Dual-task costs while walking increase in old age for some, but not for other tasks: an experimental study of healthy young and elderly persons

BackgroundIt has been suggested in the past that the ability to walk while concurrently engaging in a second task deteriorates in old age, and that this deficit is related to the high incidence of falls in the elderly. However, previous studies provided inconsistent findings about the existence of such an age-related dual-task deficit (ARD). In an effort to explain this inconsistency, we explored whether ARD while walking emerges for some, but not for other types of task.MethodsHealthy young and elderly subjects were tested under five different combinations of a walking and a non-walking task. The results were analysed jointly with those of a previous study from our lab, such that a total of 13 task combinations were evaluated. For each task combination and subject, we calculated the mean dual-task costs across both constituent tasks, and quantified ARD as the difference between those costs in elderly and in young subjects.ResultsAn analysis of covariance yielded no significant effects of obstacle presence and overall task difficulty on ARD, but a highly significant effect of visual demand: non-walking tasks which required ongoing visual observation led to ARD of more than 8%, while those without such requirements led to near-zero ARD. We therefore concluded that the visual demand of the non-walking task is critical for the emergence of ARD while walking.ConclusionCombinations of walking and concurrent visual observation, which are common in everyday life, may contribute towards disturbed gait and falls during daily activities in old age. Prevention and rehabilitation programs for seniors should therefore include training of such combinations.

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

[2]  Faith M. Gunning-Dixon,et al.  Neuroanatomical correlates of selected executive functions in middle-aged and older adults: a prospective MRI study , 2003, Neuropsychologia.

[3]  A B Schultz,et al.  Stepping over obstacles: dividing attention impairs performance of old more than young adults. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[4]  D. Damos Multiple-task performance , 2020 .

[5]  D. Roenker,et al.  Age and visual search: expanding the useful field of view. , 1988, Journal of the Optical Society of America. A, Optics and image science.

[6]  W. Sparrow,et al.  Aging effects on visual reaction time in a single task condition and when treadmill walking. , 2006, Motor control.

[7]  A. J. Campbell,et al.  Falls in old age: a study of frequency and related clinical factors. , 1981, Age and ageing.

[8]  M. Woollacott,et al.  Attentional demands and postural control: the effect of sensory context. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  M. Tinetti,et al.  Prevention of falls among the elderly. , 1989, The New England journal of medicine.

[10]  F. Craik,et al.  The handbook of aging and cognition , 1992 .

[11]  T. Salthouse,et al.  Divided attention abilities in young and old adults. , 1982, Journal of experimental psychology. Human perception and performance.

[12]  Maarten F. Bobbert,et al.  Age-related intrinsic limitations in preventing a trip and regaining balance after a trip , 2005 .

[13]  Tamara B Harris,et al.  Multitasking: Association Between Poorer Performance and a History of Recurrent Falls , 2007, Journal of the American Geriatrics Society.

[14]  Matthew G. Rhodes,et al.  Age-related differences in performance on the Wisconsin card sorting test: a meta-analytic review. , 2004, Psychology and aging.

[15]  N. Raz Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings. , 2000 .

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

[17]  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.

[18]  P. Baltes,et al.  Memorizing while walking: increase in dual-task costs from young adulthood to old age. , 2000, Psychology and aging.

[19]  M. Woollacott,et al.  Cognitive influence on postural stability: a neuromuscular analysis in young and older adults. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  Arthur F Kramer,et al.  Training effects on dual-task performance: are there age-related differences in plasticity of attentional control? , 2005, Psychology and aging.

[21]  D. Winter,et al.  Biomechanical walking pattern changes in the fit and healthy elderly. , 1990, Physical therapy.

[22]  C. Thomas-Antérion,et al.  Évolution de l'organisation hiérarchique des attributs en mémoire chez des patients Alzheimer (DTA) : suivi longitudinal et études transversales , 2004 .

[23]  Gérome C Gauchard,et al.  Higher visual dependency increases balance control perturbation during cognitive task fulfilment in elderly people , 2004, Neuroscience Letters.

[24]  S. Shaffer,et al.  Aging of the Somatosensory System: A Translational Perspective , 2007, Physical Therapy.

[25]  Jan P Vandenbroucke,et al.  In an observational study elderly patients had an increased risk of falling due to home hazards. , 2005, Journal of clinical epidemiology.

[26]  B. Troost,et al.  The effects of age on normal saccadic characteristics and their variability , 1983, Vision Research.

[27]  T. Mulder,et al.  Are older adults more dependent on visual information in regulating self-motion than younger adults? , 1998, Journal of Motor Behavior.

[28]  Jeffrey M. Hausdorff,et al.  Walking is more like catching than tapping: gait in the elderly as a complex cognitive task , 2005, Experimental Brain Research.

[29]  Xiaonan Xue,et al.  The relationship between specific cognitive functions and falls in aging. , 2007, Neuropsychology.

[30]  J. Fuster Frontal lobes , 1993, Current Opinion in Neurobiology.

[31]  R H Logie,et al.  Dual task effects of walking when talking in Alzheimer's disease. , 2004, Revue neurologique.

[32]  P. Baltes,et al.  Walking While Memorizing: Age-Related Differences in Compensatory Behavior , 2001, Psychological science.

[33]  P. Lüthje,et al.  Long-term survival after falls among the elderly in institutional care. , 2004, Archives of gerontology and geriatrics.

[34]  N Teasdale,et al.  Upright standing and gait: are there changes in attentional requirements related to normal aging? , 1996, Experimental aging research.

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

[36]  Julie M. Harris,et al.  Guidance of locomotion on foot uses perceived target location rather than optic flow , 1998, Current Biology.

[37]  R. Baloh,et al.  The vestibular system in the elderly: clinical implications. , 1989, American journal of otolaryngology.

[38]  L Nyberg,et al.  Attention, Frailty, and Falls: The Effect of a Manual Task on Basic Mobility , 1998, Journal of the American Geriatrics Society.

[39]  J. Cerella,et al.  Aging and dual-task performance: a meta-analysis. , 2003, Psychology and aging.

[40]  M. Tinetti,et al.  A multifactorial intervention to reduce the risk of falling among elderly people living in the community. , 1994, The New England journal of medicine.

[41]  Y. Lajoie,et al.  Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. , 2004, Archives of gerontology and geriatrics.

[42]  F. Craik,et al.  Effects of aging and task difficulty on divided attention performance. , 1988, Journal of experimental psychology. Human perception and performance.

[43]  J. Mcdowd,et al.  The effects of age and extended practice on divided attention performance. , 1986, Journal of gerontology.

[44]  J J Bloomberg,et al.  Optic flow dominates visual scene polarity in causing adaptive modification of locomotor trajectory. , 2005, Brain research. Cognitive brain research.

[45]  Otmar Bock,et al.  Gerontechnology and human cognition , 2008, IEEE Engineering in Medicine and Biology Magazine.

[46]  R. Kliegl,et al.  Age differences in dual-task performance after practice. , 2007, Psychology and aging.

[47]  N Teasdale,et al.  On the cognitive penetrability of posture control. , 1993, Experimental aging research.

[48]  A Thevenon,et al.  Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions , 2006, Clinical rehabilitation.

[49]  R. West,et al.  An application of prefrontal cortex function theory to cognitive aging. , 1996, Psychological bulletin.

[50]  H N Zelaznik,et al.  The influence of aging and attentional demands on recovery from postural instability , 1990, Aging.

[51]  M. Woollacott,et al.  Attention and the control of posture and gait: a review of an emerging area of research. , 2002, Gait & posture.

[52]  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.