Department of Psychological and Brain Sciences, Washington University in St. Louis, USA.
Department of Biology, Washington University in St. Louis, USA.
Hum Mov Sci. 2020 Jun;71:102619. doi: 10.1016/j.humov.2020.102619. Epub 2020 Apr 20.
Cognitive-motor dual-tasking involves concurrent performance of two tasks with distinct cognitive and motor demands and is associated with increased fall risk. In this hypothesis-driven study, younger (18-30 years, n = 24) and older (60-75 years, n = 26) adults completed six walking tasks in triplicate. Participants walked forward and backward along a GAITRite mat, in isolation or while performing a verbal fluency task. Verbal fluency tasks involved verbally listing or typing on a smartphone as many words as possible within a given category (e.g., clothes). Using repeated measures MANOVA models, we examined how age, method of fluency task (verbal or texting), and direction of walking altered dual-task performance. Given that tasks like texting and backward walking require greater cognitive resources than verbal and forward walking tasks, respectively, we hypothesized older adults would show higher dual-task costs (DTCs) than younger adults across different task types and walking directions, with degree of impairment more apparent in texting dual-task trials compared to verbal dual-task trials. We also hypothesized that both age groups would have greater DTCs while walking backward than while walking forward, regardless of task. Independent of age group, velocity and stride length were reduced for texting compared to the verbal task during both forward and backward walking; cadence and velocity were reduced while walking forward compared to walking backward for the texting task; and stride length was reduced for forward walking compared to backward walking during the verbal task. Younger adults performed better than older adults on all tasks with the most pronounced differences seen in velocity and stride length during forward-texting and backward-texting. Interaction effects for velocity and stride length while walking forward indicated younger adults performed better than older adults for the texting task but similarly during the verbal task. An interaction for cadence during the verbal task indicated younger adults performed better than older adults while walking backward but similarly while walking forward. In summary, older adults experienced greater gait decrement for all dual-task conditions. The greater declines in velocity and stride length in combination with cadence being stable suggest reductions in velocity during texting were due to shorter strides rather than a reduced rate of stepping. Contrary to our hypotheses, we found greater DTCs while walking forward rather than backward, which may be due to reduced gait performance during single-task backward walking; thus, further decrements with dual-tasking are unlikely. These findings underscore the need for further research investigating fall risk potential associated with texting and walking among aging populations and how interventions targeting stride length during dual-task circumstances may improve performance.
认知-运动双重任务涉及同时执行具有不同认知和运动要求的两项任务,与跌倒风险增加有关。在这项基于假设的研究中,年轻(18-30 岁,n=24)和年老(60-75 岁,n=26)成年人在三个重复的试验中完成了六项步行任务。参与者在 GAITRite 垫上向前和向后行走,分别进行或同时进行言语流畅性任务。言语流畅性任务涉及尽可能多地在给定类别(例如,衣服)内用智能手机口头列出或输入单词。使用重复测量 MANOVA 模型,我们研究了年龄、流畅性任务的方法(口头或打字)以及行走方向如何改变双重任务表现。由于像发短信和向后行走这样的任务比口头和向前行走任务分别需要更多的认知资源,因此我们假设老年人在不同任务类型和行走方向上的双重任务成本(DTC)会高于年轻人,而在打字双重任务试验中比在口头双重任务试验中更明显。我们还假设,无论任务如何,与向前行走相比,向后行走时两个年龄组的 DTC 都会更大。独立于年龄组,与口头任务相比,发短信时的速度和步长在向前和向后行走时都降低了;在向前行走时,与向后行走相比,发短信时的步调和速度降低了;在口头任务中,向前行走时的步长比向后行走时短。年轻人在所有任务中的表现都优于老年人,最明显的差异出现在向前发短信和向后发短信时的速度和步长上。在向前行走时,速度和步长的交互作用表明,年轻人在发短信任务中表现优于老年人,但在口头任务中表现相似。口头任务中步频的交互作用表明,年轻人在向后行走时表现优于老年人,但在向前行走时表现相似。总之,老年人在所有双重任务条件下的步态都有更大的下降。速度和步长的下降更大,而步频稳定,这表明在发短信时速度的下降是由于步幅变短而不是步幅减小。与我们的假设相反,我们发现向前行走时的 DTC 更大,而不是向后行走时的 DTC 更大,这可能是由于在单任务向后行走时步态表现较差;因此,在双重任务中进一步下降的可能性不大。这些发现强调了需要进一步研究与老龄化人口发短信和行走相关的跌倒风险潜力,以及如何通过针对双重任务情况下步长的干预来提高表现。