The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls.
BACKGROUND
This study used a dual task design to investigate the effects of two different types of cognitive tasks on stability (as measured by center of pressure displacement) in young vs older adults with and without a history of falls.


METHODS
Two secondary cognitive tasks, a sentence completion and a visual perceptual matching task, were used to produce changes in attention during quiet stance under flat vs compliant surface conditions in 20 healthy young adults, 20 healthy older adults, and 20 older adults with a history of imbalance and falls. Postural stability was quantified using forceplate measures of center of pressure (COP). Speed and accuracy of verbal response on the cognitive tasks were also quantified.


RESULTS
During the simultaneous performance of a cognitive and postural task, decrements in performance were found in the postural stability measures rather than the cognitive measures for all three groups. While no differences were found between the young adults and the older healthy adults on the firm surface, no task condition, when task complexity was increased (either through the introduction of a secondary cognitive task, or a more challenging postural condition such as standing on the compliant surface), significant differences in postural stability between the two groups became apparent. In contrast to the young and healthy older adults, postural stability in older adults with a history of falls was significantly affected by both cognitive tasks.


CONCLUSIONS
Results suggest that when postural stability is impaired, even relatively simple cognitive tasks can further impact balance. Results further suggest that the allocation of attention during the performance of concurrent tasks is complex; depending on many factors including the nature of both the cognitive and postural task, the goal of the subject and the instructions.
Shumway-Cook
A
A
Department of Physical Therapy, Northwest Hospital, Seattle, USA. AShumway@NWHsea.org
Woollacott
M
M
Kerns
K A
KA
Baldwin
M
M
D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007807:Language Tests; D008297:Male; D008499:Medical Records; D009483:Neuropsychological Tests; D011187:Posture / Q000502:physiology*; D012016:Reference Values; D013647:Task Performance and Analysis; D014796:Visual Perception