Uneven surface and cognitive dual-task independently affect gait quality in older adults.
Uneven surface and cognitive dual-task independently affect gait quality in older adults.
复制标题
不平坦的表面和认知双重任务独立影响老年人的步态质量。
DOI：
10.1016/j.gaitpost.2023.08.010
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发表时间：
2023
期刊：
影响因子：
2.4
通讯作者：
Rosso,AndreaL
中科院分区：
文献类型：
--
作者：
Suri,Anisha;VanSwearingen,Jessie;Rosano,Caterina;Brach,JenniferS;Redfern,MarkS;Sejdić,Ervin;Rosso,AndreaL
现实世界的移动性包括在具有挑战性的条件下行走。在同时的身体和认知挑战中评估步态提供了对认知健康的见解。研究问题：不平整的表面、认知任务及其组合如何影响步态质量，这种步态表现与认知功能有关吗？方法社区老年人（104例，年龄75±6岁，女性占60%）采用双任务步行范式（均匀和不平坦路面；有和没有字母排序认知任务（ABC））模拟现实生活需求。步态质量指标[速度（m/s）、节奏（步数/分钟）、步幅时间变异性（%）、适应性（m/s2）、相似度、平滑度、功率（Hz）和规律性]通过佩戴在下背部的加速度计计算。采用线性混合建模和Tukey分析分析了表面任务和认知任务对步态质量的独立影响及其相互作用。部分Spearman相关性比较了步态质量与整体认知和执行功能。结果表面任务与认知任务之间无交互作用。不平整的表面降低了步态速度（m/s） （β = -0.07）。调整速度后，不平整的表面降低了步态的平稳性（β = -0.27），增加了规律性（β = 0.09），对于均匀与不均匀、均匀abc与不均匀abc， Tukeyp < 0.05。认知任务降低步态速度（m/s） （β = -0.12）。调整速度后，认知任务增加了均匀abc vs均匀abc，不均匀abc vs不均匀abc，变异性（β = 7.60），节律性（β = -6.68）和规律性（β = 0.05）， Tukeyp < 0.05。以人口统计学为协变量，步态速度与认知无关。步态质量[均匀abc （ρp= - 0.31）和不均匀abc （ρp= - 0.28）期间变异性较低]；更大的节奏性。22、。29)和更大的信号适应性AP （ρ之间）。22、。（26）在所有行走任务中]与更好的全局认知有关。均匀行走（ρp= -0.21, p= 0.03）和不均匀行走（ρp= -0.19, p= 0.04）时的步态适应性与执行功能相关。表面行走任务和认知行走任务分别影响步态质量。我们对高功能老年人的研究表明，与任务相关的步态质量变化与认知功能的细微变化有关。
BackgroundReal-world mobility involves walking in challenging conditions. Assessing gait during simultaneous physical and cognitive challenges provides insights on cognitive health.Research questionHow does uneven surface, cognitive task, and their combination affect gait quality and does this gait performance relate to cognitive functioning?MethodsCommunity-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.ResultsNo 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), Tukeyp < .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), Tukeyp < .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 (ρp=–.31) and uneven-ABC (ρp=–.28); greater rhythmicity (ρpbetween.22 and.29) and greater signal-adaptability AP (ρpbetween.22 and.26) during all walking tasks] was associated with better global cognition. Gait adaptability during even (ρp=–0.21, p = 0.03) and uneven(ρp=–0.19, p = 0.04) walking was associated with executive function.SignificanceSurface 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.