A comparison of two walking while talking paradigms in aging.

BACKGROUND Our study aimed to [1] compare dual-task costs in gait and cognitive performance during two dual-task paradigms: walking while reciting alternate letters of the alphabet (WWR) and walking while counting backward by sevens (WWC); [2] examine the relationship between the gait and cognitive interference tasks when performed concurrently. SCOPE Gait and cognitive performance were tested in 217 non-demented older adults (mean age 76 ± 8.8 years; 56.2% female) under single and dual-task conditions. Velocity (cm/s) was obtained using an instrumented walkway. Cognitive performance was assessed using accuracy ratio: [correct responses]/[total responses]. Linear mixed effects models revealed significant dual-task costs, with slower velocity (p < .01) and decreased accuracy ratio (p < .01) in WWR and WWC compared to their respective single task conditions. Greater dual-task costs in velocity (p < .01) were observed in WWC compared to WWR. Pearson correlations revealed significant and positive relationships between gait and cognitive performance in WWR and WWC (p < .01); increased accuracy ratio was associated with faster velocity. CONCLUSIONS Our findings suggested that dual-task costs in gait increase as the complexity of the cognitive task increases. Furthermore, the positive association between the gait and cognitive tasks suggest that dual-task performance was not influenced by task prioritization strategies in this sample.

[1]  Shu-Chen Li,et al.  Dual-tasking postural control: Aging and the effects of cognitive demand in conjunction with focus of attention , 2006, Brain Research Bulletin.

[2]  Herman Buschke,et al.  Screening for Dementia by Telephone Using the Memory Impairment Screen , 2003, Journal of the American Geriatrics Society.

[3]  Xiaonan Xue,et al.  Cognitive processes related to gait velocity: results from the Einstein Aging Study. , 2006, Neuropsychology.

[4]  Wendy A Rogers,et al.  Cognitive and Motor Mechanisms Underlying Older Adults' Ability to Divide Attention While Walking , 2011, Physical Therapy.

[5]  Roee Holtzer,et al.  The relationship between attention and gait in aging: facts and fallacies. , 2012, Motor control.

[6]  Subashan Perera,et al.  The reliability and validity of measures of gait variability in community-dwelling older adults. , 2008, Archives of physical medicine and rehabilitation.

[7]  Richard B. Lipton,et al.  Within-person across-neuropsychological test variability and incident dementia. , 2008, JAMA.

[8]  F. Piras,et al.  Word and number reading in the brain: Evidence from a Voxel-based Lesion-symptom Mapping study , 2009, Neuropsychologia.

[9]  Roee Holtzer,et al.  Mobility Stress Test Approach to Predicting Frailty, Disability, and Mortality in High‐Functioning Older Adults , 2012, Journal of the American Geriatrics Society.

[10]  R. Holtzer,et al.  Performance variance on walking while talking tasks: theory, findings, and clinical implications , 2013, AGE.

[11]  P. Jolicoeur,et al.  A central capacity sharing model of dual-task performance. , 2003, Journal of experimental psychology. Human perception and performance.

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

[13]  V. Mercer,et al.  Dual‐Task Methodology: Applications in Studies of Cognitive and Motor Performance in Adults and Children , 2001, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

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

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

[16]  Olivier Beauchet,et al.  Dual-Task-Related Gait Changes in , 2004, Gerontology.

[17]  H. Buschke,et al.  Walking while talking: effect of task prioritization in the elderly. , 2007, Archives of physical medicine and rehabilitation.

[18]  A. Hartley,et al.  Age-related differences and similarities in dual-task interference. , 1999, Journal of experimental psychology. General.

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

[20]  Otmar Bock,et al.  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 , 2008, Journal of NeuroEngineering and Rehabilitation.

[21]  S. Yasumura,et al.  [Life-space of community-dwelling older adults using preventive health care services in Japan and the validity of composite scoring methods for assessment]. , 2010, [Nihon koshu eisei zasshi] Japanese journal of public health.

[22]  Charles Hall,et al.  Validity of Divided Attention Tasks In Predicting Falls in Older Individuals: A Preliminary Study , 2002, Journal of the American Geriatrics Society.

[23]  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.

[24]  Roy P C Kessels,et al.  Executive functions are associated with gait and balance in community-living elderly people. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[25]  Herman Buschke,et al.  Abnormality of gait as a predictor of non-Alzheimer's dementia. , 2002, The New England journal of medicine.

[26]  J. Kaye,et al.  Talking while walking , 1997, Neurology.

[27]  A. Hartley,et al.  Age differences in dual-task interference are localized to response-generation processes. , 2001, Psychology and aging.

[28]  Jeffrey M. Hausdorff,et al.  When does walking alter thinking? Age and task associated findings , 2009, Brain Research.

[29]  Xiaonan Xue,et al.  Quantitative gait dysfunction and risk of cognitive decline and dementia , 2007, Journal of Neurology, Neurosurgery & Psychiatry.