BACKGROUND: Specific dual-task (DT) training is effective to improve DT performance in trained tasks in patients with dementia (PwD). However, it remains an open research question whether successfully trained DTs show a transfer effect to untrained DT performances. OBJECTIVE: To examine transfer effects and the sustainability of a specific DT training in PwD. METHODS: One hundred and five patients with mild-to-moderate dementia (Mini-Mental State Examination: 21.9 +/- 2.8 points) participated in a 10-week randomized, controlled trial. The intervention group (IG) underwent a specific DT training ("walking and counting"). The control group (CG) performed unspecific low-intensity exercise. DT performance was measured under three conditions: (1) "walking and counting" (trained); (2) "walking and verbal fluency" (semi-trained), and (3) "strength and verbal fluency" (untrained). Outcomes evaluated at baseline, after training, and 3 months after the intervention period included absolute values for the motor and cognitive performance under DT conditions, and relative DT costs (DTCs) in motor, cognitive and combined motor-cognitive performance. RESULTS: The IG significantly improved DT performances in the trained condition for absolute motor and cognitive performance and for motor, cognitive, and combined motor-cognitive DTCs compared to the CG (p <= 0.001 to 0.047; etap2 = 0.044 to 0.249). Significant transfer effects were found in the semi-trained condition for absolute motor and partly cognitive performance, and for motor but not for cognitive DTCs, and only partly for combined DTCs (p <= 0.001 to 0.041; etap2 = 0.049 to 0.150). No significant transfer effects were found in the untrained condition. Three months after training cessation, DT performance in the trained condition was still elevated for most of the outcomes (p <= 0.001 to 0.038; etap2 = 0.058 to 0.187). Training gains in the DT performance in the semi-trained condition were, however, not sustained, and no significant group differences were found in the DT performance in the untrained condition after the follow-up. CONCLUSION: This study confirmed that specific DT training is effective in improving specifically trained DT performances in PwD and demonstrated sustainability of training-induced effects for at least 3 months. Effects were partially transferable to semi-trained DTs but not to untrained DTs. With increasing distance between trained and untrained DTs, transferability of training effects decreased.

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