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A high cognitive load situation (HCLS) is completing two or more tasks simultaneously (i.e. walking while talking). Differential allocation of attentional demands creates HCLS, potentially deteriorating cognitive and/or gait performance, impacting fall risk. This study investigated whether different load types [(Single-task (ST): talking/walking only, and HCLS: walking while talking on a phone)] impacted gait and cognitive performance among young (n=8; age=23.16±1.96yrs), middle-aged (n=14; age=44.79±7.42yrs), and older (n=15; age=74.47±3.91yrs) adults. In 3-minute trials, participants completed single-task walking (ST-W) and phone conversations with easy (e.g., favorite food, ST-E) and difficult (e.g., personal relationships, ST-D) topics, and also combined walking and talking (easy: HCLS-E and difficult: HCLS-D). For gait, speed, step length (SL) and stride width (SW) were analyzed with 3(ST-W, HCLS-E, HCLS-D) x 3(Age) repeated-measures ANOVAs. HCLS resulted in slower speed (p <.001, shorter SL (p <.001), and wider SW (p=.008) across groups. Older adults exhibited shorter SL across walking conditions (p=.002) compared to young and middle-aged. For cognition, Word Count (WC) and Authenticity (i.e. honesty) were analyzed with 2(Evs.D) x 2(STvs.HCLS) x 3(Age) repeated-measures ANOVAs. Main effects emerged for conversation topic in WC (p=.04) and Authenticity (p<.001); difficult topics negatively impacted participants’ cognitive performance, likely resulting from higher attention to maintain conversations without personal interactions (i.e. visual cues). Marginal age-group differences (p=.056) revealed older age resulted in less authentic conversations. The HCLS in this study negatively impacted gait and cognitive performance. Understanding this relationship may ultimately inform development of interventions to improve allocation of attentional demands, potentially mitigating fall risk.

Instances where multiple tasks are completed simultaneously are considered high cognitive load situations (HCLS, also called dual-task), potentially affecting gait performance in older adults. Walking while talking is a common HCLS that requires additional cognitive resources. Optic flow (OF) provides visual information about speed and direction of self-motion, and thus, may ameliorate gait deficits under HCLS. This study aimed to identify the effect of HCLS, as well as OF, on gait performance in older adults. The HCLS included walking while talking on the phone, compared to walking alone. Fifteen older adults (70.86±4.7yrs) underwent four experimental conditions: walking alone with(1) and without OF(2), as well as walking while talking with(3) and without OF(4). Step width, step length, and double support time were measured and examined with 2(HCLS) x 2(OF) repeated-measures ANOVAs. There was a main effect of OF; step width was narrower with OF compared to without OF (p=0.048). For step length, there was a significant interaction between HCLS and OF (p=0.045). Without OF, there were no differences in step length; however, with OF step length was significantly longer when walking alone compared to when walking while talking (p=0.002). Double support time was not affected by HCLS or OF. Considering younger adults have longer and narrower steps compared to older adults, OF may have enhanced step width regardless of HCLS and step length when walking only. Using OF in training programs designed for older adults, could be a potential factor to improve spatial gait function, more so in the mediolateral direction.

Fear of falling (FOF), defined as a psychological symptom, is related to increased fall risk, anxiety, and depressive symptoms. As physical function changes with age, FOF can appear beginning in midlife. FOF may result in avoiding physical activities, resulting in weakness of postural balance. Neuroticism is associated with anxiety and depression; thus, those high on neuroticism may have an increased FOF. This study aimed to address the relationships between FOF, neuroticism, and number of falls from external perturbations while standing. Participants included 45 participants (female: n=24; age range: 42-77yrs; age=62.44±9.25yrs). Five standing trials were completed on a force platform with perturbations. Hierarchical regression was used to investigate the impact of neuroticism (Big Five Inventory) and number of falls on FOF (The Falls Efficacy Scale International), accounting for age, anxiety (Geriatric Anxiety Scale), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Anxiety was significantly associated with FOF (model 1; age, anxiety, depression), B=0.31, β=.55, t(41)=3.08, R2=.30, p=.004, 95% CI [0.11, 0.51]. Neuroticism was not significantly related to FOF (model 2; ΔR2=.05, ΔF=2.94, p=.094), nor was number of falls (model 3; ΔR2=.00, ΔF=0.01, p=.974). Results revealed that anxiety levels had the strongest relationship with FOF. This suggests that strategies to reduce daily anxiety may decrease FOF. Future research should examine how anxiety is related to history of falls, and how changes in physical functions (e.g., mobility, vision, proprioception) may impact FOF.