Liu-Ambrose Teresa, Katarynych Lindsay A, Ashe Maureen C, Nagamatsu Lindsay S, Hsu Chun Liang
Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada V5Z 1M9.
J Gerontol A Biol Sci Med Sci. 2009 Sep;64(9):975-82. doi: 10.1093/gerona/glp063. Epub 2009 May 8.
Exploring factors that contribute to dual-task gait performance among seniors is of particular interest in falls prevention because dual-task-related gait changes are associated with increased falls risk. It is unclear currently which specific executive processes are most relevant to dual-task gait performance and whether "balance confidence" is independently associated with dual-task gait performance.
A cross-sectional analysis of 140 senior women aged 65-75 years old. Balance confidence was assessed by the Activities-Specific Balance Confidence scale. Three key executive processes were assessed by standard neuropsychological tests: (i) set shifting, (ii) working memory, and (iii) response inhibition. Dual-task gait performance was assessed by the simple and complex versions of the walking while talking (WWT) test. Two linear regression models were constructed to determine the independent association of executive functions and balance confidence with: (i) simple WWT completion time and (ii) complex WWT completion time.
Balance confidence was independently associated with both simple and complex WWT completion times after accounting for age, time to walk 40 ft without talking, and global cognition. Set shifting was independently associated with complex WWT completion time; no executive processes were independently associated with simple WWT completion time.
This study highlights that balance confidence is independently associated with dual-task gait performance. Furthermore, executive functions do not play a significant role in dual-task gait performance when the concurrent cognitive load is low. Clinicians may need to consider balance confidence and executive functions in the assessment and rehabilitation of dual-task gait performance among community-dwelling seniors.
探究导致老年人双任务步态表现的因素在预防跌倒方面尤为重要，因为与双任务相关的步态变化与跌倒风险增加有关。目前尚不清楚哪些特定的执行过程与双任务步态表现最为相关，以及“平衡信心”是否与双任务步态表现独立相关。
对140名65 - 75岁的老年女性进行横断面分析。通过特定活动平衡信心量表评估平衡信心。通过标准神经心理学测试评估三个关键执行过程：（i）任务切换，（ii）工作记忆，以及（iii）反应抑制。通过边走边说（WWT）测试的简单版和复杂版评估双任务步态表现。构建两个线性回归模型以确定执行功能和平衡信心与以下方面的独立关联：（i）简单WWT完成时间和（ii）复杂WWT完成时间。
在考虑年龄、不说话行走40英尺的时间和整体认知后，平衡信心与简单和复杂WWT完成时间均独立相关。任务切换与复杂WWT完成时间独立相关；没有执行过程与简单WWT完成时间独立相关。
本研究强调平衡信心与双任务步态表现独立相关。此外，当并发认知负荷较低时，执行功能在双任务步态表现中不发挥重要作用。临床医生在评估和康复社区居住老年人的双任务步态表现时可能需要考虑平衡信心和执行功能。
