Cognitive inhibition tasks interfere with dual-task walking and increase prefrontal cortical activity more than working memory tasks in young and older adults

Background: Prior work suggests there may be greater reliance on executive function for walking in older people. The pre-frontal cortex (PFC), which controls aspects of executive function, is known to be active during dual-task walking (DTW). However, there is debate on how PFC activity during DTW is impacted by ageing and the requirements of the cognitive task.

Research Question: Functional near infrared spectroscopy, was used to investigate how PFC activity during walking was affected by i) healthy ageing; and ii) dual-tasks that utilise inhibition or working memory aspects of executive function.

Methods: Young (n=26, 16 females, mean 20.9 years) and older (n=26, 16 females, mean 70.3 years) adults performed five conditions: normal walking; Reciting Alternate Letters of the alphabet (RAL, requiring cognitive inhibition and working memory) during standing and walking; and serial subtraction by threes (SS3, requiring working memory alone) during standing and walking. Walking speed, cognitive performance, the PFC haemodynamic response, and fear of falling ratings were analysed using linear mixed-effects modelling.

Results: Compared to quiet standing, PFC activity increased during normal walking for older adults but decreased for young adults (p<0.01). Across both groups, fear of falling contributed to higher PFC activity levels when walking (p<0.01). PFC activity increased during DTW, and this increase was greater when performing RAL compared to the SS3 task (p<0.01). Although the rate of correct responses was higher for RAL, walking speed reduced more with RAL than SS3 in the young group (p=0.01), and the rate of correct responses reduced more when walking with RAL than SS3 in the older group (p<0.01).

Significance: Older adults have increased levels of PFC activation during walking compared to younger adults and fear of falling is a cofounding factor. The interference between gait and a concurrent cognitive task is higher when the cognitive task requires inhibition.