Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study

IF 3.9

Experimental gerontology Pub Date : 2025-03-06 DOI:10.1016/j.exger.2025.112726

Thomas Jürgen Klotzbier , Julian Rudisch , Nadja Schott , Oliver Vogel , Thomas Cordes , Claudia Voelcker-Rehage , Bettina Wollesen

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引用次数: 0

Abstract

Background

This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being with ST and DT walking performance as well as cognitive and motor DT costs (cDTC; mDTC); and (3) to examine whether depressive symptomatology and well-being mediate or moderate the association between concerns about falling and DT performance in a large sample of German nursing home residents.

Methods

We analyzed data from a cross-sectional study with 449 ambulatory nursing home residents (mean age 84.1 ± 7.87 years). Performance on three cognitive tasks with different cognitive loads (serial subtraction in one's [SST_1] and three's [SST_3]; verbal fluency [VFT]; number of correctly reproduced responses) and (walking speed) was recorded each under ST and DT conditions (walking plus additional cognitive task). In addition, we assessed concerns about falling, depressive symptomatology, and psychological and physical well-being using the Falls Efficacy Scale – International (FESI), the Center for Epidemiologic Studies Depression Scale (CESD), and the Short-Form-Health Survey (SF-12), respectively.

Results

We observed significant differences in ST walking and walking while performing an additional cognitive task. Walking speed was higher in ST walking than walking during the SST_1, SST_3, and VFT (all p < 0.001). In both the ST walking and the SST_1 DT condition, the concerns about falling (and physical well-being) explained a low proportion of variance in walking speed. Physical well-being had a minor but significant mediating effect on the relationship between concerns about falling and walking speed in the ST walking and SST_1 DT condition.

Conclusions

Concerns about falling and physical well-being seem to exert a small yet statistically significant effect on ST walking under conditions of lower cognitive demand. The effect is diminished by increasing the cognitive load, as compensation becomes impossible. Interventions focusing on decreasing concerns about falling and maintaining physical well-being might compensate for limitations in walking performance of nursing home residents in ST and DT situations. Reducing fall concerns, promoting physical well-being, and adjusting cognitive demands can improve nursing home residents' walking performance.

Trials registration

DRKS00014957 (BfArM - Deutsches Register Klinischer Studien (DRKS)).

查看原文本刊更多论文

认知和情绪因素对养老院老人运动双任务表现的影响。认知、对坠落的担忧、幸福感和抑郁症状的中介和调节作用。横断面观察研究。

背景：本研究旨在(1)比较不同认知任务和困难程度的单任务（ST）和双任务（DT）条件下的步行表现；(2)调查对跌倒的担忧、抑郁症状、心理和身体健康与ST和DT步行表现以及认知和运动DT成本（cDTC）的关系；mDTC);(3)研究抑郁症状学和幸福感是否介导或调节德国养老院居民对跌倒的担忧与DT表现之间的关联。方法：采用横断面研究方法，对449名流动疗养院居民（平均年龄84.1±7.87 岁）进行数据分析。不同认知负荷（1′s [SST_1]和3′s [SST_3]连续减法）在认知任务中的表现语言流畅性；在ST和DT条件下（步行加额外的认知任务）分别记录正确复制的反应数量和（步行速度）。此外，我们分别使用国际瀑布功效量表（FESI）、流行病学研究中心抑郁量表（CESD）和短期健康调查（SF-12）评估了对跌倒、抑郁症状以及心理和身体健康的关注。结果：在执行额外的认知任务时，我们观察到ST步行和步行的显著差异。在SST_1、SST_3和VFT期间，ST步行的步行速度高于步行速度（p均为 ）结论：在认知需求较低的情况下，对跌倒和身体健康的担忧似乎对ST步行产生了较小但具有统计学意义的影响。随着认知负荷的增加，这种效果会减弱，因为补偿变得不可能。专注于减少对跌倒的担忧和保持身体健康的干预措施可能会弥补养老院居民在ST和DT情况下行走表现的局限性。减少对跌倒的担忧，促进身体健康，调整认知需求可以改善养老院居民的步行表现。试验注册：DRKS00014957 （BfArM - Deutsches Register Klinischer studen (DRKS)）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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