Sing for Your Saunter - Dementia Supplement
Sing for Your Saunter - Dementia Supplement
Older adults, and particularly those with Parkinson disease (PD), may experience walking
 difficulties that negatively impact their daily function and quality of life. People that
 have PD plus dementia are also likely to experience walking difficulties. This project will
 examine the impact of music and mentally singing on walking performance, with a goal of
 understanding what types of rhythmic cues are most helpful. Pilot work from the investigators
 suggests that imagined, mental singing (i.e., singing in head) while while walking helps
 people walk faster with greater stability, whereas walking to music also helps people walk
 faster but with reduced stability.

 In this study, the investigators will recruit people who have PD plus dementia. The
 investigators will compare walking while mentally singing, walking while singing out loud,
 and walking while listening to music, using personalized cues tailored to each person's
 walking performance. The investigators hypothesize temporal variability of gait will be lower
 in the mental singing and singing conditions compared to listening to music; and that mental
 singing, singing, and listening to music will elicit similar improvements in stride length.
During this observational study, participants will attend one visit in the laboratory. The
 visit will include participants wearing wearable sensors during the following tasks: walking
 with no cues (UNCUED), walking while listening to music (MUSIC), walking while singing out
 loud (SINGING), and walking while mentally singing (MENTAL SINGING). The wearable sensors
 will measure gait parameters including gait speed, stride length, and stride time
 variability.
Inclusion Criteria:

 -  at least 30 years of age

 -  diagnosis of idiopathic, typical Parkinson disease according to the UK Brain Bank
 Criteria

 -  Hoehn & Yahr stages 2-3 (mild to moderate disease severity)

 -  normal or corrected hearing

 -  stable on all PD medications for at least 2 months prior to study entry

 -  dementia as defined by a Clinical Dementia Rating (CDR) score of 0.5-1.0 (very mild to
 mild dementia)

 -  score of ≥ 1 on the MDS-UPDRS-III Item #10 indicating observable gait impairment

 -  a score of 1 or less on item #7 on the freezing of gait questionnaire

 -  able to walk for 10 continuous minutes independently

 Exclusion Criteria:

 -  diagnosis of any other neurological condition

 -  unstable medical or concomitant illnesses or psychiatric conditions which, in the
 opinion of the investigators, would preclude successful participation

 -  cardiac problems that interfere with ability to safely participate (i.e., uncontrolled
 congestive heart failure, myocardial infarction in past 6 months, complex cardiac
 arrhythmias, significant left ventricular dysfunction, dyspnea on exertion, chest pain
 or pressure, resting tachycardia (>100 beats/min); uncontrolled BP (resting systolic
 BP >160 mmHg or diastolic BP >100 mmHg))

 -  orthopedic problems in the lower extremities or spine that may limit walking (i.e.,
 severe arthritis, spinal stenosis)

 -  uncontrolled tremor or dyskinesia while on PD medications