Dual-tasking effects on gait variability: the role of aging, falls, and executive function.

The objectives of the present study were to test the hypothesis that the dual-tasking effect on gait variability is larger in healthy older adults than it is in healthy young adults; that this effect is larger in idiopathic elderly fallers than it is in healthy older adults; and that the dual-tasking effects on gait variability are correlated with executive function (EF). Young adults and older adults who were classified as fallers and nonfallers were studied. Gait speed, swing time, and swing time variability, a marker of fall risk, were measured during usual walking and during three different dual-tasking conditions. EF and memory were evaluated. When performing dual tasks, all three groups significantly decreased their gait speed. Dual tasking did not affect swing time variability in the young adults and in the nonfallers. Conversely, dual tasking markedly increased swing time variability in the fallers. While memory was similar in fallers and nonfallers, EF was different. The faller-specific response to dual tasking was significantly correlated with tests of EF. These findings demonstrate that dual tasking does not affect the gait variability of elderly nonfallers or young adults. In contrast, dual tasking destabilizes the gait of idiopathic elderly fallers, an effect that appears to be mediated in part by a decline in EF.