Differential associations between dual-task walking abilities and usual gait patterns in healthy older adults—Results from the Baltimore Longitudinal Study of Aging (original) (raw)
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Dual Task Decrements in Gait among Healthy Older Adults: Contributing Factors
The Journals of Gerontology Series a Biological Sciences and Medical Sciences, 2008
BackgroundThe factors that contribute to the dual task (DT) changes in performance that occur when older adults walk while simultaneously performing other tasks are not well-known. We hypothesized that cognitive and motor reserve (e.g., executive function, EF, postural control, and walking abilities) and affect (e.g., anxiety, depressive symptoms) influence the DT decrements (DTDs) in gait.Methods228 community-living, healthy older adults (mean: 76.2±4.2 yrs; 59% women) walked with and without dual tasking, e.g., subtracting 7’s, phoneme monitoring. Mobility (e.g., the Dynamic Gait Index), cognitive function (e.g., memory, EF), and affect (e.g., Geriatric Depression Scale) were quantified. Bivariate and multivariate analyses identified factors associated with the DTD in gait speed (a general measure of locomotor function), swing time, (reflecting balance during gait), and swing time variability (a measure of stride-to-stride consistency).ResultsGait speed and swing time decreased (p<0.001) and swing time variability increased (became worse) (p<0.001) during all DTs. The DTD in gait speed was correlated with comfortable-walking gait speed, but not with tests of mobility or cognitive function. The DTD in swing time variability was correlated with EF, mobility and affect (e.g., depressive symptoms). Much of the variance in the DTDs was unexplained.ConclusionsUsual-walking abilities and cognitive function contribute to the DT effects on gait, but these relationships depend on specifics of the DT, the gait feature being studied, and the particulars of the cognitive domain. Meeting the everyday challenges of walking while dual tasking apparently relies on multiple factors including a consistent gait pattern and EF.
Dual-Task Decrements in Gait: Contributing Factors Among Healthy Older Adults
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2008
Background. The factors that contribute to the dual tasking (DT) changes in performance that occur when older adults walk while simultaneously performing other tasks are not well known. We hypothesized that cognitive and motor reserve (e.g., executive function [EF], postural control, and walking abilities) and affect (e.g., anxiety, depressive symptoms) influence the DT decrements (DTDs) in gait.
BMC Geriatrics, 2021
Background Dual-task gait performance declines as humans age, leading to increased fall risk among older adults. It is unclear whether different secondary cognitive tasks mediate age-related decline in dual-task gait. This study aimed to examine how type and difficulty level of the secondary cognitive tasks differentially affect dual-task gait in older adults. Methods Twenty young and twenty older adults participated in this single-session study. We employed four different types of secondary tasks and each consisted of two difficulty levels, yielding eight different dual-task conditions. The dual-task conditions included walking and 1) counting backward by 3 s or by 7 s; 2) remembering a 5-item or 7-item lists; 3) responding to a simple or choice reaction time tasks; 4) generating words from single or alternated categories. Gait speed and cognitive task performance under single- and dual-task conditions were used to compute dual-task cost (DTC, %) with a greater DTC indicating a wor...
Journal of the American Geriatrics Society, 2011
OBJECTIVES: To investigate dual-task performance of gait and cognition in cognitively healthy and cognitively impaired older adults using a motor-cognition dual-task paradigm. DESIGN: Cross-sectional retrospective study. SETTING: The Basel Memory Clinic and the Basel Study on the Elderly (Project BASEL). PARTICIPANTS: Seven hundred eleven older adults (mean age 77.2 AE 6.2, 350 (49.2%) female and 361 (50.8%) male). MEASUREMENTS: Gait velocity and cognitive task performance using a working memory (counting backward from 50 by 2s) and a semantic memory (enumerating animal names) task were measured during single-and dualtask conditions. Gait was assessed using the GAITRite electronic walkway system. Cognitive impairment was defined as a score less than 25 on the Mini-Mental State Examination. RESULTS: During dual tasks, participants reduced gait velocity (Po.001) and calculated fewer numbers (P 5.03) but did not enumerate fewer animals and did not make more errors or repetitions (P4.10). Cognitively impaired individuals had lower baseline gait velocity and a greater reduction in gait velocity but not cognitive performance during dual tasks than cognitively healthy participants (Po.01). CONCLUSION: Gait velocity was lower during both dual tasks, whereas decrease in cognitive performance depended on the cognitive ability needed in the dual-task condition. Cognitively impaired individuals generally have poorer baseline performance and greater dual task-related gait velocity reduction than those who are cognitively healthy. Future research should include different conditions for gait to determine adaptive potentials of older adults.
“Effect of Secondary Cognitive and Motor Tasks on Selected Gait Parameters in Different Age Groups”
International Journal Of Medical Science And Clinical Invention, 2021
Since walking is a dynamic activity which is an automatic process and attention demanding task. Dual task while walking may cause changes in gait, therefore this study primarily aims to identify whether a secondary cognitive or motor task would have a greater effect on gait parameters in different age groups. Secondarily, it aims to examine difference in gait performance between young and older adults while performing cognitive and motor tasks. Student’s t- test and Repeated measure analysis of variance was used for Statistical analyses. Older group had significantly higher gait time (mean difference: 2.61,3.86, and 6.37seconds), lower stride length (mean difference: 0.26, 0.25, and 0.28 cm), and higher step width (mean difference: 1.46,1.85, and 3.13cm) during simple walking task, motor task and cognitive task while walking, respectively as compared to young adults.This study concludes that the secondary cognitive task has affect the selected gait parameters more in young and older...
Journal of NeuroEngineering and Rehabilitation, 2017
Background: Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach. Methods: An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi 2 tests). Results: Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity allowed the identification of 3 motor phenotypes (p < 0.01), without any difference for white matter hyperintensities, but with an increased Scheltens score from the first to the third motor phenotype (p = 0.05). Conclusions: Gait analysis under dual-task conditions in elderly people suffering from gait disorders or memory impairment is of great value in assessing the severity of gait disorders, differentiating between peripheral pathologies and central nervous system pathologies, and identifying motor phenotypes. Correlations between motor phenotypes and brain imaging require further studies.
Revista Brasileira de Geriatria e Gerontologia, 2016
Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed b...
Physiological and Cognitive Determinants of Dual-Task Costs for Gait Parameters: The Yishun Study
Gerontology
Background: Studies indicate that physiological and cognitive aging are causally related and functionally interdependent. However, the relative contribution of physiological factors and cognition to dual-task costs (DTC) of gait parameters has not been well studied. In this cross-sectional study, we examined the trajectory of DTC of gait parameters across the adult age spectrum for both sexes and identified the contributions of physical and cognitive performance to DTC of gait. Methods: A total of 492 community-dwelling adults, aged 21–90 years, were randomly recruited into the study. Participants were divided into 7 age groups, with 10-year age range for each group. Demographic data, height, body mass, education level, and information on comorbidities were recorded. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physical performance included visual contrast sensitivity, postural sway, hand reaction time, handgrip strength, knee ...
Aging clinical and experimental research, 2017
The present study explores the differences in gait parameters in elderly subjects with or without cognitive impairment measured by means of ambulatory actigraphy while performing a single and a dual task. Sixty-nine participants of which 23 individuals were diagnosed with Alzheimer's disease (AD), 24 individuals with mild cognitive impairment (MCI), and 22 healthy controls performed a single and dual walking task while wearing a wrist-worn accelerometer. Objective measures of gait features such as walking speed, cadence (i.e., number of steps per minute), and step variance (i.e., variance in time between two consecutive steps) were derived and analyzed. While differences in several gait parameters, namely walking speed, were found between MCI and AD patients, no differences between healthy elderly and MCI patients were found. Walking speed seems to be a gait-related feature that differs significantly between MCI and AD patients and thus could be used as an additional measurement...