Impact of Cognitive Training on Gait and Balance in Older Adults
Smith-Ray, Renae L.
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Fall-related injuries are the 5th most common cause of death for older adults (Rubenstein, 2006). Risk factors for falls include impairments in gait, balance, and cognition including memory and attention (American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopedic Surgeons, 2001). This study tested whether cognitive training of executive functions over 10 weeks improves gait and balance in older adults. Participants were randomly assigned to a cognitive training intervention or measurement-only control. Measurements were completed at baseline and 10 weeks. Distal outcomes included 10-meter walk test, 10-meter walk with cognitive distraction, and Timed Up and Go (TUG; proxy measure of balance). Proximal cognitive outcomes included Useful Field of View (UFOV) processing speed (UFOV-PS), divided attention (UFOV-DA), and selective attention (UFOV-SA), inhibition (COAST), and visuospatial working memory (Corsi blocks forward and backward). Data were analyzed using one-way ANOVA models with change scores. The 51 participants were on average age 81.7, white (96%) and female (78%). Intent to treat analyses revealed a significant improvement in TUG [F(1,36) = 5.59, p = 0.024] and a marginally significant improvement in UFOV-DA [F(1,41) = 3.16, p = 0.083] for participants who were randomized to the intervention arm. When the cohort was limited to slow walkers only (> = 9 seconds to walk 10-meters), those randomized to the intervention arm experienced significant improvements in TUG [F(1,23) = 6.35, p = 0.020] and 10-meter walk while distracted [F(1,27) = 4.85, p = 0.037] and marginally significant improvements in UFOV-DA [F(1,25) = 3.35, p = 0.080] and time to complete the COAST task [F(1,27) = 3.77, p = 0.063]. This study demonstrates that cognitive training not only leads to improvements in cognitive tasks related to executive functions but also balance and walking while distracted. These findings imply that training aspects of cognition related to balance and gait may be a promising approach to falls prevention.