Attentional demands and postural recovery: The effects of aging

Background. Cognitive demands associated with balance and locomotion may contribute to the incidence of falling among older adults. This study addressed issues related to the effects of aging on the attentional demands of recovering from an external disturbance to balance. This research also investigated whether performing a secondary cognitive task differentially affects postural recovery in young versus older adults. Method. Fifteen young and 10 healthy older adults were exposed to a series of balance disturbances. Attentional demands were assessed using a dual task paradigm where postural recovery served as the primary task, and counting backwards served as a concurrent secondary cognitive task. The effect of the counting task was assessed by comparing kinematic variables related to feet-in-place and stepping recovery strategies. Results. Recovering upright stance was found to be attentionally demanding in both age groups. The type of recovery strategy did not influence attentional demands in young adults; however, a hierarchy of increasing attentional demands between the ankle strategy and compensatory stepping was apparent among older adults. In addition, stepping appears to be more attentionally demanding for older adults than for younger adults. Counting backwards did not affect the type of strategy used; however, it did affect the kinematics of stepping. For both age groups, steps occurred when the center of mass was located in a more central location within the base of support when the secondary task was added. Conclusions. The ability to recover a stable posture following an external perturbation is more attentionally demanding for older adults than for younger adults. This would suggest that for some older adults, an increased risk for loss of balance and falls may result if sufficient attentional resources are nor allocated to the task of postural recovery.