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Abstract
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OBJECTIVE: The aim of this study was to evaluate the effects of a novel divided attention task, walking under auditory constraints, on gait performance in older adults, and to determine whether the effect was moderated by cognitive status.
DESIGN: Validation Cohort SETTING: General Community PARTICIPANTS: 104 older non-demented and ambulatory older adults INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE(S): In this pilot study, we evaluated walking under auditory constraints (WUAC) in 104 older adults who completed three pairs of walking trials on a gait mat under one of three randomly assigned conditions: one pair without auditory stimulation, and two pairs with emotionally charged auditory stimulation with happy or sad sounds.
RESULTS: The mean age of subjects was 80.6±4.9 years and 63% were women. The mean velocity during normal walking was 97.9±20.6 cm/sec and the mean cadence was 105.1±9.9 steps/min. The effect of walking under auditory constraints on gait characteristics was analyzed using a two factorial ANOVA with a 1-between factor (cognitively intact and minimal cognitive impairment groups) and a 1-within factor (type of auditory stimuli). Under both happy and sad auditory stimulation trials, cognitively intact older adults (n=96) showed an average increase in gait velocity of 2.68 cm/s (F[1.86, 191.71](1, 2)=3.99, p=0.02) and an average increase in cadence of 2.41 steps/min (F[1.75, 180.42]=10.12, p<0.001) compared to trials without auditory stimulation. In contrast, older adults with minimal cognitive impairment (Blessed test score 5-10, n=8) showed average reduction in gait velocity of 5.45 cm/s (F[1.87, 190.83]= 5.62, p=0.005) and in cadence of 3.88 steps/min (F[1.79, 183.10]=8.21, p=0.001) under both auditory stimulation conditions. Neither baseline fall history nor performance on activities of daily living accounted for these differences.
CONCLUSIONS: Our results provide preliminary evidence of the differentiating effect of emotionally charged auditory stimuli on gait performance in older individuals with minimal cognitive impairment compared to those without. A divided attention task using emotionally charged auditory stimuli might be able to elicit compensatory enhancement in gait performance in cognitively intact older individuals, but lead to decompensation in those with minimal cognitive impairment. Further investigation is needed to compare gait performance with this task to other dual-task paradigms, and separately examine the effects of physiological aging versus cognitive impairment on gait performance under auditory constraints.
Language: en |