Differences in Cognitive-Motor Interference in Older Adults While Walking and Performing a Visual-Verbal Stroop Task

Abstract

Objectives: Studies using the dual-task (DT) paradigm to explain age-related performance decline due to cognitive-motor interference (CMI) which causes DT costs (DTCs) revealed contradictory results for performances under DT conditions. This cross-sectional study analyzed whether differences in demographics, physical functioning, concerns of falling (CoF), and other mental factors can explain positive and negative DTCs in older adults while walking in DT situations. Methodology: N = 222 participants (57-89 years) performed a single task (ST) and a DT walking condition (visual-verbal Stroop task) in randomized order on a treadmill. Gait parameters (step length, step width) were measured at a constant self-selected walking speed. Demographics [age, Mini Mental Status Examination (MMSE)], physical functioning (hand grip strength), CoF [Falls Efficacy Scale International (FES-I)], and mental factors [Short Form-12 (SF-12)] were assessed. An analysis of variance (ANOVA) was used to reveal subgroup differences. A four-step hierarchical regression analysis was conducted to identify which variables determine the DTC. Results: Three subgroups were identified: (1) participants (n = 53) with positive DTCs (improvements under DT conditions); (2) participants with negative DTCs (n = 60) in all gait parameters; and (3) participants (n = 109) who revealed non-uniform DTCs. Baseline characteristics between the subgroups showed differences in age (F _(2,215) = 4.953; p = 0.008; η ² = 0.044). The regression analysis revealed that physical functioning was associated with positive DTC and CoF with negative DTC. Conclusion: The results confirmed a huge inter-individual variability in older adults. They lead us to suggest that factors causing performance differences in DTCs needs to be reassessed. Functional age seems to determine DTCs rather than calendric age. Psychological variables particularly seem to negatively influence DT performance.

Keywords: aging; cognition; concerns of falling; dual task performance; mental health; physical functioning; walking.

Figure 1

This image shows the interaction of Falls Efficacy Scale International (FES-I) and hand grip strength. Negative dual task (DT) performers showed higher concerns of falling (CoF) and greater hand grip strength. Positive DT performers had reduced hand grip strength and less CoF. Scores of FES-I and a hand grip strength for non-uniform performers were between the scores of the two other groups.

Figure 2

This image shows that participants with negative DT costs (DTCs) had greater decrements for step width and step length than the other two groups, whereas participants with positive DTC revealed improved step length with reduced step width. The non-uniform participants were between the two other groups.