The Effects of Two Types of Cognitive Tasks on Postural Stability in Older Adults With and Without a History of Falls

Shumway-Cook, Anne; Woollacott, Marjorie H.; Kerns, Kimberly A.; Baldwin, Margaret

doi:10.1093/gerona/52a.4.m232

Cited by 618 publications

(431 citation statements)

References 24 publications

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“…This supports previous findings that healthy older adults will adapt their walking in response to high cognitive demands [24]. Our results also provide further evidence for the 'posture-first' strategy whereby, if the cognitive load during a DT presents a threat to gait security, 'postural control would be the first priority for attentional resources' [10] (p. 238).…”

Section: Discussionsupporting

confidence: 89%

“…Table 4. here 10 The mean DTC and DTB outcomes and patterns of trade-off between the concurrent walking and counting tasks under each DT prioritizing condition are shown in Figure 1. DT values for CCR and velocity have been reversed in this figure so that negative values always indicate DTCs, and positive values always indicate DTBs.…”

Section: Participants' Characteristicsmentioning

confidence: 99%

“…subtracting 7s requires more attentional resources than subtracting 3s), the difficulty of these arithmetic tasks can be varied in order to create distinct levels of cognitive difficulty [9]. 3 When faced with a demanding DT situation such as concurrent walking and counting, it is thought healthy older adults prioritize gait over cognition (the so-called 'posture first strategy') [10]. This involves flexible attention-allocation between the two tasks in order to ensure gait stability, which often results in more cognitive errors.…”

Section: Introductionmentioning

confidence: 99%

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Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults’ dual-task performance

et al. 2017

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Observing prioritization effects on cognition and gait: the effect of increased cognitive load on cognitively healthy older adults' dual-task performance. Gait and Posture, 53, pp. 139-144. (doi:10.1016/j.gaitpost.2017.01.018) This is the author's final accepted version.There may be differences between this version and the published version. Previous studies exploring the effects of attention-prioritization on cognitively healthy older adults' gait and cognitive dual task (DT) performance have shown DT cost in gait outcomes but inconsistent effects on cognitive performance, which may reflect task difficulty (the cognitive load). This study aimed to identify whether changing the cognitive load during a walking and counting DT improved the challenge/sensitivity of the cognitive task to observe prioritization effects on concurrent gait and cognitive performance outcomes. Seventy-two cognitively healthy older adults (Mean = 73 years) walked 15m, counted backwards in 3sand 7s as single tasks (ST), and concurrently walked and counted backwards as DTs.Attention-prioritization was examined in Prioritizing Walking (PW) and Prioritizing Counting (PC) DT conditions. Dual-task performance costs (DTC) were calculated for number of correct cognitive responses (CCR) in the counting tasks, and step-time variability and velocity in the gait task. All DT conditions showed a benefit (DTB) for cognitive outcomes with trade-off cost to gait. In the Serial 3s task, the cognitive DTBs increased in PC over the PW condition (p<.05), with a greater cost to walking velocity (p<.05). DT effects were more pronounced in the Serial 7s with a lower cognitive DTB when PC than when PW, (p<.05) with no trade-off increase in cost to gait outcomes (p<.05). The findings suggest that increased cognitive load during a gait and cognitive DT produces more pronounced gait measures of attention-prioritization in cognitively healthy older adults. A cognitive load effect was also observed in the cognitive outcomes, with unexpected results.

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Section: Discussionsupporting

confidence: 89%

Section: Participants' Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults’ dual-task performance

et al. 2017

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“…Some research suggests that dual-tasking postural control compromises balance performance [2,7,32,36,39,40,43,59,60,68], as the resource view would predict. For instance, in support of the attention resource competition view, Andersson et al [2] found that performing a concurrent visuospatial search task decreased balance performance in middle-aged adults (M age = 40.4 years) under a challenging condition with attenuated proprioceptive sensory inputs (i.e., standing on a sway-referenced platforms).…”

Section: Dual-task Attentional Sharing Between Postural Control and Cmentioning

confidence: 99%

Dual-tasking postural control: Aging and the effects of cognitive demand in conjunction with focus of attention

Huxhold

Schmiedek

et al. 2006

Brain Research Bulletin

513

379

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Postural control in everyday life is generally accompanied by posture-unrelated cognitive activity. Thus, mild forms of dual-tasking postural control are the norm rather than the exception. Based on this consideration and available evidence, we propose and empirically examined, in young and old adults, a non-monotonic, U-shaped relation between the efficacy of postural control and concurrent cognitive demands that reflect opposing trends of the effects of attention focus and attentional resource competition. When instructed to perform an easy cognitive task that presumably shifted the focus of attention away from posture control, the center of body pressure (COP) excursions decreased both in young and older adults relative to a single-task baseline where the focus of attention was explicitly directed towards the postural control task itself. However, when performing more demanding cognitive tasks, older adults showed increased COP displacements, in line with the predicted Ushape function, whereas young adults did not. We outline mechanisms linking postural control to cognitive demand and suggest routes for future investigation.

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“…Naturally, the investigation of this interplay requires an alternative approach, in which dual-task costs in both domains of functioning are investigated (Li, Krampe, & Bondar, 2005;Lindenberger, Marsiske, & Baltes, 2000). In line with the assumption of increased cognitiveresource demands for sensorimotor functions, researchers have observed pronounced performance decrements in children (see Huang & Mercer, 2001, for a review) and older adults (Brown, Sleik, Polych, & Gage, 2002;Lindenberger et al, 2000;Rapp, Krampe, & Baltes, 2006;Shumway-Cook, Woollacott, Kerns, & Baldwin, 1997) compared with young adults when a cognitive task and a motor task had to be performed concurrently.…”

mentioning

confidence: 99%

Age differences between children and young adults in the dynamics of dual-task prioritization: Body (balance) versus mind (memory).

Schaefer¹,

Krampe²,

Lindenberger³

et al. 2008

Developmental Psychology

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Task prioritization can lead to trade-off patterns in dual-task situations. The authors compared dual-task performances in 9-and 11-year-old children and young adults performing a cognitive task and a motor task concurrently. The motor task required balancing on an ankle-disc board. Two cognitive tasks measured working memory and episodic memory at difficulty levels individually adjusted during the course of extensive training. Adults showed performance decrements in both task domains under dual-task conditions. In contrast, children showed decrements only in the cognitive tasks but actually swayed less under dual-task than under single-task conditions and continued to reduce their body sway even when instructed to focus on the cognitive task. The authors argue that children perform closer to their stability boundaries in the balance task and therefore prioritize protection of their balance under dual-task conditions.

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The Effects of Two Types of Cognitive Tasks on Postural Stability in Older Adults With and Without a History of Falls

Cited by 618 publications

References 24 publications

Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults’ dual-task performance

Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults’ dual-task performance

Dual-tasking postural control: Aging and the effects of cognitive demand in conjunction with focus of attention

Age differences between children and young adults in the dynamics of dual-task prioritization: Body (balance) versus mind (memory).

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