Abstract
Objectives
To evaluate the effect of a novel divided attention task—walking under auditory constraints—on
gait performance in older adults and to determine whether this effect was moderated
by cognitive status.
Design
Validation cohort.
Setting
General community.
Participants
Ambulatory older adults without dementia (N=104).
Interventions
Not applicable.
Main Outcome Measures
In this pilot study, we evaluated walking under auditory constraints in 104 older
adults who completed 3 pairs of walking trials on a gait mat under 1 of 3 randomly
assigned conditions: 1 pair without auditory stimulation and 2 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% (n=66) were women. The mean velocity
during normal walking was 97.9±20.6cm/s, 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 2-factorial analysis of variance with a 1-between factor (cognitively intact
and minimal cognitive impairment groups) and a 1-within factor (type of auditory stimuli).
In both happy and sad auditory stimulation trials, cognitively intact older adults
(n=96) showed an average increase of 2.68cm/s in gait velocity (F1.86,191.71=3.99; P=.02) and an average increase of 2.41 steps/min in cadence (F1.75,180.42=10.12; P<.001) as compared with trials without auditory stimulation. In contrast, older adults
with minimal cognitive impairment (Blessed test score, 5–10; n=8) showed an average
reduction of 5.45cm/s in gait velocity (F1.87,190.83=5.62; P=.005) and an average reduction of 3.88 steps/min in cadence (F1.79,183.10=8.21; P=.001) under both auditory stimulation conditions. Neither baseline fall history nor
performance of 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 with those without minimal cognitive impairment. A divided attention
task using emotionally charged auditory stimuli might be able to elicit compensatory
improvement 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 under this task to gait on other dual-task paradigms
and to separately examine the effect of physiological aging versus cognitive impairment
on gait during walking under auditory constraints.
Keywords
List of abbreviations:
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Article info
Publication history
Published online: December 23, 2014
Footnotes
Supported by the National Institute on Aging (grant no. RO1 AG025119).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
