Aging-related decrements during specific phases of the dual-task Timed Up-and-Go test

The validity of smartphone-based spatiotemporal gait measurements during walking with and without head turns: Comparison with the GAITRite® system

Smartphone accelerometry has potential to provide clinicians with specialized gait analysis not available in most clinical settings. The Gait&Balance Application (G&B App) uses smartphone accelerometry to assess spatiotemporal gait parameters under two conditions: walking looking straight ahead and walking with horizontal head turns. This study investigated the validity of G&B App gait parameters compared with the GAITRite® pressure-sensitive walkway. Healthy young and older adults (age range 21-85 years) attended a single session where a smartphone was secured over the lumbosacral junction. Data were collected concurrently with the app and GAITRite® systems as participants completed the two walking conditions. Spatiotemporal gait parameters for 54 participants were determined from both systems and agreement evaluated with partial Pearson's correlation coefficients and limits of agreement. The results demonstrated moderate to excellent validity for G&B App measures of step time (rp 0.97, 95 % CI [0.96, 0.98]), walking speed (rp 0.83 [0.78, 0.87]), and step length (rp 0.74, [0.66, 0.80]) when walking looking straight ahead, and results were comparable with head turns. The validity of walking speed and step length measures was influenced by sex and height. G&B App measures of step length variability, step time variability, step length asymmetry, and step time asymmetry had poor validity. The G&B App has potential to provide valid measures of unilateral and bilateral step time, unilateral and bilateral step length, and walking speed, under two walking conditions in healthy young and older adults. Further research should validate this tool in clinical conditions and optimise the algorithm for demographic characteristics.

Dual-tasking interference is exacerbated outdoors: A pilot study

Introduction

Walking while texting can create gait disturbances that may increase fall risk, especially in outdoors environment. To date, no study has quantified the effect of texting on motor behavior using different dynamic tasks in outdoor environments. We aimed to explore the impact of texting on dynamic tasks in indoor and outdoor environments.

Methods

Twenty participants (age 38.3 ± 12.5 years, 12 F) had a Delsys inertial sensor fixed on their back and completed walk, turn, sit-to-stand, and stand-to-sit subtasks with and without texting in both indoor and outdoor environments.

Results

While there was no difference in texting accuracy (p = 0.3), there was a higher dual-tasking cost in walking time with texting outdoors than indoors (p = 0.008).

Discussion

Dual tasking has a greater impact on walking time outdoors compared to an indoor environment. Our findings highlight the importance of patient education concerning dual-tasking and pedestrian safety in clinical settings.

Response-code conflict in dual-task interference and its modulation by age

Difficulties in performing two tasks at once can arise from several sources and usually increase in advanced age. Tasks with concurrent bimodal (e.g., manual and oculomotor) responding to single stimuli consistently revealed crosstalk between conflicting response codes as a relevant source. However, how this finding translates to unimodal (i.e., manual only) response settings and how it is affected by age remains open. To address this issue, we had young and older adults respond to high- or low-pitched tones with one (single task) or both hands concurrently (dual task). Responses were either compatible or incompatible with the pitch. When responses with the same level of compatibility were combined in dual-task conditions, their response codes were congruent to each other, whereas combining a compatible and an incompatible response created mutually incongruent (i.e., conflicting) response codes, potentially inducing detrimental crosstalk. Across age groups, dual-task costs indeed were overall highest with response-code incongruency. In these trials, compatible responses exhibited higher costs than incompatible ones, even after removing trials with strongly synchronized responses. This underadditive cost asymmetry argues against mutual crosstalk as the sole source of interference and corroborates notions of strategic prioritization of limited processing capacity based on mapping-selection difficulty. As expected, the effects of incongruent response codes were found to be especially deleterious in older adults, supporting assumptions of age-related deficits in multiple-action control at the level of task-shielding. Overall, our results suggest that aging is linked to higher response confusability and less efficient flexibility for capacity sharing in dual-task settings.

Gait monitoring for older adults during guided walking: An integrated assistive robot and wearable sensor approach

An active lifestyle can mitigate physical decline and cognitive impairment in older adults. Regular walking exercises for older individuals result in enhanced balance and reduced risk of falling. In this article, we present a study on gait monitoring for older adults during walking using an integrated system encompassing an assistive robot and wearable sensors. The system fuses data from the robot onboard Red Green Blue plus Depth (RGB-D) sensor with inertial and pressure sensors embedded in shoe insoles, and estimates spatiotemporal gait parameters and dynamic margin of stability in real-time. Data collected with 24 participants at a community center reveal associations between gait parameters, physical performance (evaluated with the Short Physical Performance Battery), and cognitive ability (measured with the Montreal Cognitive Assessment). The results validate the feasibility of using such a portable system in out-of-the-lab conditions and will be helpful for designing future technology-enhanced exercise interventions to improve balance, mobility, and strength and potentially reduce falls in older adults.

Do the dual-task "8-foot up and go" tests provide additional predictive value for early detection of cognitive decline in community-dwelling older women?

BACKGROUND

The 8-Foot Up and Go (8UG) test is a widely used mobility assessment. Some dual-task mobility assessments have been developed to help detect cognitive decline.

AIMS

This study developed a dual-task version of 8UG test to investigate the dual-task 8UG performance and to evaluate the ability of dual-task 8UG test in detecting cognitive decline.

METHODS

A total of 101 eligible community-dwelling women aged 60-74 years were grouped into the mild cognitive impairment group (MCI, n = 49) and the non-cognitive impairment group (NCI, n = 52). The 8UG tests under single-task (ST), manual dual-task (MT), and cognitive dual-task (CT) conditions were performed respectively. The dual-task cost (DTC) and the correct response rate (CRR) were calculated to quantify the dual-task interference.

RESULTS

Participants spent more time in performing the 8UG test under dual-task conditions. No differences were observed between NCI and MCI groups for 8UG parameters under ST and MT conditions (p > 0.05). When executing CT, significant differences were found in the number of correct answers and CRR (p < 0.05). CRR showed the strongest ability to predict MCI with a cut-off point of 0.50 (71.2% sensitivity and 61.2% specificity).

DISCUSSION

Both manual and cognitive dual-task were found to interfere with the 8UG performance. CRR with cutoff point of 0.50 could be a potential predictor of MCI in community-dwelling older women.

CONCLUSIONS

The CRR of the cognitive dual-task 8UG test could be recommended as a potential predictor for the early detection of MCI in community-dwelling older women.

Turning when using a smartphone in persons with and without neurologic conditions: an observational study (Preprint)

BACKGROUND

Turning during walking is a relevant and common everyday movement and it depends on a correct top-down intersegmental coordination. This could be reduced in several conditions (en bloc turning), and an altered turning kinematics has been linked to increased risk of falls. Smartphone use has been associated with poorer balance and gait; however, its effect on turning-while-walking has not been investigated yet. This study explores turning intersegmental coordination during smartphone use in different age groups and neurologic conditions.

OBJECTIVE

This study aims to evaluate the effect of smartphone use on turning behavior in healthy individuals of different ages and those with various neurological diseases.

METHODS

Younger (aged 18-60 years) and older (aged >60 years) healthy individuals and those with Parkinson disease, multiple sclerosis, subacute stroke (<4 weeks), or lower-back pain performed turning-while-walking alone (single task [ST]) and while performing 2 different cognitive tasks of increasing complexity (dual task [DT]). The mobility task consisted of walking up and down a 5-m walkway at self-selected speed, thus including 180° turns. Cognitive tasks consisted of a simple reaction time test (simple DT [SDT]) and a numerical Stroop test (complex DT [CDT]). General (turn duration and the number of steps while turning), segmental (peak angular velocity), and intersegmental turning parameters (intersegmental turning onset latency and maximum intersegmental angle) were extracted for head, sternum, and pelvis using a motion capture system and a turning detection algorithm.

RESULTS

In total, 121 participants were enrolled. All participants, irrespective of age and neurologic disease, showed a reduced intersegmental turning onset latency and a reduced maximum intersegmental angle of both pelvis and sternum relative to head, thus indicating an en bloc turning behavior when using a smartphone. With regard to change from the ST to turning when using a smartphone, participants with Parkinson disease reduced their peak angular velocity the most, which was significantly different from lower-back pain relative to the head (P<.01). Participants with stroke showed en bloc turning already without smartphone use.

CONCLUSIONS

Smartphone use during turning-while-walking may lead to en bloc turning and thus increase fall risk across age and neurologic disease groups. This behavior is probably particularly dangerous for those groups with the most pronounced changes in turning parameters during smartphone use and the highest fall risk, such as individuals with Parkinson disease. Moreover, the experimental paradigm presented here might be useful in differentiating individuals with lower-back pain without and those with early or prodromal Parkinson disease. In individuals with subacute stroke, en bloc turning could represent a compensative strategy to overcome the newly occurring mobility deficit. Considering the ubiquitous smartphone use in daily life, this study should stimulate future studies in the area of fall risk and neurological and orthopedic diseases.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00022998; https://drks.de/search/en/trial/DRKS00022998.

Association between handgrip strength and body composition, physical fitness, and biomarkers in postmenopausal women with metabolic syndrome

OBJECTIVES

This study examined the association between handgrip strength and body composition, physical fitness, and biomarkers in postmenopausal women with metabolic syndrome.

METHODS

A total of 75 postmenopausal women were diagnosed with metabolic syndrome participated in this study. Muscle strength was assessed via a hydraulic grip strength dynamometer; physical fitness tests included a timed-up-and-go, arm curl test, and 30-s chair stand. Body composition was assessed via bioelectrical impedance, from which estimates of fat mass, body fat percentage, fat-free mass, and visceral fat area were determined. Fasting plasma glucose and glycated hemoglobin were measured via blood sample analyses. Multiple linear regression analyses were conducted using handgrip strength as the dependent variable and using body composition, physical fitness, and biomarkers as independent variables.

RESULTS

The results revealed that 52% of the total sample were classified as obese, 37.3% as overweight, and only 10.7% as normal weight. Significant correlations were present between handgrip strength and fat-free mass (p=0.002; R=0.590), mean blood pressure (p=0.002; R=0.450), and arm curl (p=0.001; R=0.795).

CONCLUSION

This study showed that handgrip strength was predictive of fat-free mass, blood pressure, and upper limb strength performance.

Assessment of dual-tasking during a dynamic balance task using a smartphone app: a pilot study

[Purpose] To assess if the instrumented Timed Up and Go (iTUG) task score calculated with an iPhone application can detect gait changes under dual-tasking conditions. [Participants and Methods] Twenty participants (age 38.30 ± 12.54, 12 females) were asked to complete the TUG as a single task and under two dual-tasking conditions: 1) verbal fluency and 2) mental calculation. We used a smartphone, stopwatch, digital camera, and wearable sensor to calculate the dependent variables which included time, step count, gait speed, and iTUG score and, the dual-tasking cost (DTC) of those variables. We used Friedman analyses of variance and Wilcoxon tests for statistical analyses. [Results] the iTUG score, step count, gait speed, and the time measured by the stopwatch and wearable sensor differed significantly for all tasks, but the smartphone time did not. [Conclusion] We conclude that the iTUG score could be used as a sensitive measure for identifying gait changes under dual-tasking conditions. With the growing demands of telehealth, using technology as an objective tool for movement analysis is needed for clinicians and payers. Our findings demonstrate the potential value of the iTUG score to assess and track patient’s progress.

The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old

Introduction: Dual tasking is common in activities of daily living (ADLs) and the ability to perform them usually declines with age. While cognitive aspects influence dual task (DT) performance, most DT-cost (DT-C) related metrics include only time- or speed- delta without weighting the accuracy of cognitive replies involved in the task.

Objectives: The primary study goal was to weight the accuracy of cognitive replies as a contributing factor when estimating DT-C using a new index of DT-C that considers the accuracy of cognitive replies (P-index) in the instrumented timed up and go test (iTUG). Secondarily, to correlate the novel P-index with domains of the Mini-Mental State Examination (MMSE).

Methods: Sixty-three participants (≥85 years old) took part in this study. The single task (ST) and DT iTUG tests were performed in a semi-random order. Both the time taken to complete the task measured utilizing an inertial measurement unit (IMU), and the accuracy of the cognitive replies were used to create the novel P-index. Clinical and sociodemographic data were collected.

Results: The accuracy of the cognitive replies changed across the iTUG phases, particularly between the walk 1 and walk 2 phases. Moreover, weighting 0.6 for delta-time (W₁) and 0.4 for cognitive replies (W₂) into the P-index enhanced the prediction of the MMSE score. The novel P-index was able to explain 37% of the scores obtained by the fallers in the “spatial orientation” and “attention” domains of the MMSE. The ability of the P-index to predict MMSE scores was not significantly influenced by age, schooling, and number of medicines in use. The Bland-Altman analysis indicated a substantial difference between the time-delta-based DT-C and P-index methods, which was within the limits of agreement.

Conclusions: The P-index incorporates the accuracy of cognitive replies when calculating the DT-C and better reflects the variance of the MMSE in comparison with the traditional time- or speed-delta approaches, thus providing an improved method to estimate the DT-C.

Can dual-task paradigms predict Falls better than single task? - A systematic literature review

With about one third of adults aged 65 years and older being reported worldwide to fall each year, and an even higher prevalence with advancing age, aged-related falls and the associated disabilities and mortality are a major public health concern. In this context, identification of fall risk in healthy older adults is a key component of fall prevention. Since dual-task outcomes rely on the interaction between cognition and motor control, some studies have demonstrated the role of dual-task walking performance or costs in predicting future fallers. However, based on previous reviews on the topic, (1) discriminative and (2) predictive powers of dual tasks involving gait and a concurrent task are still a matter of debate, as is (3) their superiority over single tasks in terms of fall-risk prediction. Moreover, less attention has been paid to dual tasks involving postural control and transfers (such as gait initiation and turns) as motor tasks. In the present paper, we therefore systematically reviewed recent literature over the last 7 years in order to answer the three above mentioned questions regarding the future of lab-based dual tasks (involving posture, gait initiation, gait and turning) as easily applicable tests for identifying healthy older adult fallers. Despite great heterogeneity among included studies, we emphasized, among other things, the promising added value of dual tasks including turns and other transfers, such as in the Timed Up and Go test, for prediction of falls. Further investigation of these is thus warranted.

The impact of distinct cognitive dual-tasks on gait in Parkinson's disease and the associations with the clinical features of Parkinson's disease

AIMS

To investigate the impact of distinct cognitive dual-task abilities in patients with Parkinson's disease (PD) and compare the impact of these dual-tasks in association with the severity of PD and its clinical features.

MATERIALS AND METHODS

Modified Hoehn and Yahr Scale, UPDRS, and Standardized Mini-Mental State Examination (SMMSE) were evaluated in all PD patients. The subtype of PD and the presence of freezing of gait (FOG) were also evaluated. The Timed Up and Go (TUG) test was applied under single- and dual-task conditions including the digit span-forwards, digit span-backwards, delayed recall memory, counting down the days, counting backwards from 20, and animal fluency tests.

RESULTS

Most of the cognitive dual-tasks resulted in deterioration in gait performance in our PD subjects. Remarkably, the completion time of TUG duration under single- and dual-task of counting down days was higher in the FOG (+) PD subjects (p = 0.008, p = 0.050, respectively). Besides, the TUG duration under the dual-task of counting down days was found to be positively correlated with the UPDRS-motor scores and FOG scores.

CONCLUSION

We think that the concurrent execution of the dual-task of counting down days, which requires complex attentional skills, may disturb gait via a mechanism of overloading of the attentional reserves proceeding gait which is already defective in PD subjects. The neural correlate of this domain and its significance in performing dual-tasks in PD should be investigated in future large-scale studies. The results of these studies may provide substantial perspectives regarding the pathophysiology of gait disturbance in PD.

Differences between two types of dual tasks according to the educational level in older adults

INTRODUCTION

For dual-task paradigms, the timed up and go (TUG) test along with other cognitive or motor tasks has been used to evaluate and predict the risk of falling in older adults. However, the interference between motor-cognitive tasks can differ by the cognitive task.

OBJECTIVE

To evaluate the performance of the TUG test under a single task condition and two dual-task conditions in older adults and to explore the effect of educational level on task performance.

METHODS

A total of 418 older adults (328 females) voluntarily participated in this study. The TUG test was administered as a single task and a dual task with one secondary simultaneous task: counting aloud backward from 100 or naming animals. Comparisons were performed to determine the interference caused by each cognitive task on the motor task, and correlation analysis was performed to explore the role of educational level.

RESULTS

The animal task led to a poorer TUG performance and a higher dual-task cost than did the counting task. Furthermore, the motor task led to a higher percentage of errors and cognitive stops in the animal task. Educational level plays a significant role in the interaction between tasks.

CONCLUSIONS

Between-task interference differs by the type of cognitive task performed and the educational level of the participants. The results of the present study should be considered when dual-task assessments are planned for older adults.

The Effects of 12-Week Physical Exercise Tapping High-level Cognitive Functions

The purpose of this study was to investigate the effects of physical exercise tapping high-level cognitive functions on both cognitive function and fitness in older adults. In total, 96 healthy older adults took part in the study. Participants were randomly assigned to four groups: a cognitive training group (CG), physical exercise group (PG), simultaneous cognitive training and physical exercise group (C+PG), and the healthy control group (HG; received physical exercise materials but did not participate in a cognitive or exercise programme). The outcomes were the changes in the 6-minute walk test (6MWT), timed up-and-go (TUG) test, and the computerized modified Stroop task, which included two conditions, a naming condition (nonexecutive) and an executive condition. The results showed that the dynamic balance, cardiorespiratory endurance, and physical activity levels of the PG and C+PG were significantly better than those of the HG after the 12-week intervention. The times of the TUG test in these two groups were also significantly faster than those in the HG. Additionally, the C+PG exhibited better dual-task function than the PG. Over 12 weeks, the CG, PG, and C+PG demonstrated improved performance of executive function, but only the C+PG showed a general facilitative effect on nonexecutive control. Physical exercise tapping high-level cognitive functions and cognitive training can thus improve executive function more quickly than physical exercise alone. Moreover, physical exercise tapping high-level cognitive functions showed better fitness improvement than cognitive training alone, especially in dynamic balance.

Visual dependence affects the motor behavior of older adults during the Timed Up and Go (TUG) test

BACKGROUND

Older adults show greater postural instabilities under misleading visual cues relative to younger adults. We investigated the effects of age-related visual dependence on motor performance under increased attention demands by adding a motor task and visual stimulus to the Timed Up and Go (TUG) test sub-components.

METHOD

We designed a cross-sectional quantitative study. Twenty-eight younger (n = 12) and older (n = 16) adults completed the TUG test while wearing a head-mounted display (HMD) that presented a visual stimulus and/or carrying a cup of water. Outcome measures were turning cadence; gait speed; pitch, yaw, and roll peak trunk velocities (PTVs); and acceleration ranges of sit-to-stand and stand-to-sit.

RESULTS

Wearing the HMD caused significant performance differences in the TUG test tasks due to age and visual dependence, although performance was lower across all groups with the HMD (p < 0.01). Older adults showed lower roll PTV in turning compared to younger adults (p = 0.03). Visually dependent older adults showed smaller mediolateral and vertical acceleration ranges (p < 0.04) in sit-to-stand compared to visually independent older adults.

CONCLUSION

The demand for orienting posture to a vertical position during sit-to-stand may differentiate older adults who are more visually dependent-and thus at greater fall risk- from those who are more visually independent. Age-related differences in turning behavior suggest a relationship with fall risk that warrants further investigation.

The Role of Time Constraints in Athletes' Egocentric Mental Rotation Performance

A selective effect of motor expertise on mental rotation is revealed by a high correlation between the performance of sports experts and ability on a mental rotation task. Evidence is shown by studies involving a spatial factor, such as image interference or a movement constraint. Alternatively, the time constraint, as another performance factor, is considered critical in the effect of sport expertise on mental rotation. Three experiments were conducted to examine the role of time constraints in egocentric mental rotation and the stage performance of athletes (divers) and nonathletes. In Experiment 1, an egocentric mental rotation task in an untimed condition was conducted, and reaction times (RTs), error rates (ERs), RTs at 0 °, and mental rotation speed were assessed. The results indicated that divers outperformed nonathletes in terms of RT, as well as perceptual and decision stages and rotation stages. Experiments 2 and 3 added a relative time constraint (subtracting 1/2 SD of all the subjects' RT from the M of each group's RT) and an absolute time constraint (subtracting 1/2 SD of all the subjects' RT from the M of all the subjects' RT) to the task, respectively. Superior RT and lower ER were observed for the divers in the time constraint condition. Moreover, the results illustrated that divers were faster than nonathletes in both stages when facing time pressure. In general, the present study has, for the first time, confirmed the role of time in the relationship between sports expertise and mental rotation.

Dual task performance and history of falls in community-dwelling older adults

INTRODUCTION

Falls are a common problem for older adults, and the identification of people at high risk of falling is a major challenge to health systems.

OBJECTIVE

To evaluate the association between the history of falls and single-task Timed Up and Go Test (single TUG) or dual-task TUG variables.

METHODS

Three hundred seventy seven community-dwelling older persons, with ages ranging from 65 and 92 years, participated in this cross-sectional study. Each participant performed two tests: single TUG and dual TUG. The cognitive task for dual TUG consisted of counting backward by one from 100 while performing the test. The number of cognitive errors, cognitive stops and motor stops were recorded. A new variable comprising time, errors and stops in the dual TUG was computed.

RESULTS

The number of falls was significantly associated with mean single and dual TUG performance, mean cognitive errors, mean cognitive stops and mean motor stops. The score in the single TUG time was not able to significantly classify participants as fallers or non-fallers in any of the sexes. On the other hand, the variable "dual TUG time spent adding cognitive stops and cognitive errors" achieved the best ability to classify women as fallers or non-fallers, while "dual task cost" and "dual TUG time spent adding cognitive stops" were the best variables to classify men.

CONCLUSIONS

Dual TUG including cognitive stops and cognitive errors may be more capable than the single TUG to detect differences and accurately classify fallers and non-fallers in the elderly.

Role of Gender in Dual-Tasking Timed Up and Go Tests: A Cross-Sectional Study

Gender plays a role in cognitive performance. Yet the selection of a secondary task, an important paradigm in studies of posture control, has not considered gender as a variable. We explored whether different cognitive tasks differentially influence performance during the Timed Up and Go (TUG) test in men and women. Twenty young adults performed five cognitive tasks while seated and during the TUG test. Men exhibited a slower normalized cadence than women. When seated, women recalled more items than men and men were more accurate in mental calculation task. There were no changes in spatiotemporal measures. We conclude that gender did not play a major role in motor-cognitive interference during dual task TUG test.

Thinking on your feet: An analysis of movement and cognition in a sit to stand task

The maintenance of upright posture involves constant adjustment to external and internal perturbations. This balancing act is often assumed to be an automatic process, but studies suggest that cognitive processes, particularly attention, are necessary for the control of posture. The current study examines the role of attention in balance using a dual-task paradigm. Twenty-four healthy young adults performed a sit-to-stand (STS) task on either a stable or unstable platform while performing a secondary cognitive task of counting backwards aloud. Movement of the upper and lower body was analyzed using the largest Lyapunov exponent (λ₁) and standard deviation (SD). Results replicated earlier findings (Gibbons, Amazeen, & Likens, 2018) that the transition from sit to stand was marked by increased variability and a temporary destabilization of postural control. Participants exhibited greater movement variability overall on the unstable platform (large SD), but small λ₁ indicated that movement was controlled. During second task performance, SD increased for the upper body only. Further research is necessary to understand the interaction between attention and balance in young adults.

Association between muscle function and body composition, vitamin D status, and blood glucose in postmenopausal women with type 2 diabetes

AIMS

The aim of this study was to examine the association between muscle function, and body composition, vitamin D status, and blood glucose in post-menopausal women with type 2 diabetes (T2D).

METHODS

Forty post-menopausal women (62.48±7.67years; 154.6±5.11cm; 73.93±15.43kg; 31.13±5.82 BMI kg/m²) with a diagnosis of T2D participated in this cross-sectional study. The patients performed fasting blood sample exams, anthropometrics assessments, body composition, and clinical exams. Subjects performed physical tests including handgrip, timed up and go, 30-s chair stand, arm curl, and sit-to-stand. The correlation between the parameters of physical tests, age, body composition, vitamin D, and blood glucose was assessed by Pearson correlation.

RESULTS

The results showed there were significant correlations between blood glucose and relative strength (R=-0.398, p=0.011), arm curl test (R=-0.367 and p=0.020), and hip flexion (R=0.427, p=0.006).

CONCLUSIONS

These findings are important because they highlight the importance of resistance training in individuals with T2D and the relationship with a fat increase during a dicrease process. Furthermore, the concentration of serum glucose might be associated with decreases in muscle strength and muscle function in older adults. Thus, T2D patients should be involved with strength training to improve the strength and the muscle hypertrophy.

The benefits of Tai Chi and brisk walking for cognitive function and fitness in older adults

The purpose of this study was to investigate the benefits of exercises with different cognitive demands for cognitive functions (Executive and non-Executive) in healthy older adults. A cross-sectional design was adopted. In total, 84 healthy older adults were enrolled in the study. They were categorized into the Tai Chi group (TG), the brisk walking group (BG) or the control group (CG). Each participant performed the Stroop task and a digit comparison task. The Stroop task included the following three conditions: a naming condition, an inhibition condition and an executive condition. There were two experimental conditions in the digit comparison task: the non-delay condition and the delay condition. The results indicated that participants of the TG and BG revealed significant better performance than the CG in the executive condition of cognitive tasks and fitness. There was no significant difference of reaction time (RT) and accuracy rate in the inhibition and delay conditions of cognitive tasks and fitness between the TG and BG. The TG showed shorter reaction time in the naming and the executive conditions, and more accurate in the inhibition conditions than the BG. These findings demonstrated that regular participation in brisk walking and Tai Chi have significant beneficial effects on executive function and fitness. However, due to the high cognitive demands of the exercise, Tai Chi benefit cognitive functions (Executive and non-Executive) in older adults more than brisk walking does. Further studies should research the underlying mechanisms at the behavioural and neuroelectric levels, providing more evidence to explain the effect of high-cognitive demands exercise on different processing levels of cognition.