Uneven terrain versus dual-task walking: differential challenges imposed on walking behavior in older adults are predicted by cognitive and sensorimotor function

Valay A Shah; Yenisel Cruz-Almeida; Arkaprava Roy; Erta Cenko; Ryan J Downey; Daniel P Ferris; Chris J Hass; Patricia A Reuter-Lorenz; David J Clark; Todd M Manini; Rachael D Seidler

doi:10.1101/2023.03.14.531779

Uneven terrain versus dual-task walking: differential challenges imposed on walking behavior in older adults are predicted by cognitive and sensorimotor function

bioRxiv [Preprint]. 2023 Mar 15:2023.03.14.531779. doi: 10.1101/2023.03.14.531779.

Authors

Valay A Shah^{1

2}, Yenisel Cruz-Almeida^{3

4}, Arkaprava Roy⁵, Erta Cenko^{2

6}, Ryan J Downey⁷, Daniel P Ferris⁷, Chris J Hass¹, Patricia A Reuter-Lorenz⁸, David J Clark^{9

10}, Todd M Manini², Rachael D Seidler^{1

11}

Affiliations

¹ Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
² Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA.
³ Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA.
⁴ Dept. of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA.
⁵ Dept. of Biostatistics, University of Florida, Gainesville, FL, USA.
⁶ Dept. of Epidemiology, University of Florida, Gainesville, FL, USA.
⁷ Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
⁸ Dept. of Psychology, University of Michigan, Ann Arbor, MI, USA.
⁹ Dept of Physiology and Aging, University of Florida, Gainesville, FL, USA.
¹⁰ Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA.
¹¹ Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.

Abstract

Aging is associated with declines in walking function. To understand these mobility declines, many studies have obtained measurements while participants walk on flat surfaces in laboratory settings during concurrent cognitive task performance (dual-tasking). This may not adequately capture the real-world challenges of walking at home and around the community. Here, we hypothesized that uneven terrains in the walking path impose differential changes to walking speed compared to dual-task walking. We also hypothesized that changes in walking speed resulting from uneven terrains will be better predicted by sensorimotor function than cognitive function. Sixty-three community-dwelling older adults (65-93 yrs old) performed overground walking under varying walking conditions. Older adults were classified into two mobility function groups based on scores of the Short Physical Performance Battery. They performed uneven terrain walking across four surface conditions (Flat, Low, Medium, and High unevenness) and performed single and verbal dual-task walking on flat ground. Participants also underwent a battery of cognitive (cognitive flexibility, working memory, inhibition) and sensorimotor testing (grip strength, 2-pt discrimination, pressure pain threshold). Our results showed that walking speed decreased during both dual-task walking and across uneven terrain walking conditions compared to walking on flat terrain. Participants with lower mobility function had even greater decreases in uneven terrain walking speeds. The change in uneven terrain speed was associated with attention and inhibitory function. Changes in both dual-task and uneven terrain walking speeds were associated with 2-point tactile discrimination. This study further documents associations between mobility, executive functions, and somatosensation, highlights the differential costs to walking imposed by uneven terrains, and identifies that older adults with lower mobility function are more likely to experience these changes to walking function.

Keywords: Aging; dual-tasking; uneven terrains; walking.

Publication types

Preprint

Grants and funding

P30 AG028740/AG/NIA NIH HHS/United States