Visual dependence affects the motor behavior of older adults during the Timed Up and Go (TUG) test

Older adults show greater postural instabilities under misleading visual cues relative to younger adults. We investigated the effects of age-related visual dependence on motor performance under increased attention demands by adding a motor task and visual stimulus to the Timed Up and Go (TUG) test sub-components.

We designed a cross-sectional quantitative study. Twenty-eight younger (n = 12) and older (n = 16) adults completed the TUG test while wearing a head-mounted display (HMD) that presented a visual stimulus and/or carrying a cup of water. Outcome measures were turning cadence; gait speed; pitch, yaw, and roll peak trunk velocities (PTVs); and acceleration ranges of sit-to-stand and stand-to-sit.

Wearing the HMD caused significant performance differences in the TUG test tasks due to age and visual dependence, although performance was lower across all groups with the HMD (p < 0.01). Older adults showed lower roll PTV in turning compared to younger adults (p = 0.03). Visually dependent older adults showed smaller mediolateral and vertical acceleration ranges (p < 0.04) in sit-to-stand compared to visually independent older adults.

The demand for orienting posture to a vertical position during sit-to-stand may differentiate older adults who are more visually dependent-and thus at greater fall risk- from those who are more visually independent. Age-related differences in turning behavior suggest a relationship with fall risk that warrants further investigation.