Performance variance on walking while talking tasks: theory, findings, and clinical implications
Performance variance on walking while talking tasks: theory, findings, and clinical implications
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DOI：
10.1007/s11357-013-9570-7
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发表时间：
2014-02-01
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影响因子：
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通讯作者：
Verghese, Joe
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文献类型：
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作者：
Holtzer, Roee;Wang, Cuiling;Verghese, Joe
涉及行走和认知干扰测试的双重任务通常用于移动性评估和干预。然而，解释双任务绩效成本差异的因素却知之甚少。因此，我们研究了两个假定的结构，姿势储备和危险估计，在边走边说范式的性能的调节作用。参与者为285名非痴呆老年人（平均年龄= 76.9岁;女性%= 54.4）。姿势储备的操作存在或不存在临床步态异常。一个经验因素，执行功能的措施的基础上，作为危险估计的标志。通过联合线性混合效应模型的双向交互作用，考察了姿势储备和危险估计对双任务成本的调节作用。观察到步态速度（95%CI = 30.814至39.121）和认知准确性（95%CI = 6.568至13.607）的显著双任务成本。高风险估计值对步态速度（95% CI = -8.372至-0.151）和认知准确性（95% CI = -8.372至-0.680）下降具有保护作用。姿势储备差与步态速度下降减少相关（95% CI = -9.611至-0.702），但不能缓解认知准确性下降（95% CI = -3.016至4.559）。评估姿势储备和危险估计可以帮助改善认知和运动障碍患者的移动风险评估程序和干预措施。
Dual tasks that involve walking and cognitive interference tests are commonly used in mobility assessments and interventions. However, factors that explain variance in dual-task performance costs are poorly understood. We, therefore, examined the moderating effects of two putative constructs, postural reserve and hazard estimate, on performance on a walking while talking paradigm. Participants were 285 non-demented older adults (mean age = 76.9 years; %female = 54.4). Postural reserve was operationalized as the presence or absence of clinical gait abnormalities. An empirical factor, based on measures of executive functions, served as a marker for hazard estimate. The moderation effects of postural reserve and hazard estimate on dual-task costs were examined via two-way interactions in a joint linear mixed effect model. Significant dual-task costs were observed for gait speed (95% CI = 30.814 to 39.121) and cognitive accuracy (95% CI = 6.568 to 13.607). High hazard estimate had a protective effect against decline in gait speed (95% CI = -8.372 to -0.151) and cognitive accuracy (95% CI = -8.372 to -0.680). Poor postural reserve was associated with reduced decline in gait speed (95% CI = -9.611 to -0.702) but did not moderate the decline in cognitive accuracy (95% CI = -3.016 to 4.559). Assessing postural reserve and hazard estimate can help improve mobility risk assessment procedures and interventions for individuals with cognitive and movement disorders.