Age-related differences in dual task walking: a cross sectional study

BackgroundVariability in stride velocity during walking characterizes gait instability and predicts falling in older individuals. Walking while executing a cognitive task is also associated with increased risk of falling, particularly in older adults. Variability in stride velocity, particularly during dual task walking conditions, may differ between younger and older individuals. The purpose of this study was to examine whether gait velocity and variability in stride velocity differ between older community-dwelling women and younger women during dual task walking.MethodsTwenty-three older (80 ± 9 years) and 19 younger (23 ± 2 years) women walked under each of two conditions: (1) walking at a self-selected velocity and (2) walking at a self-selected velocity while incrementally counting backwards. Gait velocity and variability in stride velocity were measured with GAITRite® instrumentation.ResultsGait velocity decreased and variability in stride variability increased, in both groups, during dual task walking. The relative reduction in gait velocity and the magnitude of variability in stride velocity were greater in the older subjects than younger subjects.ConclusionThe gait changes observed in dual task walking characterize reduced gait stability and indicate that cognitively demanding tasks during walking have a destabilizing effect on gait that may place older persons at greater risk of falls.

[1]  M. Grabiner,et al.  Age-related changes in spatial and temporal gait variables. , 2001, Archives of physical medicine and rehabilitation.

[2]  G. L. Pellecchia,et al.  Postural sway increases with attentional demands of concurrent cognitive task. , 2003, Gait & posture.

[3]  Jeffrey M. Hausdorff,et al.  Influence of Executive Function on Locomotor Function: Divided Attention Increases Gait Variability in Alzheimer's Disease , 2003, Journal of the American Geriatrics Society.

[4]  P. J. Bowman,et al.  Central Nervous System–Active Medications and Risk for Falls in Older Women , 2002, Journal of the American Geriatrics Society.

[5]  Jeffrey M. Hausdorff,et al.  Dual‐tasking effects on gait variability: The role of aging, falls, and executive function , 2006, Movement disorders : official journal of the Movement Disorder Society.

[6]  Jeffrey M. Hausdorff,et al.  Effects of Cognitive Challenge on Gait Variability in Patients with Parkinson’s Disease , 2003, Journal of geriatric psychiatry and neurology.

[7]  R. Fitzpatrick,et al.  Age-related differences in walking stability. , 2003, Age and ageing.

[8]  Bastiaan R Bloem,et al.  Quantitative assessment of the stops walking while talking test in the elderly. , 2003, Archives of physical medicine and rehabilitation.

[9]  V. Parmar,et al.  Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait & Posture 2004;20(1):20–25 , 2006 .

[10]  Jeffrey M. Hausdorff,et al.  Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. , 2001, Journal of applied physiology.

[11]  F. Horak.  Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? , 2006, Age and ageing.

[12]  Mark Latt,et al.  Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. , 2004, Gait & posture.

[13]  Nir Giladi,et al.  Impaired regulation of stride variability in Parkinson's disease subjects with freezing of gait , 2003, Experimental Brain Research.

[14]  Joseph H Abramson,et al.  WINPEPI (PEPI-for-Windows): computer programs for epidemiologists , 2004, Epidemiologic perspectives & innovations : EP+I.

[15]  K. Aminian,et al.  Dual-task-related gait changes in the elderly: does the type of cognitive task matter? , 2005, Journal of motor behavior.

[16]  Tamara B Harris,et al.  Is a Fall Just a Fall: Correlates of Falling in Healthy Older Persons. The Health, Aging and Body Composition Study , 2003, Journal of the American Geriatrics Society.

[17]  Jeffrey M. Hausdorff,et al.  Dual tasking, gait rhythmicity, and Parkinson's disease: Which aspects of gait are attention demanding? , 2005, The European journal of neuroscience.

[18]  Patima Silsupadol,et al.  Training of balance under single- and dual-task conditions in older adults with balance impairment. , 2006, Physical therapy.

[19]  Jeffrey M. Hausdorff,et al.  Increased gait unsteadiness in community-dwelling elderly fallers. , 1997, Archives of physical medicine and rehabilitation.

[20]  Kamiar Aminian,et al.  AGE‐RELATED DECLINE OF GAIT CONTROL UNDER A DUAL‐TASK CONDITION , 2003, Journal of the American Geriatrics Society.

[21]  A M Wing,et al.  Age differences in postural stability are increased by additional cognitive demands. , 1996, The journals of gerontology. Series B, Psychological sciences and social sciences.

[22]  J. Hollman,et al.  Age-related differences in spatiotemporal markers of gait stability during dual task walking. , 2006, Gait & posture.

[23]  JoAnne K. Gronley,et al.  Classification of walking handicap in the stroke population. , 1995, Stroke.

[24]  M. Batavia,et al.  The validity and reliability of the GAITRite system's measurements: A preliminary evaluation. , 2001, Archives of physical medicine and rehabilitation.

[25]  R. Craik,et al.  Gait Variability in Community‐Dwelling Older Adults , 2001, Journal of the American Geriatrics Society.

[26]  M. Woollacott,et al.  Motor Control: Translating Research into Clinical Practice , 2006 .

[27]  L. Nyberg,et al.  “Stops walking when talking” as a predictor of falls in elderly people , 1997, The Lancet.

[28]  B. E. Maki,et al.  Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear? , 1997, Journal of the American Geriatrics Society.

[29]  A. Shumway-cook,et al.  The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. , 1997, Physical therapy.

[30]  Jeffrey M. Hausdorff,et al.  Gait variability and fall risk in community-living older adults: a 1-year prospective study. , 2001, Archives of physical medicine and rehabilitation.

[31]  A M Jette,et al.  Moderate exercise improves gait stability in disabled elders. , 1998, Archives of physical medicine and rehabilitation.

[32]  K. Aminian,et al.  Stride-to-stride variability while enumerating animal names among healthy young adults: result of stride velocity or effect of attention-demanding task? , 2008, Gait & posture.

[33]  John H. Hollman,et al.  Age‐Related Differences in Stride‐to‐Stride Variability During Dual Task Walking: A Pilot Study , 2004 .

[34]  M. Tinetti,et al.  Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs , 1999, Journal of the American Geriatrics Society.

[35]  M. Morris,et al.  Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. , 2003, Gait & posture.

[36]  W Poewe,et al.  Influence of Concurrent Tasks on Gait: A Dual-Task Approach , 1995, Perceptual and motor skills.

[37]  M. Tinetti,et al.  Risk Factors for Serious Injury During Falls by Older Persons in the Community , 1995, Journal of the American Geriatrics Society.

[38]  Li-Shan Chou,et al.  Cognitive task effects on gait stability following concussion , 2006, Experimental Brain Research.

[39]  Jeffrey M. Hausdorff,et al.  Gait variability and basal ganglia disorders: Stride‐to‐stride variations of gait cycle timing in parkinson's disease and Huntington's disease , 1998, Movement disorders : official journal of the Movement Disorder Society.