A Comparison between young and old adults in their ability to rapidly sidestep during gait when attention is divided.
BACKGROUND
The incidence of falls among older adults is high and the risk factors are often complex in nature. Considerable research has been done in the area of age-related changes of balance in an attempt to better understand the increased risk of falls. Studies of cognitive changes, however, suggest that the elderly are less able to divide their attention between two or more activities. This inability to divide attention could explain the increased risks of falls in the elderly.


OBJECTIVE
To investigate the effects of divided attention, age and prior knowledge of movement path, on kinetic measures and the position of the sacral marker relative to the center of pressure (COP) when individuals perform a rapid sidestep during walking.


METHODS
32 young and 32 old adults participated in this study. Subjects walked and took a sidestep without interrupting forward progression. An arithmetic task was performed during half of the walking trials with the sidestep direction preplanned or unknown. Peak lateral ground reaction force, mean distance between COP and sacrum, walking velocity, performance speed and accuracy of the cognitive task were measured.


RESULTS
Both groups significantly decreased their mediolateral distance between the sacral marker and the COP in the dual-task trials (p = 0.04). Both groups significantly decreased their walking speed in the dual-task trials (p < 0.0001). Prior knowledge of the sidestep direction significantly affected the peak lateral ground reaction force and the sacral marker to COP distance but the differences were age-dependent. Young adults had a larger value in the unknown condition than in the preplanned condition (p < 0.0001). For the cognitive task, both groups decreased their performance speed (p < 0.0001) but maintained their performance accuracy as compared to the baseline data (p > 0.05).


CONCLUSIONS
Our results revealed that old adults tended to be conservative, when facing the dual-task trials or unknown test condition. The fact that the older adults in the current study did not perform similarly to the younger adults suggests that they might have a fear of fall when facing a challenging balance task.
Cho
Chiung-Yu
CY
Department of Physical Therapy, Medical College, National Cheng Kung University, Tainan, Taiwan. cycho@mail.ncku.edu.tw
Gilchrist
Louise
L
White
Scott
S
D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008606:Mental Processes / Q000502:physiology; D008875:Middle Aged; D016138:Walking / Q000502:physiology*