title: Older adults with and without stroke reduce cadence to meet the demands of talking.
abstract: OBJECTIVE
  Cognitive tasks performed while walking can be challenging for older adults, especially for those with stroke. Conversational speech requires attention and working memory. The purpose of this study was to examine how older adults with and without stroke meet the demands of walking while talking.
  
  
  METHODS
  Community-dwelling older adults, 12 without stroke and 24 with, were videotaped walking an irregular elliptical pathway. Audio recordings were made as subjects discussed topics such as describing a memorable vacation. Each participant performed in single and dual task conditions: speaking, walking, and speaking while walking. Primary measures of interest included cadence and speech rate. Components of language including measures of fluency, grammatical complexity, and semantic content were analyzed to examine additional changes in speech. Paired t-tests were used to compare single and dual task performance for each group. Group differences for dual task effects were examined with independent sample t tests.
  
  
  RESULTS
  Cadence decreased with the addition of talking for those without stroke, P < .007, and those with stroke, P < .001. Speech rates did not change with walking for either group; those without stroke did not alter the language components. Participants with stroke reduced the grammatical complexity and semantic content of speech when walking, P's < .013. Those without stroke spent more time doing both tasks at once than those with stroke, P < .023.
  
  
  CONCLUSIONS
  Clinicians can expect older adults to reduce walking speed to meet the demands of walking and talking. Older adults with stroke may use additional strategies to walk and talk simultaneously.
authors.affiliation: Department of Physical Therapy & Rehabilitation Science, University of Kansas Medical Center, KS, USA. pohlp@sage.edu
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Pohl
authors.forename: Susan
authors.initials: S
authors.lastname: Kemper
authors.forename: Catherine F
authors.initials: CF
authors.lastname: Siengsukon
authors.forename: Lara
authors.initials: L
authors.lastname: Boyd
authors.forename: Eric
authors.initials: E
authors.lastname: Vidoni
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Herman
mesh_terms: D000368:Aged; D003071:Cognition; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D013060:Speech; D000071939:Stroke Rehabilitation; D014741:Video Recording; D016138:Walking