Risk Factors for Decline in Gait Speed During Walking While Talking in Older Adults

Overview

Journal Gait Posture

Specialty Orthopedics

Date 2022 May 20

PMID 35594829

Authors

Oshadi Jayakody

Helena M Blumen

Emmeline Ayers

Joe Verghese

Affiliations

Soon will be listed here.

Abstract

Background & Aims: Slow gait speed during Walking While Talking (walking while reciting alternate letters of the alphabet; WWT) is associated with an increased risk of developing dementia and falls. The aim of this study was to examine longitudinal changes in WWT-speed and to identify risk factors that may modify the rate of change in WWT-speed.

Methods: A total of 431 older participants (55.7% female; M Age=76.8 ± 6.4 years; mean follow up 2.1 ± 1.8 years) enrolled in the Central Control of Mobility in Aging study were examined. WWT-speed (cm/s) was measured with a computerized walkway. The following baseline measures were examined as risk factors: demographics [age, sex, education], medical illnesses [hypertension, diabetes, cardiac arrhythmias, history of stroke, Parkinson's disease, kidney disease, arthritis], cognitive functions [global cognition, executive function, processing speed], physical and sensory functions [unipedal stance time, gait speed during single task walking, visual acuity], psychological variables [depression, anxiety] and falls. Linear mixed effect models were used to examine 1) change in WWT-speed over time, and 2) risk factors associated with change in WWT-speed over time.

Results: WWT-speed declined in an accelerating non-linear fashion over time after adjusting for baseline age, sex and education. The rate of decline in WWT-speed was modified by older age (b -0.16 95%CI -0.22, -0.09), poorer balance (b -1.73 95%CI -2.57, -0.90), and faster gait speed during single task walking (b -0.06 95%CI -0.08, -0.04).

Significance: This study identified fixed and modifiable risk factors of faster decline in WWT-speed over time in community-residing older adults.

Citing Articles

White Matter Hyperintensities Are Associated with Slower Gait Speed in Older Adults without Dementia.

Vazquez J, Verghese J, Barzilai N, Milman S, Blumen H Neurodegener Dis. 2024; 1-9.

PMID: 39025052 PMC: 11747921. DOI: 10.1159/000538944.

References

Hausdorff J, Schweiger A, Herman T, Yogev-Seligmann G, Giladi N . Dual-task decrements in gait: contributing factors among healthy older adults. J Gerontol A Biol Sci Med Sci. 2009; 63(12):1335-43. PMC: 3181497. DOI: 10.1093/gerona/63.12.1335. View

Faulkner K, Redfern M, Cauley J, Landsittel D, Studenski S, Rosano C . Multitasking: association between poorer performance and a history of recurrent falls. J Am Geriatr Soc. 2007; 55(4):570-6. DOI: 10.1111/j.1532-5415.2007.01147.x. View

Bogen B, Aaslund M, Ranhoff A, Moe-Nilssen R . Two-year changes in gait variability in community-living older adults. Gait Posture. 2019; 72:142-147. DOI: 10.1016/j.gaitpost.2019.06.005. View

Mahoney J, Cotton K, Verghese J . Multisensory Integration Predicts Balance and Falls in Older Adults. J Gerontol A Biol Sci Med Sci. 2018; 74(9):1429-1435. PMC: 6696711. DOI: 10.1093/gerona/gly245. View

McDonough A, Batavia M, Chen F, Kwon S, Ziai J . The validity and reliability of the GAITRite system's measurements: A preliminary evaluation. Arch Phys Med Rehabil. 2001; 82(3):419-25. DOI: 10.1053/apmr.2001.19778. View

Srygley J, Mirelman A, Herman T, Giladi N, Hausdorff J . When does walking alter thinking? Age and task associated findings. Brain Res. 2008; 1253:92-9. PMC: 2631095. DOI: 10.1016/j.brainres.2008.11.067. View

Holtzer R, Verghese J, Wang C, Hall C, Lipton R . Within-person across-neuropsychological test variability and incident dementia. JAMA. 2008; 300(7):823-30. PMC: 2736784. DOI: 10.1001/jama.300.7.823. View

Verghese J, Holtzer R, Lipton R, Wang C . Mobility stress test approach to predicting frailty, disability, and mortality in high-functioning older adults. J Am Geriatr Soc. 2012; 60(10):1901-5. PMC: 3470773. DOI: 10.1111/j.1532-5415.2012.04145.x. View

Hall C, Echt K, Wolf S, Rogers W . Cognitive and motor mechanisms underlying older adults' ability to divide attention while walking. Phys Ther. 2011; 91(7):1039-50. DOI: 10.2522/ptj.20100114. View

10.

Holtzer R, Wang C, Verghese J . Performance variance on walking while talking tasks: theory, findings, and clinical implications. Age (Dordr). 2013; 36(1):373-81. PMC: 3889876. DOI: 10.1007/s11357-013-9570-7. View

11.

Muir S, Speechley M, Wells J, Borrie M, Gopaul K, Montero-Odasso M . Gait assessment in mild cognitive impairment and Alzheimer's disease: the effect of dual-task challenges across the cognitive spectrum. Gait Posture. 2011; 35(1):96-100. DOI: 10.1016/j.gaitpost.2011.08.014. View

12.

Holtzer R, Verghese J, Xue X, Lipton R . Cognitive processes related to gait velocity: results from the Einstein Aging Study. Neuropsychology. 2006; 20(2):215-23. DOI: 10.1037/0894-4105.20.2.215. View

13.

Duff K, Humphreys Clark J, OBryant S, Mold J, Schiffer R, Sutker P . Utility of the RBANS in detecting cognitive impairment associated with Alzheimer's disease: sensitivity, specificity, and positive and negative predictive powers. Arch Clin Neuropsychol. 2008; 23(5):603-12. PMC: 2570647. DOI: 10.1016/j.acn.2008.06.004. View

14.

Verghese J, Holtzer R, Lipton R, Wang C . Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci. 2009; 64(8):896-901. PMC: 2709543. DOI: 10.1093/gerona/glp033. View

15.

Verghese J, Wang C, Allali G, Holtzer R, Ayers E . Modifiable Risk Factors for New-Onset Slow Gait in Older Adults. J Am Med Dir Assoc. 2016; 17(5):421-5. DOI: 10.1016/j.jamda.2016.01.017. View

16.

Jayakody O, Breslin M, Ayers E, Verghese J, Barzilai N, Milman S . Relative Trajectories of Gait and Cognitive Decline in Aging. J Gerontol A Biol Sci Med Sci. 2021; 77(6):1230-1238. PMC: 9159658. DOI: 10.1093/gerona/glab346. View

17.

Wise T, Radua J, Via E, Cardoner N, Abe O, Adams T . Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis. Mol Psychiatry. 2016; 22(10):1455-1463. PMC: 5622121. DOI: 10.1038/mp.2016.72. View

18.

Ho J, Verghese J, Abramowitz M . Walking while Talking in Older Adults with Chronic Kidney Disease. Clin J Am Soc Nephrol. 2020; 15(5):665-672. PMC: 7269215. DOI: 10.2215/CJN.12401019. View

19.

Verghese J, Kuslansky G, Holtzer R, Katz M, Xue X, Buschke H . Walking while talking: effect of task prioritization in the elderly. Arch Phys Med Rehabil. 2007; 88(1):50-3. PMC: 1894901. DOI: 10.1016/j.apmr.2006.10.007. View

20.

Montero-Odasso M, Sarquis-Adamson Y, Speechley M, Borrie M, Hachinski V, Wells J . Association of Dual-Task Gait With Incident Dementia in Mild Cognitive Impairment: Results From the Gait and Brain Study. JAMA Neurol. 2017; 74(7):857-865. PMC: 5710533. DOI: 10.1001/jamaneurol.2017.0643. View