Date of Graduation

5-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Health, Sport and Exercise Science (PhD)

Degree Level

Graduate

Department

Health, Human Performance and Recreation

Advisor/Mentor

Ganio, Mathew S.

Committee Member

Ganio, Matthew S.

Second Committee Member

Schmitt, Abigail

Third Committee Member

Ferguson, Alishia

Keywords

Cognitive Performance; Executive Function; Gait Speed; Physical Function

Abstract

Concurrently performing motor and cognitive tasks, also known as dual-tasking (DT), is a daily activity being shown to produce decrements in gait and cognitive performance in older adults (OA) (Bootsma-van der Wiel et al., 2003; CDC, 2023; Kenny et al., 2017). Determining if OAs can cognitively flex attention allocation between motor and cognitive tasks during DT activities offers insight into how to educate older adults on improving activities of daily life (Della Sala et al., 1995; Mac-Auliffe et al., 2021; Montero-Odasso et al., 2012). Purpose: To evaluate changes in DTC in older adults during DT walking with instructed task prioritization of either the cognitive or motor task to examine cognitive attention allocation during DT assessments to determine cognitive flexibility in older adults. Additionally, this study investigated if there was a difference in task difficulty between 3 cognitive task and if task difficulty impacted DTC of cognition on gait performance. Methods: Participants completed single-task walking assessments at perceived normal walking speed as well as completed single-task cognitive assessments of category verbal fluency (CF), initial verbal fluency (IF), and spontaneous narrative (SN). Participants then completed all cognitive tasks for dual-task assessments at perceived normal walking speed under 3 instructed priority conditions: no priority (NP), walking priority walking (WP), and cognitive priority (CP). At the conclusion of each task, participants completed the NASA Task Load Index to report their perceived difficulty of each task. Results: Participants significantly improved DTC of cognition on walking performance under WP dual-task instructions when compared to NP and CP for all cognitive tasks (p<.001) with no significant changes observed between NP and CP dual-task walking. When examining DTC of walking on cognitive performance, there was a significant improvement observed during SC under CP instructions (p<.001) with no further significant changes being observed in cognitive performance. Participants reported that the IF task was significantly more mentally demanding, required more effort, and was more frustrating compared to CF and SC cognitive tasks (p<.05). It was also reported that the SC task was significantly less mentally demanding, required less effort and was less frustrating when compared to CF and IF cognitive task (p<.05). Even though participants reported a significant difference in mental demand, effort, and frustration between the cognitive tasks, there were no significant differences observed in DTC of cognition on walking performance between any cognitive tasks. Conclusion: Results of this study indicate that instructed task prioritization has a positive effect on gait speed during dual-task walking and that older adults were cognitive flexible under instructed task prioritization conditions. Additionally, although older adults reported that the IF cognitive task was more difficult than CF and SC, no changes in DTC were observed suggesting that older adults can maintain DT walking performance while completing more difficult cognitive tasks.

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