St George Rebecca J, Jayakody Oshadi, Healey Rebecca, Breslin Monique, Hinder Mark R, Callisaya Michele L
School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Sandy Bay, Australia; Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.
Department of Medicine, Albert Einstein College of Medicine, New York, USA.
Gait Posture. 2022 Jun;95:186-191. doi: 10.1016/j.gaitpost.2022.04.021. Epub 2022 Apr 26.
Prior work suggests there may be greater reliance on executive function for walking in older people. The pre-frontal cortex (PFC), which controls aspects of executive function, is known to be active during dual-task walking (DTW). However, there is debate on how PFC activity during DTW is impacted by ageing and the requirements of the cognitive task.
Functional near infrared spectroscopy, was used to investigate how PFC activity during walking was affected by (i) healthy ageing; and (ii) dual-tasks that utilise inhibition or working memory aspects of executive function.
Young (n = 26, 16 females, mean 20.9 years) and older (n = 26, 16 females, mean 70.3 years) adults performed five conditions: normal walking; Reciting Alternate Letters of the alphabet (RAL, requiring cognitive inhibition and working memory) during standing and walking; and serial subtraction by threes (SS3, requiring working memory alone) during standing and walking. Walking speed, cognitive performance, the PFC haemodynamic response, and fear of falling ratings were analysed using linear mixed-effects modelling.
Compared to quiet standing, PFC activity increased during normal walking for older adults but decreased for young adults (p < 0.01). Across both groups, fear of falling contributed to higher PFC activity levels when walking (p < 0.01). PFC activity increased during DTW, and this increase was greater when performing RAL compared to the SS3 task (p < 0.01). Although the rate of correct responses was higher for RAL, walking speed reduced more with RAL than SS3 in the young group (p = 0.01), and the rate of correct responses reduced more when walking with RAL than SS3 in the older group (p < 0.01).
Older adults have increased levels of PFC activation during walking compared to younger adults and fear of falling is a cofounding factor. The interference between gait and a concurrent cognitive task is higher when the cognitive task requires inhibition.
先前的研究表明,老年人在行走时可能更依赖执行功能。已知控制执行功能各方面的前额叶皮质(PFC)在双任务行走(DTW)过程中会被激活。然而,关于DTW期间PFC活动如何受到衰老和认知任务要求的影响,仍存在争议。
使用功能近红外光谱技术来研究行走过程中PFC活动如何受到以下因素的影响:(i)健康衰老;(ii)利用执行功能的抑制或工作记忆方面的双任务。
年轻成年人(n = 26,16名女性,平均年龄20.9岁)和年长成年人(n = 26,16名女性,平均年龄70.3岁)进行了五种情况的测试:正常行走;站立和行走时背诵字母表中的交替字母(RAL,需要认知抑制和工作记忆);站立和行走时进行逐三递减减法(SS3,仅需要工作记忆)。使用线性混合效应模型分析行走速度、认知表现、PFC血流动力学反应和跌倒恐惧评分。
与安静站立相比,年长成年人在正常行走时PFC活动增加,而年轻成年人则减少(p < 0.01)。在两组中,行走时对跌倒的恐惧导致PFC活动水平更高(p < 0.01)。DTW期间PFC活动增加,并且与SS3任务相比,执行RAL时这种增加更大(p < 0.01)。尽管RAL的正确反应率更高,但年轻组中RAL比SS3导致的行走速度下降更多(p = 0.01),年长组中行走时RAL比SS3导致的正确反应率下降更多(p < 0.01)。
与年轻成年人相比,年长成年人在行走时PFC激活水平增加,对跌倒的恐惧是一个混杂因素。当认知任务需要抑制时,步态与并发认知任务之间的干扰更高。