Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. To examine associations between brain volumes, dual-task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual-task performance, and measures of gait and balance. Greater cognitive and combined dual-task effects (DTE) are associated with smaller brain volumes. In contrast, motor DTE is not associated with distinct pattern of brain volumes. As brain volumes decrease, dual-task performance becomes more motor prioritized. Cognitive DTE is more strongly associated with decreased performance on measures of gait and balance than motor DTE. Decreased gait and balance performance are also associated with increased motor task prioritization. Cognitive DTE appears to be more strongly associated with decreased automaticity and gait and balance ability than motor DTE and should be utilized as a clinical and research outcome measure in this population. The increased motor task prioritization associated with decreased brain volume and function indicates a potential for accommodative strategies to maximize function in those with CI. Counterintuitive correlations between motor brain volumes and motor DTE in our study suggest a complicated interaction between brain pathology and function.
