Objective
To determine whether the cognitive function contribution to straight- and curved-path walking differs for older adults.
Design
Cross-sectional observational study.
Setting
Ambulatory clinical research training center.
Participants
One hundred six people aged 65 years to 92 years, able to walk household distances independently with or without an assistive device, and who scored ≥ 24 on the Mini-Mental State Examination.
Intervention
Not applicable.
Main Outcome Measurements
Cognitive function was assessed using the Digit Symbol Substitution Test (DSST) as a measure of psychomotor speed, and Trail Making Tests A and B (Trails A, Trails B), and the Trail Making Test difference score (Trails B-A) as executive function measures of complex visual scanning and set-shifting. Gait speed recorded over an instrumented walkway was used as the measure of straight-path walking. Curved-path walking was assessed using the Figure-of-8 Walk Test (F8W) and recorded as the total time and number of steps for completion.
Results
Both DSST and Trails A independently contributed to usual gait speed (P < 0.001). Trails A performance contributed to F8W time (P < 0.001). Neither Trails B nor Trails B-A contributed to usual gait speed or time to complete the F8W. For the number of steps taken to complete the F8W, Trails A, Trails B, and Trails B-A (all P < 0.001) were independent contributors while DSST performance was not.
Conclusion
Curved-path walking, as measured by F8W test, involves different cognitive processes compared to straight-path walking. Cognitive flexibility and set-shifting processes uniquely contributed to how individuals navigated curved-paths. The measure of curved-path walking provides different and meaningful information about daily life walking ability than usual gait speed alone.