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Walking Safely After Age 70 Requires More Attention,
Thinking - So They Say
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Editor's Note: I'm not really buying a lot of this
research that says senior citizens have difficulty walking safely after
reaching age 70. I'm sure it's true for a few, but I see more seniors
everyday playing tennis, running, jogging and doing other activities
that require a fast gait. Many of these are well into their 90s. - TS |
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Researchers see
slow gait (senior shuffle) as significant risk for falls
March 27, 2006 - Psychologists wanting to help old
people safely cross the street and otherwise ambulate around this busy
world have found that from age 70 and up, safe walking may require solid
"executive control" (which includes attention) and memory skills. For
the old, slow gait is a significant risk factor for falls, many of which
result in disabling fractures, loss of independence or even death.
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The finding may help explain why cognitive problems
in old age, including dementia, are associated with falls. Cognitive
tests could help doctors assess risk for falls; conversely, slow gait
could alert them to check for cognitive impairment.
The findings are in the March issue of
Neuropsychology, which is published by the American Psychological
Association (APA).
Roee Holtzer, PhD, and his colleagues conducted a
cross-sectional study of 186 cognitively normal, community-dwelling
adults aged 70 and older at New York City's Albert Einstein College of
Medicine. Gait speed was tested with and without interference. In the
interference conditions, participants had to walk while reciting
alternate letters of the alphabet.
Performance on cognitive tests of executive control
and memory, and to a lesser extent of verbal ability, predicted "gait
velocity" (walking speed) tested without interference. For gait velocity
tested with interference, only executive control and memory were
predictive.
Adding interference to the tests of gait allowed
the researchers to better simulate the real world, in which walkers
continually deal with distractions. The authors conclude that executive
control and memory function are important when the individual has to
walk in a busy environment.
The findings suggest that in old age, walking
involves higher-order executive-control processes. That is, the
intersecting cognitive and motor processes involved in walking may both
rely on a common brain substrate, or set of structures. As a result,
changes in that substrate would affect both cognition and gait.
Falls are a serious public-health issue for an
aging population. Many older people are aging in the suburbs, where
traffic conditions are often not designed for pedestrians of any age.
And in cities, traffic lights at busy intersections are not usually
timed to give people with slower perceptions and reflexes more time to
safely cross the street.
Holtzer says that risk assessment and prevention
programs for falls, which have typically focused on balance, strength
and gait but not cognitive function, have had limited success. Given the
new research, he posits that cognitive and neuropsychological
performance, plus gait, could both factor into risk assessment and
intervention design. What's more, cognitive rehabilitation and/or
medication targeting cognitive functions such as executive control and
memory might, among other benefits, reduce the risk of falling in people
at risk.
Future study is needed to follow people through the
life span to see how age affects the relationship between cognitive
functions and gait. Holtzer cites evidence that gait is more automatic
and less effortful in young than old people and points out that even
within the narrow age range of his study's participant sample, each
additional year tightened the relationship between cognitive function
and gait velocity.
About the source:
Article: "Cognitive Processes Related to Gait
Velocity: Results From the Einstein Again Study," Roee Holtzer, PhD, Joe
Verghese, MD, Xiaonan Xue, PhD, and Richard B. Lipton, MD, Albert
Einstein College of Medicine, Yeshiva University. Neuropsychology, Vol.
20, No. 2.
The American Psychological Association (APA), in
Washington, DC, is the largest scientific and professional organization
representing psychology in the United States and is the world's largest
association of psychologists. APA's membership includes more than
150,000 researchers, educators, clinicians, consultants and students.
Through its divisions in 54 subfields of psychology and affiliations
with 60 state, territorial and Canadian provincial associations, APA
works to advance psychology as a science, as a profession and as a means
of promoting human welfare.
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