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Cognitive and motor mechanisms underlying older adults' ability to divide attention while walking.
Phys Ther. 2011 Jul; 91(7):1039-50.PT

Abstract

BACKGROUND

An impaired ability to allocate attention to gait during dual-task situations is a powerful predictor of falls.

OBJECTIVE

The primary purpose of this study was to examine the relative contributions of participant characteristics and motor and cognitive factors to the ability to walk while performing cognitive tasks. The impact of cognitive task complexity on walking also was examined.

DESIGN

A cross-sectional, exploratory study design was used.

METHODS

Seventy-seven community-dwelling older adults with a mean (SD) age of 75.5 (5.8) years completed comprehensive testing. Participant characteristics were assessed via questionnaires. The motor test battery included measures of strength (force-generating capacity), gait speed, and static and dynamic balance. The cognitive abilities test battery assessed psychomotor and perceptual speed, recall and working memory, verbal and spatial ability, and attention (sustained, selective, and divided). Time to walk while performing 4 cognitive tasks was measured. In addition, dual-task costs (DTCs) were calculated. Multiple hierarchical regressions explored walking under dual-task conditions.

RESULTS

The ability to walk and perform a simple cognitive task was explained by participant characteristics and motor factors alone, whereas walking and performing a complex cognitive task was explained by cognitive factors in addition to participant and motor factors. Regardless of the cognitive task, participants walked slower under dual-task conditions than under single-task conditions. Increased cognitive task complexity resulted in greater slowing of gait: gait DTCs were least for the simplest conditions and greatest for the complex conditions. Limitations Walking performance was characterized by a single parameter (time), whereas other spatiotemporal parameters have been related to dual-task performance. However, this type of measurement (timed performance) will be easy to implement in the clinic.

CONCLUSIONS

Two factors-participant characteristics and motor abilities-explained the majority of variance of walking under dual-task conditions; however, cognitive abilities also contributed significantly to the regression models. Rehabilitation focused on improving underlying balance and gait deficits, as well as specific cognitive impairments, may significantly improve walking under dual-task conditions.

Authors+Show Affiliations

Rehabilitation R & D Center of Excellence (151R), Atlanta VA Medical Center, 1670 Clairmont Rd, Decatur, GA 30033, USA. chall7@emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

21527384

Citation

Hall, Courtney D., et al. "Cognitive and Motor Mechanisms Underlying Older Adults' Ability to Divide Attention While Walking." Physical Therapy, vol. 91, no. 7, 2011, pp. 1039-50.
Hall CD, Echt KV, Wolf SL, et al. Cognitive and motor mechanisms underlying older adults' ability to divide attention while walking. Phys Ther. 2011;91(7):1039-50.
Hall, C. D., Echt, K. V., Wolf, S. L., & Rogers, W. A. (2011). Cognitive and motor mechanisms underlying older adults' ability to divide attention while walking. Physical Therapy, 91(7), 1039-50. https://doi.org/10.2522/ptj.20100114
Hall CD, et al. Cognitive and Motor Mechanisms Underlying Older Adults' Ability to Divide Attention While Walking. Phys Ther. 2011;91(7):1039-50. PubMed PMID: 21527384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive and motor mechanisms underlying older adults' ability to divide attention while walking. AU - Hall,Courtney D, AU - Echt,Katharina V, AU - Wolf,Steven L, AU - Rogers,Wendy A, Y1 - 2011/04/28/ PY - 2011/4/30/entrez PY - 2011/4/30/pubmed PY - 2011/9/29/medline SP - 1039 EP - 50 JF - Physical therapy JO - Phys Ther VL - 91 IS - 7 N2 - BACKGROUND: An impaired ability to allocate attention to gait during dual-task situations is a powerful predictor of falls. OBJECTIVE: The primary purpose of this study was to examine the relative contributions of participant characteristics and motor and cognitive factors to the ability to walk while performing cognitive tasks. The impact of cognitive task complexity on walking also was examined. DESIGN: A cross-sectional, exploratory study design was used. METHODS: Seventy-seven community-dwelling older adults with a mean (SD) age of 75.5 (5.8) years completed comprehensive testing. Participant characteristics were assessed via questionnaires. The motor test battery included measures of strength (force-generating capacity), gait speed, and static and dynamic balance. The cognitive abilities test battery assessed psychomotor and perceptual speed, recall and working memory, verbal and spatial ability, and attention (sustained, selective, and divided). Time to walk while performing 4 cognitive tasks was measured. In addition, dual-task costs (DTCs) were calculated. Multiple hierarchical regressions explored walking under dual-task conditions. RESULTS: The ability to walk and perform a simple cognitive task was explained by participant characteristics and motor factors alone, whereas walking and performing a complex cognitive task was explained by cognitive factors in addition to participant and motor factors. Regardless of the cognitive task, participants walked slower under dual-task conditions than under single-task conditions. Increased cognitive task complexity resulted in greater slowing of gait: gait DTCs were least for the simplest conditions and greatest for the complex conditions. Limitations Walking performance was characterized by a single parameter (time), whereas other spatiotemporal parameters have been related to dual-task performance. However, this type of measurement (timed performance) will be easy to implement in the clinic. CONCLUSIONS: Two factors-participant characteristics and motor abilities-explained the majority of variance of walking under dual-task conditions; however, cognitive abilities also contributed significantly to the regression models. Rehabilitation focused on improving underlying balance and gait deficits, as well as specific cognitive impairments, may significantly improve walking under dual-task conditions. SN - 1538-6724 UR - https://www.unboundmedicine.com/medline/citation/21527384/Cognitive_and_motor_mechanisms_underlying_older_adults'_ability_to_divide_attention_while_walking_ L2 - https://academic.oup.com/ptj/article-lookup/doi/10.2522/ptj.20100114 DB - PRIME DP - Unbound Medicine ER -