Abstract
Executive function and motor control deficits adversely affect gait performance with age, but the neural correlates underlying this interaction during stair climbing remains unclear. Twenty older adults (72.7 ± 6.9 years) completed single tasks: standing and responding to a response time task (SC), ascending or descending stairs (SMup, SMdown); and a dual-task: responding while ascending or descending stairs (DTup, DTdown). Prefrontal hemodynamic response changes (∆HbO2, ∆HbR) were examined using functional near-infrared spectroscopy (fNIRS), gait speed was measured using in-shoe smart insoles, and vocal response time and accuracy were recorded. Findings revealed increased ∆HbO2 (p = 0.020) and slower response times (p < 0.001) during dual- versus single tasks. ∆HbR (p = 0.549), accuracy (p = 0.135) and gait speed (p = 0.475) were not significantly different between tasks or stair climbing conditions. ∆HbO2 and response time findings suggest that executive processes are less efficient during dual-tasks. These findings, in addition to gait speed and accuracy maintenance, may provide insights into the neural changes that precede performance declines. To capture the subtle differences between stair ascent and descent and extend our understanding of the neural correlates of stair climbing in older adults, future studies should examine more difficult cognitive tasks.
Highlights
Stairs have been identified as a common source of injurious falls amongst older adults [1]
Studies that have examined the relationship between executive functions and gait in older adults have demonstrated that executive function deficits are associated with declines in gait performance [4,5,6,7]
After controlling for gender, that oxygencerebral racy and gait findingsfindings revealedrevealed that cerebral oxygenation and vocal response time increased between single and dualtasks, but there ation and vocal response time increased between single and dual- tasks, but there were were no significant differences between cerebral deoxygenation, response accuracy and no significant differences between cerebral deoxygenation, response accuracy and gait gait speed across single and dual-tasks or stair ascent and descent
Summary
Stairs have been identified as a common source of injurious falls amongst older adults [1]. Stair ambulation may be highly demanding because it involves elements of dynamic balance, lower body strength and attention [8,9]. For both ascent and descent, motor planning begins prior to reaching the first step and continues thereafter to ensure precise foot placement and the proper integration of sensory and visual information [10,11,12]. Older adults who report a fear of falling may increase their handrail usage to ensure stability on stairs [9,13]
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