Task matters: an investigation on the effect of different secondary tasks on dual-task gait in older adults

Abstract Background Dual-task gait performance declines as humans age, leading to increased fall risk among older adults. It is unclear whether different secondary cognitive tasks mediate age-related decline in dual-task gait. This study aimed to examine how type and difficulty level of the secondary cognitive tasks differentially affect dual-task gait in older adults. Methods Twenty young and twenty older adults participated in this single-session study. We employed four different types of secondary tasks and each consisted of two difficulty levels, yielding eight different dual-task conditions. The dual-task conditions included walking and 1) counting backward by 3 s or by 7 s; 2) remembering a 5-item or 7-item lists; 3) responding to a simple or choice reaction time tasks; 4) generating words from single or alternated categories. Gait speed and cognitive task performance under single- and dual-task conditions were used to compute dual-task cost (DTC, %) with a greater DTC indicating a worse performance. Results A significant three-way interaction was found for the gait speed DTC (p = .04). Increased difficulty in the reaction time task significantly increased gait speed DTC for older adults (p = .01) but not for young adults (p = .90). In contrast, increased difficulty level in the counting backward task significantly increased gait speed DTC for young adults (p = .03) but not for older adults (p = .85). Both groups responded similarly to the increased task difficulty in the other two tasks. Conclusions Older adults demonstrated a different response to dual-task challenges than young adults. Aging might have different impacts on various cognitive domains and result in distinctive dual-task gait interference patterns.

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How Does Explicit Prioritization Alter Walking During Dual-Task Performance? Effects of Age and Sex on Gait Speed and Variability

Physical Therapy ◽

10.2522/ptj.20090043 ◽

2010 ◽

Vol 90 (2) ◽

pp. 177-186 ◽

Cited By ~ 164

Author(s):

Galit Yogev-Seligmann ◽

Yael Rotem-Galili ◽

Anat Mirelman ◽

Ruth Dickstein ◽

Nir Giladi ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Dual Task ◽

Gait Speed ◽

Cognitive Task ◽

Age Groups ◽

Cross Sectional Study ◽

Gait Variability ◽

Cross Sectional ◽

Task Conditions

BackgroundPrevious studies have demonstrated that the performance of a secondary task during walking alters gait.ObjectiveThis study investigated the effects of task prioritization on walking in young and older adults to evaluate the “default” prioritization scheme used, the flexibility to alter prioritization and cortical resources allocated to gait and a secondary cognitive task, and any age-associated changes in these abilities.DesignA cross-sectional study that explicitly altered the focus of attention was used to investigate the effects of prioritization in young and older adults who were healthy.MethodsGait speed and gait variability were evaluated in young adults (n=40) and older adults (n=17) who were healthy, both during usual walking and under 3 dual-task conditions: (1) no specific prioritization instructions, (2) prioritization of gait, and (3) prioritization of the cognitive task.ResultsYoung adults significantly increased gait speed in the gait prioritization condition compared with gait speed in the no-instruction condition; a similar tendency was seen in the older adults. Gait speed was reduced when priority was given to the cognitive task in both age groups; however, this effect was less dramatic in the older adults. In the young adults, prioritization of gait tended to have different effects on gait speed among both men and women. In the older adults, but not in the young adults, all dual-task conditions produced increased gait variability, whereas prioritization did not alter this gait feature.LimitationsThe sample size and the relative homogeneity of the older adults could be considered as possible limitations of the study.ConclusionsEven among young adults, the effects of secondary, cognitive tasks on gait speed are strongly influenced by prioritization. This finding was less significant in the older adults, suggesting that there is an age-associated decline in the ability to flexibly allocate attention to gait. Somewhat surprisingly, when prioritization was not explicitly instructed, gait speed in both young and older adults most closely resembled that of the condition when they were instructed to focus attention on the cognitive task.

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An fNIRS Investigation of Discrete and Continuous Cognitive Demands During Dual-Task Walking in Young Adults

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.711054 ◽

2021 ◽

Vol 15 ◽

Author(s):

Tabassum Tahmina Rahman ◽

Nadia Polskaia ◽

Gabrielle St-Amant ◽

Talia Salzman ◽

Diana Tobón Vallejo ◽

...

Keyword(s):

Young Adults ◽

Dual Task ◽

Gait Speed ◽

Repeated Measures ◽

Cognitive Task ◽

Cognitive Tasks ◽

Cognitive Demands ◽

Functional Near Infrared Spectroscopy ◽

Attentional Demands ◽

Time Accuracy

Introduction: Dual-task studies have demonstrated that walking is attention-demanding for younger adults. However, numerous studies have attributed this to task type rather than the amount of required to accomplish the task. This study examined four tasks: two discrete (i.e., short intervals of attention) and two continuous (i.e., sustained attention) to determine whether greater attentional demands result in greater dual-task costs due to an overloaded processing capacity.Methods: Nineteen young adults (21.5 ± 3.6 years, 13 females) completed simple reaction time (SRT) and go/no-go (GNG) discrete cognitive tasks and n-back (NBK) and double number sequence (DNS) continuous cognitive tasks with or without self-paced walking. Prefrontal cerebral hemodynamics were measured using functional near-infrared spectroscopy (fNIRS) and performance was measured using response time, accuracy, and gait speed.Results: Repeated measures ANOVAs revealed decreased accuracy with increasing cognitive demands (p = 0.001) and increased dual-task accuracy costs (p < 0.001). Response times were faster during the single compared to dual-tasks during the SRT (p = 0.005) and NBK (p = 0.004). DNS gait speed was also slower in the dual compared to single task (p < 0.001). Neural findings revealed marginally significant interactions between dual-task walking and walking alone in the DNS (p = 0.06) and dual -task walking compared to the NBK cognitive task alone (p = 0.05).Conclusion: Neural findings suggest a trend towards increased PFC activation during continuous tasks. Cognitive and motor measures revealed worse performance during the discrete compared to continuous tasks. Future studies should consider examining different attentional demands of motor tasks.

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Effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions

10.21203/rs.2.10381/v1 ◽

2019 ◽

Author(s):

Hamid Allahverdipour ◽

Iman Dianat ◽

Galavizh Mameh ◽

mohammad Asghari Jafarabadi

Keyword(s):

Older Adults ◽

Dual Task ◽

Cognitive Task ◽

Dynamic Balance ◽

The Elderly ◽

Static Balance ◽

Timed Up And Go ◽

Task Conditions ◽

And Control ◽

Single Versus

Abstract Background: The aim of this study was to evaluate the effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions. Methods: The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1kg, 2kg and 3kg in each hand) loads on dynamic and static balance of 42 older adults (21 males and 21 females), aged ≥ 60 years were studied. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. Results: The TUG speed of female participants was generally slower than that of male participants. Cognitive task influenced the participants’ dynamic balance during the dual-task conditions, while the static balance was not affected in this phase. The dynamic and static balance measures were more influenced when performing the multi-tasks than when doing the dual-tasks. The effects of various levels of physical demand on the dynamic balance varied greatly under dual- and multi-task conditions. Conclusions: The findings add to the understanding of the factors influencing the elderly balance and control under cognitive and physical functioning.

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Asymmetric interference between cognitive task components and concurrent sensorimotor coordination

Journal of Neurophysiology ◽

10.1152/jn.00073.2018 ◽

2018 ◽

Vol 120 (1) ◽

pp. 330-342

Author(s):

Joshua Baker ◽

Antonio Castro ◽

Andrew K. Dunn ◽

Suvobrata Mitra

Keyword(s):

Information Processing ◽

Dual Task ◽

Time Course ◽

Cognitive Task ◽

Tracking Task ◽

Cognitive Tasks ◽

State Monitoring ◽

Sensorimotor Coordination ◽

Dual Tasking ◽

Task Conditions

Everyday cognitive tasks are frequently performed under dual-task conditions alongside continuous sensorimotor coordinations (CSCs) such as driving, walking, or balancing. Observed interference in these dual-task settings is commonly attributed to demands on executive function or attentional resources, but the time course and reciprocity of interference are not well understood at the level of information-processing components. Here we used electrophysiology to study the detailed chronometry of dual-task interference between a visual oddball task and a continuous visuomanual tracking task. The oddball task’s electrophysiological components were linked to underlying cognitive processes, and the tracking task served as a proxy for the continuous cycle of state monitoring and adjustment inherent to CSCs. Dual-tasking interfered with the oddball task’s accuracy and attentional processes (attenuated P2 and P3b magnitude and parietal alpha-band event-related desynchronization), but errors in tracking due to dual-tasking accrued at a later timescale and only in trials in which the target stimulus appeared and its tally had to be incremented. Interference between cognitive tasks and CSCs can be asymmetric in terms of timing as well as affected information-processing components. NEW & NOTEWORTHY Interference between cognitive tasks and continuous sensorimotor coordination (CSC) has been widely reported, but this is the first demonstration that the cognitive operation that is impaired by concurrent CSC may not be the one that impairs the CSC. Also demonstrated is that interference between such tasks can be temporally asymmetric. The asynchronicity of this interference has significant implications for understanding and mitigating loss of mobility in old age, and for rehabilitation for neurological impairments.

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The Effect of Different Types of Walking on Dual-Task Performance and Task Prioritization among Community-Dwelling Older Adults

The Scientific World JOURNAL ◽

10.1155/2014/259547 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Maayan Agmon ◽

Einat Kodesh ◽

Rachel Kizony

Keyword(s):

Older Adults ◽

Task Performance ◽

Dual Task ◽

Cognitive Task ◽

Community Dwelling ◽

Cognitive Tasks ◽

Dual Task Performance ◽

Different Types ◽

Task Prioritization ◽

Community Dwelling Older Adults

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.

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Influence of Gymnastic Background on Triangle Completion Performance in Single and Dual-Task Conditions

The Open Sports Sciences Journal ◽

10.2174/1875399x01306010015 ◽

2013 ◽

Vol 6 (1) ◽

pp. 15-21 ◽

Cited By ~ 1

Author(s):

Andrei Garcia Popov ◽

Nicole Paquet ◽

Yves Lajoie

Keyword(s):

Reaction Time ◽

Dual Task ◽

Cognitive Task ◽

Linear Displacement ◽

Angular Deviation ◽

Linear Distance ◽

Task Conditions ◽

And Control ◽

Triangle Completion ◽

The Impact

Spatial orientation skills of gymnasts have been investigated in the past, but their navigation skills have not been well described. For instance, little is known on their performance on triangle completion in the absence of vision. The question is whether gymnasts require less attention than non-gymnasts in executing this task. The aims were to study the impact of dual-task on triangle completion performance and reaction time, and to compare this effect in young adults with or without a gymnastic background. Participants were blindfolded and guided along the first two legs of a 5x5 m right angle triangle and then, independently turned and walked towards the origin of this triangle. After they had stopped, their foot position was marked on the floor and angular deviation and linear distance traveled were measured. In the dualtask, reaction time was gathered during the independent walk with participants responding verbally ‘top’ as fast as possible after a sound signal. Gymnasts were found to have smaller angular deviation and longer linear distance traveled than non-gymnasts. Both groups showed longer reaction time in dual-task compared to baseline in sitting and this increase was similar for both groups. The results suggest that gymnastics training improves the perception and control of direction. However, it does not modify perception of linear displacement, nor the attention required to execute the triangle completion task. In dual-task, other cognitive tasks requiring working memory might have had a larger impact on both navigation errors and cognitive task performance.

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Allocation of Attentional Resources toward a Secondary Cognitive Task Leads to Compromised Ankle Proprioceptive Performance in Healthy Young Adults

Rehabilitation Research and Practice ◽

10.1155/2014/170304 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Kazuhiro Yasuda ◽

Yuki Sato ◽

Naoyuki Iimura ◽

Hiroyasu Iwata

Keyword(s):

Young Adults ◽

Ankle Joint ◽

Dual Task ◽

Cognitive Task ◽

Critical Factor ◽

Matching Task ◽

Difficulty Level ◽

Task Condition ◽

Dual Task Condition ◽

Attentional Resources

The objective of the present study was to determine whether increased attentional demands influence the assessment of ankle joint proprioceptive ability in young adults. We used a dual-task condition, in which participants performed an ankle ipsilateral position-matching task with and without a secondary serial auditory subtraction task during target angle encoding. Two experiments were performed with two different cohorts: one in which the auditory subtraction task was easy (experiment 1a) and one in which it was difficult (experiment 1b). The results showed that, compared with the single-task condition, participants had higher absolute error under dual-task conditions in experiment 1b. The reduction in position-matching accuracy with an attentionally demanding cognitive task suggests that allocation of attentional resources toward a difficult second task can lead to compromised ankle proprioceptive performance. Therefore, these findings indicate that the difficulty level of the cognitive task might be the possible critical factor that decreased accuracy of position-matching task. We conclude that increased attentional demand with difficult cognitive task does influence the assessment of ankle joint proprioceptive ability in young adults when measured using an ankle ipsilateral position-matching task.

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Reduction of Dual-task Costs by Noninvasive Modulation of Prefrontal Activity in Healthy Elders

Journal of Cognitive Neuroscience ◽

10.1162/jocn_a_00897 ◽

2016 ◽

Vol 28 (2) ◽

pp. 275-281 ◽

Cited By ~ 39

Author(s):

Brad Manor ◽

Junhong Zhou ◽

Azizah Jor'dan ◽

Jue Zhang ◽

Jing Fang ◽

...

Keyword(s):

Older Adults ◽

Dual Task ◽

Cognitive Task ◽

Brain Regions ◽

Dual Tasking ◽

Single Task ◽

Novel Approach ◽

Before And After ◽

Improved Performance ◽

Task Conditions

Dual tasking (e.g., walking or standing while performing a cognitive task) disrupts performance in one or both tasks, and such dual-task costs increase with aging into senescence. Dual tasking activates a network of brain regions including pFC. We therefore hypothesized that facilitation of prefrontal cortical activity via transcranial direct current stimulation (tDCS) would reduce dual-task costs in older adults. Thirty-seven healthy older adults completed two visits during which dual tasking was assessed before and after 20 min of real or sham tDCS targeting the left pFC. Trials of single-task standing, walking, and verbalized serial subtractions were completed, along with dual-task trials of standing or walking while performing serial subtractions. Dual-task costs were calculated as the percent change in markers of gait and postural control and serial subtraction performance, from single to dual tasking. Significant dual-task costs to standing, walking, and serial subtraction performance were observed before tDCS (p < .01). These dual-task costs were less after real tDCS as compared with sham tDCS as well as compared with either pre-tDCS condition (p < .03). Further analyses indicated that tDCS did not alter single task performance but instead improved performance solely within dual-task conditions (p < .02). These results demonstrate that dual tasking can be improved by modulating prefrontal activity, thus indicating that dual-task decrements are modifiable and may not necessarily reflect an obligatory consequence of aging. Moreover, tDCS may ultimately serve as a novel approach to preserving dual-task capacity into senescence.

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ASSOCIATIONS OF DUAL TASK EXERGAMING WITH COGNITIVE-MOTOR INTERFERENCE IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT: A SINGLE-ARM PILOT STUDY

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.11 ◽

2021 ◽

pp. 1-7

Author(s):

L. Kannan ◽

T. Bhatt

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Dual Task ◽

Balance Control ◽

Cognitive Task ◽

Cognitive Tasks ◽

Future Studies ◽

Wii Fit ◽

Sequencing Task

Purpose: To examine the feasibility and effectiveness of dual task (DT) exergaming to improve volitional balance control in older adults with mild cognitive impairment (MCI). Methods: Ten older adults with MCI were examined at baseline (week-0) and post-training (week-5) on volitional balance control (maximum excursion of center of gravity, MXE [%]) while performing cognitive task (auditory clock test or letter number sequencing task) and on the NIH-motor and cognitive toolboxes. DT exergaming training lasted for 12 sessions which consisted of performing explicit cognitive tasks while playing the Wii-Fit balance games. Results: From pre- to post-training, MXE improved (p<0.05); however, cognitive accuracy (cognitive task) remained the same (p>0.05). Improvement in NIH motor and cognitive toolbox tests was observed post-training (p<0.05). Conclusion: DT exergaming was associated to improvements in balance control under attention-demanding conditions in MCI. Future studies may focus on examining the efficacy of such training.

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