Cognitive-Postural Multitasking Training in Older Adults – Effects of Input-Output Modality Mappings on Cognitive Performance and Postural Control

Abstract

Older adults exhibit impaired cognitive and balance performance, particularly under multi-task conditions, which can be improved through training. Compatibility of modality mappings in cognitive tasks (i.e., match between stimulus modality and anticipated sensory effects of motor responses), modulates physical and cognitive dual-task costs. However, the effects of modality specific training programs have not been evaluated yet. Here, we tested the effects of cognitive-postural multi-tasking training on the ability to coordinate task mappings under high postural demands in healthy older adults. Twenty-one adults aged 65-85 years were assigned to one of two groups. While group 1 performed cognitive-postural triple-task training with compatible modality mappings (i.e., visual-manual and auditory-vocal dual n-back tasks), group 2 performed the same tasks with incompatible modality mappings (i.e., visual-vocal and auditory-manual n-back tasks). Throughout the 6-weeks balance training intervention, working-memory load was gradually increased while base-ofsupport was reduced. Before training (T0), after a 6-week passive control period (T1), and immediately after the intervention (T2), participants performed spatial dual oneback tasks in semi-tandem stance position. Our results indicate improved workingmemory performance and reduced dual-task costs for both groups after the passive control period, but no training-specific performance gains. Furthermore, balance performance did not improve in response to training. Notably, the cohort demonstrated meaningful interindividual variability in training responses. Our findings raise questions about practice effects and age-related heterogeneity of training responses following cognitive-motor training. Following multi-modal balance training, neither compatible nor incompatible modality mappings had an impact on the observed outcomes.

A Comparison of Two Multi-Tasking Approaches to Cognitive Training in Cardiac Surgery Patients

“…A number of studies have also shown interference effects during the concurrent performance of motor tasks involving postural control and cognitive tasks, with pronounced effects in the elderly [32,38,39]. The study of Brahms et al [40] investigated the effects of cognitive-motor multi-tasking interventions on postural stability and cognitive performance in healthy older adults. These findings showed that the simultaneous performance of cognitive and postural tasks was moderated by modality compatibility mapping, workload memory, and increased postural demands.…”

“…The obtained data indicate the formation of beneficial effects on cognitive functions in a short time period after CABG, which is especially important in patients to establish medical adherence and optimization of rehabilitation procedures in general. In most previous studies, short-term effects of multi-tasking training were not studied, especially in the cardiac cohort of patients [40,41,43]. It can be assumed that if the duration of the course is extended, it would have a greater positive impact on cognitive performance in cardiac surgery patients.…”

The State-of-the-art of Research into Human Multitasking: An Editorial

“…Effortless cognitive-motor multitasking is an ability that suffers as we are getting older, which could have serious health implications due to an increased risk of fall-related injury in older adults. In the context of cognitive-postural multitasking, the article by Brahms et al (2021) evaluated the effect of a modality-specific, multitasking training intervention in older adults, which utilized the performance benefit of modality compatibility mappings. A six-weeks programme with difficulty progression on both the cognitive and postural tasks compared gains in balance performance between a group that practised with modality compatible task mappings and a group with modality incompatible modality mappings.…”