mental State Examination. Compared to the PreDM group, the T2DM group had significantly poorer dual-task cognitive performance (TUG-Cog) (P = .001)and higher fatigue (P = .004). The T2DM group also had lower Mini-Mental State Examination (P = .04) scores and lower SPPB scores (P = .02). There was no significant difference in TUG-Motor time (P = .129). In both groups, TUG-Motor time strongly correlated with SPPB (T2DM, r = -.720; PreDM, r = -.727) and TUG-Cog time moderately correlated with SPPB (T2DM, r = -.596; PreDM, r = -.517) (P < .01 for all). Dual-task performance is closely linked to physical function in older adults with T2DM and PreDM. Older adults with T2DM showed greater deficits in dual-task cognition, cognitive function, and physical performance than those with PreDM. Early interventions to improve dual-task ability may help preserve independence and reduce fall risk in this population.