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Hwang J, Liu C, Winesett SP, Chatterjee SA, Gruber AD, Swanson CW, Manini TM, Hass CJ, Seidler RD, Ferris DP, Roy A, Clark DJ. Prefrontal cortical activity during uneven terrain walking in younger and older adults. Front Aging Neurosci 2024; 16:1389488. [PMID: 38765771 PMCID: PMC11099210 DOI: 10.3389/fnagi.2024.1389488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Walking in complex environments increases the cognitive demand of locomotor control; however, our understanding of the neural mechanisms contributing to walking on uneven terrain is limited. We used a novel method for altering terrain unevenness on a treadmill to investigate the association between terrain unevenness and cortical activity in the prefrontal cortex, a region known to be involved in various cognitive functions. Methods Prefrontal cortical activity was measured with functional near infrared spectroscopy while participants walked on a novel custom-made terrain treadmill surface across four different terrains: flat, low, medium, and high levels of unevenness. The assessments were conducted in younger adults, older adults with better mobility function and older adults with worse mobility function. Mobility function was assessed using the Short Physical Performance Battery. The primary hypothesis was that increasing the unevenness of the terrain would result in greater prefrontal cortical activation in all groups. Secondary hypotheses were that heightened prefrontal cortical activation would be observed in the older groups relative to the younger group, and that prefrontal cortical activation would plateau at higher levels of terrain unevenness for the older adults with worse mobility function, as predicted by the Compensation Related Utilization of Neural Circuits Hypothesis. Results The results revealed a significant main effect of terrain, indicating a significant increase in prefrontal cortical activation with increasing terrain unevenness during walking in all groups. A significant main effect of group revealed that prefrontal cortical activation was higher in older adults with better mobility function compared to younger adults and older adults with worse mobility function in all pooled terrains, but there was no significant difference in prefrontal cortical activation between older adults with worse mobility function and younger adults. Contrary to our hypothesis, the older group with better mobility function displayed a sustained increase in activation but the other groups did not, suggestive of neural compensation. Additional findings were that task-related increases in prefrontal cortical activation during walking were lateralized to the right hemisphere in older adults with better mobility function but were bilateral in older adults with worse mobility function and younger adults. Discussion These findings support that compared to walking on a flat surface, walking on uneven terrain surfaces increases demand on cognitive control resources as measured by prefrontal cortical activation.
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Affiliation(s)
- Jungyun Hwang
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Chang Liu
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Steven P. Winesett
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Sudeshna A. Chatterjee
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, United States
| | - Anthony D. Gruber
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Clayton W. Swanson
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Todd M. Manini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, United States
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Rachael D. Seidler
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Daniel P. Ferris
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Arkaprava Roy
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - David J. Clark
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
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Kao PC, Pierro MA, Gonzalez DM. Performance during attention-demanding walking conditions in older adults. Gait Posture 2024; 109:70-77. [PMID: 38281432 DOI: 10.1016/j.gaitpost.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Conventional balance and gait assessments for fall risk screening are often conducted under unperturbed conditions. However, older adults can allocate their attention to motor tasks (balance or walking) without revealing performance deficiencies, posing a challenge in identifying those with compromised gait and balance. RESEARCH QUESTIONS Do community-dwelling older adults exhibit greater changes in cognitive and/or walking performance under balance-challenging conditions compared to typical dual-task walking conditions? METHODS Twenty-nine healthy, community-dwelling older adults performed four cognitive tasks (visual and auditory Stroop tasks, Clock task, and Paced Auditory Serial Addition Test) while walking with and without lateral treadmill sways (Perturbed vs. Unperturbed) and during standing. We calculated dual-task costs (DTC) and walking perturbation effects (WPE) as the percentage of change in cognitive and walking performance between dual and single-task conditions and between Perturbed and Unperturbed conditions, respectively. RESULTS Older adults exhibited similar DTC and WPE on cognitive task performance. However, in walking performance, they demonstrated significantly greater WPE than DTC across all gait and stability measures (p < 0.01), including the mean and variability of stride and margins of stability (MOS) measures, the variability of trunk movement and lower-limb joint angles, and the local stability measures. Older adults took shorter but wider steps, exhibited shorter MOSAP but greater MOSML, and experienced increased movement variability and walking instability to a greater extent than during dual-task walking. Overall, changes in variability and stability measures were more pronounced than those in mean gait measures. SIGNIFICANCE Introducing destabilizing perturbations to increase the task demands of balance and gait assessments is a more effective method to challenge older adults compared to simply adding a concurrent cognitive task. Fall screening assessments for community-dwelling older adults should incorporate balance-challenging conditions, such as introducing gait perturbations.
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Affiliation(s)
- Pei-Chun Kao
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA, United States; New England Robotics Validation and Experimentation (NERVE) Center, University of Massachusetts Lowell, Lowell, MA, United States.
| | - Michaela A Pierro
- Biomedical Engineering and Biotechnology Program, University of Massachusetts Lowell, Lowell, MA, United States
| | - Daniela M Gonzalez
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, United States
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Weisberg SM, Ebner NC, Seidler RD. Getting LOST: A conceptual framework for supporting and enhancing spatial navigation in aging. Wiley Interdiscip Rev Cogn Sci 2024; 15:e1669. [PMID: 37933623 PMCID: PMC10939954 DOI: 10.1002/wcs.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023]
Abstract
Spatial navigation is more difficult and effortful for older than younger individuals, a shift which occurs for a variety of neurological, physical, and cognitive reasons associated with aging. Despite a large body of evidence documenting age-related deficits in spatial navigation, comparatively less research addresses how to facilitate more effective navigation behavior for older adults. Since navigation challenges arise for a variety of reasons in old age, a one-size-fits-all solution is unlikely to work. Here, we introduce a framework for the variety of spatial navigation challenges faced in aging, which we call LOST-Location, Orientation, Spatial mapping, and Transit. The LOST framework builds on evidence from the cognitive neuroscience of spatial navigation, which reveals distinct components underpinning human wayfinding. We evaluate research on navigational aids-devices and depictions-which help people find their way around; and we reflect on how navigation aids solve (or fail to solve) specific wayfinding difficulties faced by older adults. In summary, we emphasize a bespoke approach to improving spatial navigation in aging, which focuses on tailoring navigation solutions to specific navigation challenges. Our hope is that by providing precise support to older navigators, navigation opportunities can facilitate independence and exploration, while minimizing the danger of becoming lost. We conclude by delineating critical knowledge gaps in how to improve older adults' spatial navigation capacities that the novel LOST framework could guide to address. This article is categorized under: Psychology > Development and Aging Neuroscience > Cognition Neuroscience > Behavior.
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Affiliation(s)
- Steven M. Weisberg
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL 32611
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr., Gainesville, FL 32611
| | - Natalie C. Ebner
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL 32611
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr., Gainesville, FL 32611
- Institute on Aging, University of Florida, 2004 Mowry Rd., Gainesville, FL 32611
- Department of Physiology and Aging, University of Florida, 1345 Center Drive, Gainesville, FL 32610-0274
| | - Rachael D. Seidler
- Department of Applied Physiology & Kinesiology, University of Florida, 1864 Stadium Rd., Gainesville, FL 32611
- Department of Neurology, University of Florida, 1149 Newell Dr., Gainesville, FL 32611
- Normal Fixel Institute for Neurological Diseases, University of Florida, 3009 SW Williston Rd. 1864 Stadium Rd., Gainesville, FL 32608
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Richardson DP, Foxe JJ, Freedman EG. Reduced Proactive and Reactive Cognitive Flexibility in Older Adults Underlies Performance Costs During Dual-Task Walking: A Mobile Brain/Body Imaging (MoBI) Study. bioRxiv 2024:2024.01.27.577090. [PMID: 38328169 PMCID: PMC10849668 DOI: 10.1101/2024.01.27.577090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Age-related reductions in cognitive flexibility may limit modulation of control processes during systematic increases to cognitive-motor demands, exacerbating dual-task costs. In this study, behavioral and neurophysiologic changes to proactive and reactive control during progressive cognitive-motor demands were compared across older and younger adults to explore the basis for age-differences in cognitive-motor interference (CMI). 19 younger (19 - 29 years old, mean age = 22.84 +/- 2.75 years, 6 male, 13 female) and 18 older (60 - 77 years old, mean age = 67.89 +/- 4.60 years, 9 male, 9 female) healthy adults completed cued task-switching while alternating between sitting and walking on a treadmill. Gait kinematics, task performance measures, and brain activity were recorded using electroencephalography (EEG) based Mobile Brain/Body Imaging (MoBI). Response accuracy on easier trial types improved in younger, but not older adults when they walked while performing the cognitive task. As difficulty increased, walking provoked accuracy costs in older, but not younger adults. Both groups registered faster responses and reduced gait variability during dual-task walking. Older adults exhibited lower amplitude modulations of proactive and reactive neural activity as cognitive-motor demands systematically increased, which may reflect reduced flexibility for progressive preparatory and reactive adjustments over behavioral control.
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Affiliation(s)
- David P. Richardson
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
| | - John J. Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
| | - Edward G. Freedman
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
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Liu S, Rosso AL, Baillargeon EM, Weinstein AM, Rosano C, Torres-Oviedo G. Novel attentional gait index reveals a cognitive ability-related decline in gait automaticity during dual-task walking. Front Aging Neurosci 2024; 15:1283376. [PMID: 38274986 PMCID: PMC10808635 DOI: 10.3389/fnagi.2023.1283376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Gait automaticity refers to the ability to walk with minimal recruitment of attentional networks typically mediated through the prefrontal cortex (PFC). Reduced gait automaticity (i.e., greater use of attentional resources during walking) is common with aging, contributing to an increased risk of falls and reduced quality of life. A common assessment of gait automaticity involves examining PFC activation using near-infrared spectroscopy (fNIRS) during dual-task (DT) paradigms, such as walking while performing a cognitive task. However, neither PFC activity nor task performance in isolation measures automaticity accurately. For example, greater PFC activation could be interpreted as worse gait automaticity when accompanied by poorer DT performance, but when accompanied by better DT performance, it could be seen as successful compensation. Thus, there is a need to incorporate behavioral performance and PFC measurements for a more comprehensive evaluation of gait automaticity. To address this need, we propose a novel attentional gait index as an analytical approach that combines changes in PFC activity with changes in DT performance to quantify automaticity, where a reduction in automaticity will be reflected as an increased need for attentional gait control (i.e., larger index). Methods The index was validated in 173 participants (≥65 y/o) who completed DTs with two levels of difficulty while PFC activation was recorded with fNIRS. The two DTs consisted of reciting every other letter of the alphabet while walking over either an even or uneven surface. Results As DT difficulty increases, more participants showed the anticipated increase in the attentional control of gait (i.e., less automaticity) as measured by the novel index compared to PFC activation. Furthermore, when comparing across individuals, lower cognitive function was related to higher attentional gait index, but not PFC activation or DT performance. Conclusion The proposed index better quantified the differences in attentional control of gait between tasks and individuals by providing a unified measure that includes both brain activation and performance. This new approach opens exciting possibilities to assess participant-specific deficits and compare rehabilitation outcomes from gait automaticity interventions.
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Affiliation(s)
- Shuqi Liu
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Andrea L. Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Emma M. Baillargeon
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea M. Weinstein
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
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Liu S, Rosso AL, Baillargeon EM, Weinstein AM, Rosano C, Torres-Oviedo G. Novel automaticity index reveals a cognitive ability-related decline in gait automaticity during dual-task walking. bioRxiv 2023:2023.07.31.551290. [PMID: 37577644 PMCID: PMC10418087 DOI: 10.1101/2023.07.31.551290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Gait automaticity refers to the ability to walk with minimal recruitment of attentional networks typically mediated through the prefrontal cortex (PFC). Reduced gait automaticity is common with aging, contributing to an increased risk of falls and reduced quality of life. A common assessment of gait automaticity involves examining PFC activation using near-infrared spectroscopy (fNIRS) during dual-task (DT) paradigms, such as walking while performing a cognitive task. However, neither PFC activity nor task performance in isolation measures automaticity accurately. For example, greater PFC activation could be interpreted as worse gait automaticity when accompanied by poorer DT performance, but when accompanied by better DT performance, it could be seen as successful compensation. Thus, there is a need to incorporate behavioral performance and PFC measurements for a more comprehensive evaluation of gait automaticity. To address this need, we propose a novel automaticity index as an analytical approach that combines changes in PFC activity with changes in DT performance to quantify gait automaticity. We validated the index in 173 participants (≥65 y/o) who completed DTs with two levels of difficulty while PFC activation was recorded with fNIRS. The two DTs consisted of reciting every other letter of the alphabet while walking over either an even or uneven surface. We found that as DT difficulty increases, more participants showed the anticipated decrease in automaticity as measured by the novel index compared to PFC activation. Furthermore, when comparing across individuals, lower cognitive function related to worse automaticity index, but not PFC activation or DT performance. In sum, the proposed index better quantified the differences in automaticity between tasks and individuals by providing a unified measure of gait automaticity that includes both brain activation and performance. This new approach opens exciting possibilities to assess participant-specific deficits and compare rehabilitation outcomes from gait automaticity interventions.
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Affiliation(s)
- Shuqi Liu
- Sensorimotor Learning Laboratory, University of Pittsburgh, Department of Bioengineering, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Andrea L. Rosso
- University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USA
| | - Emma M. Baillargeon
- University of Pittsburgh, Department of Medicine, Division of Geriatric Medicine, Pittsburgh, PA, USA
| | - Andrea M. Weinstein
- University of Pittsburgh, Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Caterina Rosano
- University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USA
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, University of Pittsburgh, Department of Bioengineering, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
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Liu C, Downey RJ, Salminen JS, Rojas SA, Richer N, Pliner EM, Hwang J, Cruz-Almeida Y, Manini TM, Hass CJ, Seidler RD, Clark DJ, Ferris DP. Electrical Brain Activity during Human Walking with Parametric Variations in Terrain Unevenness and Walking Speed. bioRxiv 2023:2023.07.31.551289. [PMID: 37577540 PMCID: PMC10418077 DOI: 10.1101/2023.07.31.551289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Mobile brain imaging with high-density electroencephalography (EEG) can provide insight into the cortical processes involved in complex human walking tasks. While uneven terrain is common in the natural environment and poses challenges to human balance control, there is limited understanding of the supraspinal processes involved with traversing uneven terrain. The primary objective of this study was to quantify electrocortical activity related to parametric variations in terrain unevenness for neurotypical young adults. We used high-density EEG to measure brain activity when thirty-two young adults walked on a novel custom-made uneven terrain treadmill surface with four levels of difficulty at a walking speed tailored to each participant. We identified multiple brain regions associated with uneven terrain walking. Alpha (8 - 13 Hz) and beta (13 - 30 Hz) spectral power decreased in the sensorimotor and posterior parietal areas with increasing terrain unevenness while theta (4 - 8 Hz) power increased in the mid/posterior cingulate area with terrain unevenness. We also found that within stride spectral power fluctuations increased with terrain unevenness. Our secondary goal was to investigate the effect of parametric changes in walking speed (0.25 m/s, 0.5m/s, 0.75 m/s, 1.0 m/s) to differentiate the effects of walking speed from uneven terrain. Our results revealed that electrocortical activities only changed substantially with speed within the sensorimotor area but not in other brain areas. Together, these results indicate there are distinct cortical processes contributing to the control of walking over uneven terrain versus modulation of walking speed on smooth, flat terrain. Our findings increase our understanding of cortical involvement in an ecologically valid walking task and could serve as a benchmark for identifying deficits in cortical dynamics that occur in people with mobility deficits.
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Affiliation(s)
- Chang Liu
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL
| | - Ryan J. Downey
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Jacob S. Salminen
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Sofia Arvelo Rojas
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Natalie Richer
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Erika M. Pliner
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Jungyun Hwang
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Todd M. Manini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL
| | - David J. Clark
- Department of Neurology, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Daniel P. Ferris
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL
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Shah VA, Cruz-Almeida Y, Roy A, Cenko E, Downey RJ, Ferris DP, Hass CJ, Reuter-Lorenz PA, Clark DJ, Manini TM, Seidler RD. Uneven terrain versus dual-task walking: differential challenges imposed on walking behavior in older adults are predicted by cognitive and sensorimotor function. bioRxiv 2023:2023.03.14.531779. [PMID: 36993462 PMCID: PMC10054936 DOI: 10.1101/2023.03.14.531779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Aging is associated with declines in walking function. To understand these mobility declines, many studies have obtained measurements while participants walk on flat surfaces in laboratory settings during concurrent cognitive task performance (dual-tasking). This may not adequately capture the real-world challenges of walking at home and around the community. Here, we hypothesized that uneven terrains in the walking path impose differential changes to walking speed compared to dual-task walking. We also hypothesized that changes in walking speed resulting from uneven terrains will be better predicted by sensorimotor function than cognitive function. Sixty-three community-dwelling older adults (65-93 yrs old) performed overground walking under varying walking conditions. Older adults were classified into two mobility function groups based on scores of the Short Physical Performance Battery. They performed uneven terrain walking across four surface conditions (Flat, Low, Medium, and High unevenness) and performed single and verbal dual-task walking on flat ground. Participants also underwent a battery of cognitive (cognitive flexibility, working memory, inhibition) and sensorimotor testing (grip strength, 2-pt discrimination, pressure pain threshold). Our results showed that walking speed decreased during both dual-task walking and across uneven terrain walking conditions compared to walking on flat terrain. Participants with lower mobility function had even greater decreases in uneven terrain walking speeds. The change in uneven terrain speed was associated with attention and inhibitory function. Changes in both dual-task and uneven terrain walking speeds were associated with 2-point tactile discrimination. This study further documents associations between mobility, executive functions, and somatosensation, highlights the differential costs to walking imposed by uneven terrains, and identifies that older adults with lower mobility function are more likely to experience these changes to walking function.
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Affiliation(s)
- Valay A Shah
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Dept. of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Arkaprava Roy
- Dept. of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Erta Cenko
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
- Dept. of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Ryan J Downey
- Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Daniel P Ferris
- Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Chris J Hass
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | | | - David J Clark
- Dept of Physiology and Aging, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Todd M Manini
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Rachael D Seidler
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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Fettrow T, Hupfeld K, Hass C, Pasternak O, Seidler R. Neural correlates of gait adaptation in younger and older adults. Sci Rep 2023; 13:3842. [PMID: 36890163 PMCID: PMC9995534 DOI: 10.1038/s41598-023-30766-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Abstract
Mobility decline is a major concern for older adults. A key component of maintaining mobility with advancing age is the ability to learn and adapt to the environment. The split-belt treadmill paradigm is an experimental protocol that tests the ability to adapt to a dynamic environment. Here we examined the magnetic resonance imaging (MRI) derived structural neural correlates of individual differences in adaptation to split-belt walking for younger and older adults. We have previously shown that younger adults adopt an asymmetric walking pattern during split-belt walking, particularly in the medial-lateral (ML) direction, but older adults do not. We collected T[Formula: see text]-weighted and diffusion-weighted MRI scans to quantify brain morphological characteristics (i.e. in the gray matter and white matter) on these same participants. We investigated two distinct questions: (1) Are there structural brain metrics that are associated with the ability to adopt asymmetry during split-belt walking; and (2) Are there different brain-behavior relationships for younger and older adults? Given the growing evidence that indicates the brain has a critical role in the maintenance of gait and balance, we hypothesized that brain areas commonly associated with locomotion (i.e. basal ganglia, sensorimotor cortex, cerebellum) would be associated with ML asymmetry and that older adults would show more associations between split-belt walking and prefrontal brain areas. We identified multiple brain-behavior associations. More gray matter volume in the superior frontal gyrus and cerebellar lobules VIIB and VIII, more sulcal depth in the insula, more gyrification in the pre/post central gyri, and more fractional anisotropy in the corticospinal tract and inferior longitudinal fasciculus corresponded to more gait asymmetry. These associations did not differ between younger and older adults. This work progresses our understanding of how brain structure is associated with balance during walking, particularly during adaptation.
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Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA.
- NASA Langley Research Center, Hampton, VA, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Chris Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachael Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
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10
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Downey RJ, Richer N, Gupta R, Liu C, Pliner EM, Roy A, Hwang J, Clark DJ, Hass CJ, Manini TM, Seidler RD, Ferris DP. Uneven terrain treadmill walking in younger and older adults. PLoS One 2022; 17:e0278646. [PMID: 36534645 PMCID: PMC9762558 DOI: 10.1371/journal.pone.0278646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
We developed a method for altering terrain unevenness on a treadmill to study gait kinematics. Terrain consisted of rigid polyurethane disks (12.7 cm diameter, 1.3-3.8 cm tall) which attached to the treadmill belt using hook-and-loop fasteners. Here, we tested four terrain unevenness conditions: Flat, Low, Medium, and High. The main objective was to test the hypothesis that increasing the unevenness of the terrain would result in greater gait kinematic variability. Seventeen younger adults (age 20-40 years), 25 higher-functioning older adults (age 65+ years), and 29 lower-functioning older adults (age 65+ years, Short Physical Performance Battery score < 10) participated. We customized the treadmill speed to each participant's walking ability, keeping the speed constant across all four terrain conditions. Participants completed two 3-minute walking trials per condition. Using an inertial measurement unit placed over the sacrum and pressure sensors in the shoes, we calculated the stride-to-stride variability in step duration and sacral excursion (coefficient of variation; standard deviation expressed as percentage of the mean). Participants also self-reported their perceived stability for each condition. Terrain was a significant predictor of step duration variability, which roughly doubled from Flat to High terrain for all participant groups: younger adults (Flat 4.0%, High 8.2%), higher-functioning older adults (Flat 5.0%, High 8.9%), lower-functioning older adults (Flat 7.0%, High 14.1%). Similarly, all groups exhibited significant increases in sacral excursion variability for the Medium and High uneven terrain conditions, compared to Flat. Participants were also significantly more likely to report feeling less stable walking over all three uneven terrain conditions compared to Flat. These findings support the hypothesis that altering terrain unevenness on a treadmill will increase gait kinematic variability and reduce perceived stability in younger and older adults.
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Affiliation(s)
- Ryan J. Downey
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
| | - Natalie Richer
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
| | - Rohan Gupta
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
| | - Chang Liu
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
| | - Erika M. Pliner
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
| | - Arkaprava Roy
- Department of Biostatistics, University of Florida, Gainesville, FL, United States of America
| | - Jungyun Hwang
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States of America
| | - David J. Clark
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States of America
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States of America
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Todd M. Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States of America
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Daniel P. Ferris
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States of America
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11
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Sato SD, Choi JT. Corticospinal drive is associated with temporal walking adaptation in both healthy young and older adults. Front Aging Neurosci 2022; 14:920475. [PMID: 36062156 PMCID: PMC9436318 DOI: 10.3389/fnagi.2022.920475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Healthy aging is associated with reduced corticospinal drive to leg muscles during walking. Older adults also exhibit slower or reduced gait adaptation compared to young adults. The objective of this study was to determine age-related changes in the contribution of corticospinal drive to ankle muscles during walking adaptation. Electromyography (EMG) from the tibialis anterior (TA), soleus (SOL), medial, and lateral gastrocnemius (MGAS, LGAS) were recorded from 20 healthy young adults and 19 healthy older adults while they adapted walking on a split-belt treadmill. We quantified EMG-EMG coherence in the beta-gamma (15-45 Hz) and alpha-band (8-15 Hz) frequencies. Young adults demonstrated higher coherence in both the beta-gamma band coherence and alpha band coherence, although effect sizes were greater in the beta-gamma frequency. The results showed that slow leg TA-TA coherence in the beta-gamma band was the strongest predictor of early adaptation in double support time. In contrast, early adaptation in step length symmetry was predicted by age group alone. These findings suggest an important role of corticospinal drive in adapting interlimb timing during walking in both young and older adults.
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Affiliation(s)
- Sumire D. Sato
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, United States
| | - Julia T. Choi
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, United States
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12
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Lehmann N, Kuhn YA, Keller M, Aye N, Herold F, Draganski B, Taube W, Taubert M. Brain Activation During Active Balancing and Its Behavioral Relevance in Younger and Older Adults: A Functional Near-Infrared Spectroscopy (fNIRS) Study. Front Aging Neurosci 2022; 14:828474. [PMID: 35418854 PMCID: PMC8997341 DOI: 10.3389/fnagi.2022.828474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/28/2022] [Indexed: 12/26/2022] Open
Abstract
Age-related deterioration of balance control is widely regarded as an important phenomenon influencing quality of life and longevity, such that a more comprehensive understanding of the neural mechanisms underlying this process is warranted. Specifically, previous studies have reported that older adults typically show higher neural activity during balancing as compared to younger counterparts, but the implications of this finding on balance performance remain largely unclear. Using functional near-infrared spectroscopy (fNIRS), differences in the cortical control of balance between healthy younger (n = 27) and older (n = 35) adults were explored. More specifically, the association between cortical functional activity and balance performance across and within age groups was investigated. To this end, we measured hemodynamic responses (i.e., changes in oxygenated and deoxygenated hemoglobin) while participants balanced on an unstable device. As criterion variables for brain-behavior-correlations, we also assessed postural sway while standing on a free-swinging platform and while balancing on wobble boards with different levels of difficulty. We found that older compared to younger participants had higher activity in prefrontal and lower activity in postcentral regions. Subsequent robust regression analyses revealed that lower prefrontal brain activity was related to improved balance performance across age groups, indicating that higher activity of the prefrontal cortex during balancing reflects neural inefficiency. We also present evidence supporting that age serves as a moderator in the relationship between brain activity and balance, i.e., cortical hemodynamics generally appears to be a more important predictor of balance performance in the older than in the younger. Strikingly, we found that age differences in balance performance are mediated by balancing-induced activation of the superior frontal gyrus, thus suggesting that differential activation of this region reflects a mechanism involved in the aging process of the neural control of balance. Our study suggests that differences in functional brain activity between age groups are not a mere by-product of aging, but instead of direct behavioral relevance for balance performance. Potential implications of these findings in terms of early detection of fall-prone individuals and intervention strategies targeting balance and healthy aging are discussed.
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Affiliation(s)
- Nico Lehmann
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Nico Lehmann,
| | - Yves-Alain Kuhn
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Martin Keller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Norman Aye
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Bogdan Draganski
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Marco Taubert
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Science, Otto von Guericke University, Magdeburg, Germany
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13
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Hupfeld KE, Geraghty JM, McGregor HR, Hass CJ, Pasternak O, Seidler RD. Differential Relationships Between Brain Structure and Dual Task Walking in Young and Older Adults. Front Aging Neurosci 2022; 14:809281. [PMID: 35360214 PMCID: PMC8963788 DOI: 10.3389/fnagi.2022.809281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when they perform a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underlie dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18–34 years) and 23 older adults (66–86 years). We also collected T1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: (1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and (2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.
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Affiliation(s)
- Kathleen E. Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Justin M. Geraghty
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Heather R. McGregor
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - C. J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- University of Florida Norman Fixel Institute for Neurological Diseases, Gainesville, FL, United States
- *Correspondence: Rachael D. Seidler
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14
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Langeard A, Torre MM, Temprado JJ. A Dual-Task Paradigm Using the Oral Trail Making Test While Walking to Study Cognitive-Motor Interactions in Older Adults. Front Aging Neurosci 2021; 13:712463. [PMID: 34588973 PMCID: PMC8475182 DOI: 10.3389/fnagi.2021.712463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/06/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: With aging, gait becomes more dependent on executive functions, especially on switching abilities. Therefore, cognitive-motor dual-task (DT) paradigms should study the interferences between gait and switching tasks. This study aimed to test a DT paradigm based on a validated cognitive switching task to determine whether it could distinguish older-old adults (OO) from younger-old adults (YO). Methods: Sixty-five healthy older participants divided into 29 younger-old (<70 years) and 36 older-old (≥70 years) age groups were evaluated in three single-task (ST) conditions as follows: a cognitive task including a processing speed component [Oral Trail Making Test part A (OTMT-A)], a cognitive task including a switching component [Oral Trail Making Test part B (OTMT-B)], and a gait evaluation at normal speed. They were also evaluated under two DT conditions, i.e., one associating gait with OTMT-A and the other associating gait with OTMT-B. Cognitive and gait performances were measured. The comparison of cognitive and gait performances between condition, logistic regression, and receiver operating characteristic (ROC) analyses were performed. Results: The cognitive and gait performances were differently affected by the different conditions (i.e., ST, DT, OTMT-A, and OTMT-B). The OTMT-B produced higher interference on gait and cognitive performances. Moreover, a higher number of errors on the OTMT-B performed while walking was associated with the older-old age group. Conclusion: Using validated cognitive flexibility tasks, this DT paradigm confirms the high interference between switching tasks and gait in older age. It is easily implemented, and its sensitivity to age may highlight its possible usefulness to detect cognitive or motor declines.
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Affiliation(s)
- Antoine Langeard
- Aix-Marseille Université, CNRS, ISM, Institut des Sciences du Mouvement, Marseille, France.,Normandie Univ, UNICAEN, INSERM, COMETE, Caen, France
| | - Marta Maria Torre
- Aix-Marseille Université, CNRS, ISM, Institut des Sciences du Mouvement, Marseille, France
| | - Jean-Jacques Temprado
- Aix-Marseille Université, CNRS, ISM, Institut des Sciences du Mouvement, Marseille, France
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