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The role of concern about falling on stepping performance during complex activities
Shaira Viaje1, Geert Crombez2, Stephen R Lord1,3
1Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, PO Box 1165, Sydney, Randwick, NSW, 2031, Australia.
BMC Geriatrics
|November 29, 2019
Summary
Older adults concerned about falling show slower reaction times during dual-task situations. Improved sensorimotor and cognitive function can mitigate this effect, suggesting graded exposure may reduce fear of falling.
Area of Science:
- Gerontology
- Neuroscience
- Rehabilitation Science
Background:
- Concern about falling in older adults is poorly understood.
- Anxiety impacts cognitive resources needed for balance, affecting dual-task performance.
- Older adults require more cognitive resources for balance, potentially impairing concurrent cognitive-motor tasks.
Purpose of the Study:
- Investigate the effect of a visuospatial dual-task on stepping performance in older adults with varying levels of fall concern.
- Assess the impact of repeated dual-task exposure on high fall concern individuals.
- Examine the interplay between fall concern, cognitive function, and motor performance.
Main Methods:
- 308 community-dwelling older adults (70-90 years) performed a Choice Stepping Reaction Time (CSRT) task under single and dual-task conditions.
- Participants rated concern and confidence for each stepping trial.
- General fall concern, affect, sensorimotor, and cognitive functioning were measured.
Main Results:
- Dual-tasking increased total stepping reaction times.
- Higher general concern about falling correlated with slower reaction times, particularly during dual-tasking.
- Sensorimotor and executive functioning moderated the relationship between fall concern and reaction time.
- Repeated task exposure reduced immediate task-specific concern and increased confidence.
Conclusions:
- Higher fall concern leads to greater dual-task difficulties in older adults.
- Enhanced sensorimotor and cognitive function can reduce the negative impact of fall concern.
- Graded exposure may reduce fear of falling during challenging activities, especially with concurrent balance, mood, and cognitive therapies.
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