Wollesen B, Wanstrath M, van Schooten KS, Delbaere K. A taxonomy of cognitive tasks to evaluate cognitive-motor interference on spatiotemoporal gait parameters in older people: a systematic review and meta-analysis.
Eur Rev Aging Phys Act 2019;
16:12. [PMID:
31372186 PMCID:
PMC6661106 DOI:
10.1186/s11556-019-0218-1]
[Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/02/2019] [Indexed: 02/07/2023] Open
Abstract
Background
Walking in natural environments can be considered a dual-task (DT) scenario that requires increasing cognitive resources with advancing age. Previous reviews concluded that gait speed under DT conditions is equivalent to gait speed as a single task (ST) in the prediction of future falls in older people. However, without a clear taxonomy, these conclusions might be premature. The aim of this review is to use a taxonomy for classifying cognitive tasks of cognitive-motor interference (CMI) paradigms while walking to identify which task domains lead to more pronounced cognitive-motor decrements due to fall risk and concern about falling (CoF) in older people.
Methods
A systematic literature research following PRISMA guidelines was conducted using MEDLINE, Psych-Info and EMBASE. Inclusion criteria were: older people ≥60 years with a previous fall or CoF, use of a DT paradigm to discriminate fallers and non-fallers, straight overground walking, reported gait measurements during ST and DT conditions. A meta-analysis estimated the effect of DT costs for the cognitive task domain and spatiotemporal gait parameters.
Results
N = 3737 studies were found within the databases. Nineteen studies were included (n = 14 for meta-analysis). Fallers and people with CoF showed reduced walking speed for ST and DT conditions. Effects of DT were examined for mental tracking tasks. The combined odds ratio (OR [95% confidence interval]) for fallers vs. non-fallers for ST was 3.13 [0.47, 5.80] with moderate heterogeneity (I2 = 48%). For DT, the OR was 5.17 [2.42, 7.93] with low heterogeneity (I2 = 37%). Comparing participants with and without CoF, the OR for ST was 12.41 [9.97, 14.84] with high heterogeneity (I2 = 85%) and OR for mental tracking DT was 10.49 [7.58, 13.40] with moderate heterogeneity (I2 = 51%).
Conclusion
CMI was not significantly different between fallers and non-fallers or people with and without CoF; however, our taxonomy revealed a large variety of cognitive conditions and a higher number of studies using mental tracking tasks, which make it impossible to draw firm conclusions. Future studies should use a more standardised and ecologically valid approach when evaluating the validity of DT gait performance in the prediction of falls, CoF or other age-related conditions.
Trial registration
This review was registered at Prospero with the ID: CRD42017068912.
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