Uneven surface and cognitive dual-task independently affect gait quality in older adults

Anisha Suri; Jessie VanSwearingen; Caterina Rosano; Jennifer S Brach; Mark S Redfern; Ervin Sejdić; Andrea L Rosso

doi:10.1016/j.gaitpost.2023.08.010

Uneven surface and cognitive dual-task independently affect gait quality in older adults

Gait Posture. 2023 Sep:106:34-41. doi: 10.1016/j.gaitpost.2023.08.010. Epub 2023 Aug 22.

Authors

Anisha Suri¹, Jessie VanSwearingen², Caterina Rosano³, Jennifer S Brach², Mark S Redfern⁴, Ervin Sejdić⁵, Andrea L Rosso⁶

Affiliations

¹ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, PA, USA.
² Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, PA, USA.
³ Department of Epidemiology, School of Public Health, University of Pittsburgh, PA, USA.
⁴ Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, PA, USA.
⁵ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, PA, USA; The Edward S. Rogers Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada; North York General Hospital, Toronto, ON, Canada.
⁶ Department of Epidemiology, School of Public Health, University of Pittsburgh, PA, USA. Electronic address: alr143@pitt.edu.

PMID: 37647710
PMCID: PMC10591986 (available on 2024-09-01)
DOI: 10.1016/j.gaitpost.2023.08.010

Abstract

Background: Real-world mobility involves walking in challenging conditions. Assessing gait during simultaneous physical and cognitive challenges provides insights on cognitive health.

Research question: How does uneven surface, cognitive task, and their combination affect gait quality and does this gait performance relate to cognitive functioning?

Methods: Community-dwelling older adults (N = 104, age=75 ± 6 years, 60 % females) performed dual-task walking paradigms (even and uneven surface; with and without alphabeting cognitive task (ABC)) to mimic real-world demands. Gait quality measures [speed(m/s), rhythmicity(steps/minute), stride time variability (%), adaptability (m/s²), similarity, smoothness, power (Hz) and regularity] were calculated from an accelerometer worn on the lower back. Linear-mixed modelling and Tukey analysis were used to analyze independent effects of surface and cognitive task and their interaction on gait quality. Partial Spearman correlations compared gait quality with global cognition and executive function.

Results: No interaction effects between surface and cognitive task were found. Uneven surface reduced gait speed(m/s) (β = -0.07). Adjusted for speed, uneven surface reduced gait smoothness (β = -0.27) and increased regularity (β = 0.09), Tukey p < .05, for even vs uneven and even-ABC vs uneven-ABC. Cognitive task reduced gait speed(m/s) (β = -0.12). Adjusted for speed, cognitive task increased variability (β = 7.60), reduced rhythmicity (β = -6.68) and increased regularity (β = 0.05), Tukey p < .05, for even vs even-ABC and uneven vs uneven-ABC. With demographics as covariates, gait speed was not associated with cognition. Gait quality [lower variability during even-ABC (ρ_p =-.31) and uneven-ABC (ρ_p =-.28); greater rhythmicity (ρ_p between.22 and.29) and greater signal-adaptability AP (ρ_p between.22 and.26) during all walking tasks] was associated with better global cognition. Gait adaptability during even (ρ_p =-0.21, p = 0.03) and uneven(ρ_p =-0.19, p = 0.04) walking was associated with executive function.

Significance: Surface and cognitive walking tasks independently affected gait quality. Our study with high-functioning older adults suggests that task-related changes in gait quality are related to subtle changes in cognitive functioning.

Keywords: Accelerometry; Cognitive function; Dual tasks; Gait; Healthy aging.

MeSH terms

Aged
Aged, 80 and over
Cognition
Executive Function
Female
Gait*
Humans
Male
Walking Speed
Walking* / psychology

Abstract

MeSH terms

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