Abstract
Abstract This systematic review investigated whether healthy older adults benefit from training interventions in motor–cognitive dual-task (DT) situations and which specific aspects of the intervention and/or task selection contribute to training benefits. Training effects were analysed with regard to the training programme (e.g., general ST or DT training) and task conditions (e.g., standing or walking, complexity of secondary cognitive task). Literature was searched via OVIDsp (Medline, EMBASE, PsycINFO). DT studies were included by the following criteria: (1) investigation of at least one motor task, (2) assessment of DT performance outcomes on standing or walking, (3) conduction of an intervention, and (4) investigation of older adults in an experimental–control group design or an old–young comparison. Thirteen studies met all inclusion criteria. Four types of interventions were identified: (1) general single-task (ST) motor training, (2) specific ST motor training, (3) general DT training, and (4) task-related (specific) DT training. For DT standing conditions only DT interventions improved motor performance, whereas DT walking also benefits by ST training. Most benefits on motor and cognitive performance seem to be reached by DT training interventions whereas a GST produced lowest effects. Thus, balance orientated motor and cognitive DT performance in healthy older adults can be improved by performance related exercises. Furthermore, to reach beneficial effects, it seems necessary that the training intervention includes a certain level of exercise load such as rising difficulties, appropriate intensity and duration, a certain level of task specificity, and variable task prioritization. The transfer of training effects into everyday situations needs to be further investigated.
Highlights
Most daily activities require the management of motor– cognitive tasks while simultaneously processing external information: for example, crossing a street while observing traffic flow or thinking about the shopping list while carrying a cup of tea from one room to another
Motor and cognitive performance declines in DT situations are considered in light of several theoretical positions: The central bottleneck theory states that due to an information processing bottleneck only one task can be processed at a time; processing of a second task cannot commence until the first is complete
Older adults with a history of falls performed more inefficient in DT situations than healthy older or younger adults, indicating that fallers might have problems to shift attention in DT situations and in turn to prioritize gait [58]. All these findings suggest that motor–cognitive performance changes in gait and balance control under DT conditions are a result of task settings, selection of motor and secondary cognitive task, study designs and examined target groups
Summary
Most daily activities require the management of motor– cognitive tasks while simultaneously processing external information: for example, crossing a street while observing traffic flow or thinking about the shopping list while carrying a cup of tea from one room to another. These motor– cognitive interactions can be described as motor–cognitive dual-task (DT) performance. The four-dimensional multiple resource model [95] proposes that there will be greater interference between two tasks to the extent that they
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