Walking while Talking and Falls in Aging

Abstract

Background: While divided attention tasks are recognized as predictors of falls in older adults, a comprehensive examination of this association is lacking. Objective: We examined the validity of a ‘walking while talking' (WWT) task for predicting falls. Methods: We studied the associations of 8 selected gait markers measured during WWT (individually as well as domains derived by factor analysis) with incident falls in 646 adults (mean age 79.9 years; 61% women) enrolled in an aging study who received quantitative gait assessments. Cox regressions adjusted for multiple potential confounders and normal-pace walking were used to examine the associations. Results: Over a mean follow-up of 2.6 years, 337 participants (52%) fell. Step length was the only individual WWT parameter that predicted falls [hazard ratio (HR) 0.98; p = 0.034]. Factor analysis identified 3 gait domains, of which only the pace factor predicted falls (HR 1.31; p = 0.002). Results remained robust after adjusting for multiple potential confounders and accounting for normal-pace walking. Conclusions: WWT performance was a significant predictor of falls. Gait domains in WWT should be further studied to improve current fall risk assessments and to develop new interventions.

Effects of Emotionally Charged Auditory Stimulation on Gait Performance in the Elderly: A Preliminary Study

“…In a recent study, principal component analysis was used to cluster the variables derived from quantitative gait analyses into statistically independent gait domains: rhythm, pace, and variability. 17 Velocity and step length belong to the pace domain; abnormalities in this domain have been shown to predict falls. 17 Cadence, swing time, and step time belong to the variability domain, and abnormalities in this domain have been shown to predict dementia.…”

“…17 Velocity and step length belong to the pace domain; abnormalities in this domain have been shown to predict falls. 17 Cadence, swing time, and step time belong to the variability domain, and abnormalities in this domain have been shown to predict dementia. 17 Thus, the walking under auditory constraints task may differentially affect the control of pacing and variability during gait, and velocity and cadence may be the dominant variables in these domains.…”

“…17 Cadence, swing time, and step time belong to the variability domain, and abnormalities in this domain have been shown to predict dementia. 17 Thus, the walking under auditory constraints task may differentially affect the control of pacing and variability during gait, and velocity and cadence may be the dominant variables in these domains. However, discrete effects may also be due to the small sample size.…”

“…17,18 Walking while talking replicates what many would consider a “typical” experience for elderly individuals because many individuals may engage in intermittent conversation during ambulatory activity. However, walking during listening to background auditory stimuli is an even more ubiquitous occurrence.…”

Acquiring visual information for locomotion by older adults: A systematic review

“…Additionally, increased anxiety and decrements in cognitive resources have also been found to be associated with falling among older adults (Bergland and Wyller, 2004;Holtzer et al, 2007;Persad et al, 1995;van Schoor et al, 2002). For example, older adults who stop walking when talking have been found to have a higher risk of falling (Ayers et al, 2014;LundinOlsson et al, 1997). Simultaneously performing two tasks requires more attentional resources and older adults, especially those with decrements in cognitive processing, are more prone to failures in either of the motor or cognitive tasks performed (see (YogevSeligmann et al, 2008), for a review).…”