Summary: The ability to walk and talk at two tasks begins to decline around age 55. This decline is the result of changes in cognition and underlying brain function rather than physical changes associated with aging.
Source: Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research
Walking is a complex task that is most often done while performing other tasks like talking, reading signs, or making decisions.
For most, after the age of 65, such “dual tasking” deteriorates gait performance and can even cause unsteadiness. Curiously, older people who are more affected by dual-tasking are at a higher risk of suffering from health problems, including falls and dementia.
A new study published in The Lancet Healthy longevity reported that the ability to perform dual tasks when walking begins to decline at age 55, up to a decade before “old age” as traditionally defined by the 65-year threshold.
Moreover, this decreased ability to walk and talk at the same time is not caused by changes in physical function, but rather by changes in cognition and underlying brain function.
“Our results suggest that in middle age, poor dual-task walking performance could be an indicator of accelerated brain aging or another pre-symptomatic neurodegenerative condition,” said co-lead author Junhong. Zhou, Ph.D., Assistant Scientist I, Hinda and Arthur Marcus Institute for Research in Aging.
“We evaluated a large number of people between the ages of 40 and 64 who are part of a study called the Barcelona Brain Health Initiative (BBHI). We observed that the ability to walk in normal, calm conditions remained relatively stable in this age group.
“However, even in this relatively healthy cohort, when we asked participants to walk and at the same time perform a mental arithmetic task, we were able to observe subtle but significant changes in gait from the middle of sixth grade onwards. decade of life.”
“This means that a simple dual-task walking test, which probes the brain’s ability to perform two tasks at the same time, can uncover early age-related changes in brain function that may signify an increased risk of developing dementia later in life,” Zhou said.
The article is the result of a unique collaboration between researchers at the Hinda and Arthur Marcus Institute of Hebrew SeniorLife in Boston and the Guttmann Institute in Barcelona, Spain, where the Barcelona Brain Health Initiative (BBHI) is conducted. ) population-based.
The Principal Investigator of BBHI is Professor David Batres-Faz of the University of Barcelona and Dr Alvaro Pascual-Leone, Medical Director of the Deanna and Sidney Wolk Center for Memory Health, and Principal Investigator at Hinda and Arthur Marcus. Institute for Aging Research at Hebrew SeniorLife, and who is Scientific Director of BBHI.
“Compared to silent walking, walking under dual-task conditions adds stress to the motor control system because the two tasks (walking and mental arithmetic, for example) have to compete for shared resources in the brain. This what we believe is that the ability to manage this stress and adequately maintain performance in both tasks is an essential brain function that tends to decline with age.
“Our study is significant because it found that changes in this type of brain resilience occur much earlier than previously thought,” Zhou said.
“Now we have a clearer picture of age-related changes in gait control and how this relates to cognitive and brain health,” Zhou said.
“It is important to note that although we observed that dual task walking tended to decrease with age across the cohort, not all study participants fit this description.”
“For example, we observed that a portion of participants over the age of 60 who completed the dual-task test as well as participants aged 50 or younger. This means that dual-task walking performance does not necessarily decline with age, and some people appear to be more resilient to the effects of aging.
“We hope our study will stimulate future research attempts to uncover lifestyle and other modifiable factors that support maintenance of dual-task performance into old age, as well as interventions that target these factors. “
Results
996 people were recruited for the BBHI study between May 5, 2018 and July 7, 2020, of which 640 participants completed gait and cognitive assessments during this period (average of 24 days [SD 34] between the first and second visit) and were included in the analysis (342 men and 298 women). Nonlinear associations were observed between age and dual task performance.
From the age of 54, the DTC at stride time (β=0 27 [95% CI 0·11 to 0·36]; p<0 0001) and stride time variability (0 24 [0·08 to 0·32]; p=0 0006) increased with age. In people aged 54 years or older, the decrease in global cognitive function was correlated with the increase in DTC in stride time (β=–0 27 [–0·38 to –0·11]; p=0 0006) and increased DTC for stride time variability (β=–0 19 [–0·28 to –0·08]; p=0 0002).
About this brain aging research news
Author: Press office
Source: Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research
Contact: Press Office – Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research
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Original research: Free access.
“Age-related contribution of cognitive function to dual-task gait in middle-aged adults in Spain: observations from a population-based study” by Junhong Zhou et al. Lancet Healthy Longevity
Abstract
The age-related contribution of cognitive function to dual-task gait in middle-aged adults in Spain: findings from a population-based study
Background
Poor dual-task walking performance is associated with risk of falls and cognitive decline in adults aged 65 or older. When and why performance of the dual-task gait begins to deteriorate is unknown. This study aimed to characterize the relationships between age, dual-task gait and cognitive function in middle age (i.e. between 40 and 64 years of age).
Methods
We performed a secondary analysis of data from community-dwelling adults aged 40 to 64 who participated in the Barcelona Brain Health Initiative (BBHI) study, an ongoing longitudinal cohort study in Barcelona, Spain. Participants were eligible for inclusion if they were able to walk independently without assistance and had completed gait and cognition assessments at the time of analysis and ineligible if they could not understand the walking protocol. study, had clinically diagnosed neurological or psychiatric conditions, were cognitively impaired, or had lower extremity pain, osteoarthritis, or rheumatoid arthritis that may cause abnormal gait. Stride time and stride time variability were measured under single-task (i.e., walking only) and dual-task (i.e., walking while performing subtractions in series). Dual-task cost (DTC; the percentage increase in single-task gait outcomes at dual-task conditions) for each gait outcome was calculated and used as the primary measure in the analyses. Global cognitive function and composite scores of five cognitive domains were derived from neuropsychological testing. We used locally estimated scatterplot smoothing to characterize the relationship between age and dual-task gait, and structural equation modeling to determine whether cognitive function mediated the association between observed biological age and the dual task.
Results
996 people were recruited for the BBHI study between May 5, 2018 and July 7, 2020, of which 640 participants completed gait and cognitive assessments during this period (average of 24 days [SD 34] between the first and second visit) and were included in our analysis (342 men and 298 women). Nonlinear associations were observed between age and dual task performance. From the age of 54, the DTC at stride time (β=0 27 [95% CI 0·11 to 0·36]; p<0 0001) and stride time variability (0 24 [0·08 to 0·32]; p=0 0006) increased with age. In people aged 54 years or older, the decrease in global cognitive function was correlated with the increase in DTC in stride time (β=–0 27 [–0·38 to –0·11]; p=0 0006) and increased DTC for stride time variability (β=–0 19 [–0·28 to –0·08]; p=0 0002).
Interpretation
Dual-task walking performance begins to deteriorate during the sixth decade of life, and after this point inter-individual variance in cognition explains a substantial portion of dual-task performance.
Funding
La Caixa Foundation, Guttmann Institute and Fundació Abertis.