title: Sensorimotor and Cognitive Predictors of Impaired Gait Adaptability in Older People.
abstract: BACKGROUND
  The ability to adapt gait when negotiating unexpected hazards is crucial to maintain stability and avoid falling. This study investigated whether impaired gait adaptability in a task including obstacle and stepping targets is associated with cognitive and sensorimotor capacities in older adults.
  
  
  METHODS
  Fifty healthy older adults (74±7 years) were instructed to either (a) avoid an obstacle at usual step distance or (b) step onto a target at either a short or long step distance projected on a walkway two heel strikes ahead and then continue walking. Participants also completed cognitive and sensorimotor function assessments.
  
  
  RESULTS
  Stroop test and reaction time performance significantly discriminated between participants who did and did not make stepping errors, and poorer Trail-Making test performance predicted shorter penultimate step length in the obstacle avoidance condition. Slower reaction time predicted poorer stepping accuracy; increased postural sway, weaker quadriceps strength, and poorer Stroop and Trail-Making test performances predicted increased number of steps taken to approach the target/obstacle and shorter step length; and increased postural sway and higher concern about falling predicted slower step velocity.
  
  
  CONCLUSIONS
  Superior executive function, fast processing speed, and good muscle strength and balance were all associated with successful gait adaptability. Processing speed appears particularly important for precise foot placements; cognitive capacity for step length adjustments; and early and/or additional cognitive processing involving the inhibition of a stepping pattern for obstacle avoidance. This information may facilitate fall risk assessments and fall prevention strategies.
authors: Neuroscience Research Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors: Maria Joana D
authors: MJD
authors: Caetano
authors: Neuroscience Research Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors: Jasmine C
authors: JC
authors: Menant
authors: Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nürnberg, Germany.
authors: Daniel
authors: D
authors: Schoene
authors: Neuroscience Research Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors: Paulo H S
authors: PHS
authors: Pelicioni
authors: Neuroscience Research Australia.|School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors: Daina L
authors: DL
authors: Sturnieks
authors: Neuroscience Research Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors: Stephen R
authors: SR
authors: Lord
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000222:Adaptation, Physiological; D000368:Aged; D000375:Aging / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology
keywords: Balance; Cognition; Falls; Gait; Physical function