Abstract
Lowry
KA, Brach JS, Nebes RD, Studenski SA, VanSwearingen JM. Contributions
of cognitive function to straight- and curved-path walking in older
adults.
Objective
To determine whether the cognitive function contribution to straight- and curved-path walking differs for older adults.
Design
Cross-sectional observational study.
Setting
Ambulatory clinical research training center.
Participants
People
(N=106) aged 65 to 92 years, able to walk household distances
independently with or without an assistive device, and who scored 24 or
greater on the Mini-Mental State Examination.
Interventions
Not applicable.
Main Outcome Measures
Cognitive
function was assessed using the Digit Symbol Substitution Test (DSST)
as a measure of psychomotor speed, and Trail Making Test Parts A and B
(TMT-A and TMT-B) and the Trail Making Test difference score (TMT-B-A)
as executive function measures of complex visual scanning and set
shifting. Gait speed recorded over an instrumented walkway was used as
the measure of straight-path walking. Curved-path walking was assessed
using the Figure-of-8 Walk Test (F8W) and recorded as the total time and
number of steps for completion.
Results
Both DSST and TMT-A independently contributed to usual gait speed (P<.001). TMT-A performance contributed to F8W time (P<.001).
Neither TMT-B nor TMT-B-A contributed to usual gait speed or time to
complete the F8W. For the number of steps taken to complete the F8W,
TMT-A, TMT-B, and TMT-B-A (all P<.001) were independent contributors, while DSST performance was not.
Conclusions
Curved-path
walking, as measured by the F8W, involves different cognitive processes
compared with straight-path walking. Cognitive flexibility and
set-shifting processes uniquely contributed to how individuals navigated
curved paths. The measure of curved-path walking provides different and
meaningful information about daily life walking ability than usual gait
speed alone.
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