Walking while Talking in Older Adults with Chronic Kidney Disease

Area of Science:

• Gerontology and Geriatric Medicine
• Nephrology
• Neuroscience
• Biomechanics

Background:

• Walking while talking is a dual cognitive-motor task that predicts frailty, falls, and cognitive decline in older adults.
• Adults with chronic kidney disease (CKD) exhibit gait abnormalities during normal walking.
• The impact of CKD on gait and cognitive-motor interference during dual-tasking remains unclear.

Purpose of the Study:

• To investigate whether adults with CKD experience greater gait abnormalities and cognitive-motor interference during the walking while talking task compared to those without CKD.
• To quantify the association between estimated glomerular filtration rate (eGFR) and gait performance during dual-tasking in older adults.

Main Methods:

• Quantitative gait analysis was performed on 330 community-dwelling, nondisabled adults aged 65 years and older.
• Participants underwent gait assessments while walking alone and while talking to measure dual-task cost.
• CKD was defined as an eGFR < 60 ml/min per 1.73 m²; associations were analyzed using multivariable linear spline regression.

Main Results:

• CKD was present in 41% of participants and associated with slower gait speed and gait cycle abnormalities during walking while talking.
• Lower eGFR was significantly correlated with slower gait speed, shorter step length, reduced swing phase duration, and increased double support time.
• CKD was specifically associated with poorer performance in the rhythm domain of both walking while talking and dual-task cost.

Conclusions:

• CKD is associated with significant gait impairments and increased cognitive-motor interference when older adults perform the walking while talking task.
• These findings suggest that CKD may exacerbate risks for falls and cognitive decline through impaired dual-tasking abilities.
• Gait rhythm appears to be a key domain affected by reduced eGFR during cognitive-motor dual-tasking.