Abstract
Background and purposeDeficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability.MethodsWe performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART) and seated Pursuit Rotor Test (PRT). Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI).ResultsParticipants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group.Discussion and conclusionsOlder adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately.
Highlights
Dividing attention between simultaneous activities in order to multitask is a highly functional human behavior
Participants with diabetes mellitus (DM) walked slower and took more steps off path when multitasking during the Walking and Remembering Test (WART)
There is no question that diabetes can affect the peripheral nervous system [10], and functional deficits in individuals with diabetes are often attributed to peripheral neuropathy
Summary
Dividing attention between simultaneous activities in order to multitask is a highly functional human behavior This complex balancing of attentional resources is often described as an executive function [1] and can be elicited by dual-task paradigms that examine the changes in performance that occur when multiple tasks are undertaken simultaneously [2]. Such dualtask studies suggest that an impaired ability to multitask may influence gait and function in a number of high risk groups [3,4,5], including the rapidly increasing population of older adults with type 2 diabetes [6, 7]. Older adults with diabetes may suffer from an increased fear of falling and loss of balance confidence [16], which could exacerbate gait disturbances regardless of somatosensory loss [17]
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