scholarly journals Falls Risk and Simulated Driving Performance in Older Adults

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
John G. Gaspar ◽  
Mark B. Neider ◽  
Arthur F. Kramer

Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance.

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maayan Agmon ◽  
Einat Kodesh ◽  
Rachel Kizony

Background. The ability to safely conduct different types of walking concurrently with a cognitive task (i.e., dual task) is crucial for daily life. The contribution of different walking types to dual-task performance has not yet been determined, nor is there agreement on the strategies that older adults use to divide their attention between two tasks (task prioritization).Objectives. To compare the effect of walking in three different directions (forward, backward, and sideways) on dual-task performance and to explore the strategies of older adults to allocate their attention in response to different motor task demands.Design. A cross-sectional study.Subjects. Thirty-two (22 female) community-dwelling older adults (aged72.7±5.7years).Methods. Subjects randomly conducted single and dual task: walking to three directions separately, cognitive tasks separately, and combination of the two.Results. Walking forward was the least demanding task, during single (FW < BW, SW) (P<.001) and dual tasks (FW < BW < SW) (P<.001). The calculation of DTC revealed the same pattern (P<.001). DTC of the cognitive tasks was not significantly different among the three walking types.Conclusions. The decline mainly in the motor performance during dual task indicates that participants prioritized the cognitive task. These findings challenge the “posture first” paradigm for task prioritization.


2021 ◽  
Vol 13 ◽  
Author(s):  
Krystal M. Kirby ◽  
Sreekrishna Pillai ◽  
Robert M. Brouillette ◽  
Jeffrey N. Keller ◽  
Alyssa N. De Vito ◽  
...  

Prior research has suggested that measurements of brain functioning and performance on dual tasks (tasks which require simultaneous performance) are promising candidate predictors of fall risk among older adults. However, no prior study has investigated whether brain function measurements during dual task performance could improve prediction of fall risks and whether the type of subtasks used in the dual task paradigm affects the strength of the association between fall characteristics and dual task performance. In this study, 31 cognitively normal, community-dwelling older adults provided a self-reported fall profile (number of falls and fear of falling), completed a gait dual task (spell a word backward while walking on a GaitRite mat), and completed a supine dual task (rhythmic finger tapping with one hand while completing the AX continuous performance task (AX-CPT) with the other hand) during functional magnetic resonance imaging (fMRI). Gait performance, AX-CPT reaction time and accuracy, finger tapping cadence, and brain functioning in finger-tapping-related and AX-CPT-related brain regions all showed declines in the dual task condition compared to the single task condition. Dual-task gait, AX-CPT and finger tapping performance, and brain functioning were all independent predictors of fall profile. No particular measurement domain stood out as being the most strongly associated measure with fall variables. Fall characteristics are determined by multiple factors; brain functioning, motor task, and cognitive task performance in challenging dual-task conditions all contribute to the risk of falling.


Author(s):  
Tilo Strobach ◽  
Peter Frensch ◽  
Herrmann Josef Müller ◽  
Torsten Schubert

2015 ◽  
Vol 21 (7) ◽  
pp. 519-530 ◽  
Author(s):  
Brittany C. LeMonda ◽  
Jeannette R. Mahoney ◽  
Joe Verghese ◽  
Roee Holtzer

AbstractThe Walking While Talking (WWT) dual-task paradigm is a mobility stress test that predicts major outcomes, including falls, frailty, disability, and mortality in aging. Certain personality traits, such as neuroticism, extraversion, and their combination, have been linked to both cognitive and motor outcomes. We examined whether individual differences in personality dimensions of neuroticism and extraversion predicted dual-task performance decrements (both motor and cognitive) on a WWT task in non-demented older adults. We hypothesized that the combined effect of high neuroticism-low extraversion would be related to greater dual-task costs in gait velocity and cognitive performance in non-demented older adults. Participants (N=295; age range,=65–95 years; female=164) completed the Big Five Inventory and WWT task involving concurrent gait and a serial 7’s subtraction task. Gait velocity was obtained using an instrumented walkway. The high neuroticism-low extraversion group incurred greater dual-task costs (i.e., worse performance) in both gait velocity {95% confidence interval (CI) [−17.68 to −3.07]} and cognitive performance (95% CI [−19.34 to −2.44]) compared to the low neuroticism-high extraversion group, suggesting that high neuroticism-low extraversion interferes with the allocation of attentional resources to competing task demands during the WWT task. Older individuals with high neuroticism-low extraversion may be at higher risk for falls, mobility decline and other adverse outcomes in aging. (JINS, 2015, 21, 519–530)


2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Hironori Ohsugi ◽  
Shohei Ohgi ◽  
Kenta Shigemori ◽  
Eric B Schneider

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