The effect of different types of walking on dual-task performance and task prioritization among community-dwelling older adults.

ABSTRACT

BACKGROUND: The ability to safely conduct different types of walking concurrently with a cognitive task (i.e., dual task) is crucial for daily life. The contribution of different walking types to dual-task performance has not yet been determined, nor is there agreement on the strategies that older adults use to divide their attention between two tasks (task prioritization). OBJECTIVES: To compare the effect of walking in three different directions (forward, backward, and sideways) on dual-task performance and to explore the strategies of older adults to allocate their attention in response to different motor task demands. DESIGN: A cross-sectional study. SUBJECTS: Thirty-two (22 female) community-dwelling older adults (aged 72.7±5.7 years). METHODS: Subjects randomly conducted single and dual task walking to three directions separately, cognitive tasks separately, and combination of the two. RESULTS: Walking forward was the least demanding task, during single (FW < BW, SW) (P < .001) and dual tasks (FW < BW < SW) (P < .001). The calculation of DTC revealed the same pattern (P < .001). DTC of the cognitive tasks was not significantly different among the three walking types. CONCLUSIONS: The decline mainly in the motor performance during dual task indicates that participants prioritized the cognitive task. These findings challenge the "posture first" paradigm for task prioritization.