Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study
Background: This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being w...
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Elsevier
2025-05-01
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| Series: | Experimental Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556525000555 |
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| author | Thomas Jürgen Klotzbier Julian Rudisch Nadja Schott Oliver Vogel Thomas Cordes Claudia Voelcker-Rehage Bettina Wollesen |
| author_facet | Thomas Jürgen Klotzbier Julian Rudisch Nadja Schott Oliver Vogel Thomas Cordes Claudia Voelcker-Rehage Bettina Wollesen |
| author_sort | Thomas Jürgen Klotzbier |
| collection | DOAJ |
| description | Background: This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being with ST and DT walking performance as well as cognitive and motor DT costs (cDTC; mDTC); and (3) to examine whether depressive symptomatology and well-being mediate or moderate the association between concerns about falling and DT performance in a large sample of German nursing home residents. Methods: We analyzed data from a cross-sectional study with 449 ambulatory nursing home residents (mean age 84.1 ± 7.87 years). Performance on three cognitive tasks with different cognitive loads (serial subtraction in one's [SST_1] and three's [SST_3]; verbal fluency [VFT]; number of correctly reproduced responses) and (walking speed) was recorded each under ST and DT conditions (walking plus additional cognitive task). In addition, we assessed concerns about falling, depressive symptomatology, and psychological and physical well-being using the Falls Efficacy Scale – International (FESI), the Center for Epidemiologic Studies Depression Scale (CESD), and the Short-Form-Health Survey (SF-12), respectively. Results: We observed significant differences in ST walking and walking while performing an additional cognitive task. Walking speed was higher in ST walking than walking during the SST_1, SST_3, and VFT (all p < 0.001). In both the ST walking and the SST_1 DT condition, the concerns about falling (and physical well-being) explained a low proportion of variance in walking speed. Physical well-being had a minor but significant mediating effect on the relationship between concerns about falling and walking speed in the ST walking and SST_1 DT condition. Conclusions: Concerns about falling and physical well-being seem to exert a small yet statistically significant effect on ST walking under conditions of lower cognitive demand. The effect is diminished by increasing the cognitive load, as compensation becomes impossible. Interventions focusing on decreasing concerns about falling and maintaining physical well-being might compensate for limitations in walking performance of nursing home residents in ST and DT situations. Reducing fall concerns, promoting physical well-being, and adjusting cognitive demands can improve nursing home residents' walking performance. Trials registration: DRKS00014957 (BfArM - Deutsches Register Klinischer Studien (DRKS)). |
| format | Article |
| id | doaj-art-3a046d12197340ddbb66da70e57f9b6b |
| institution | OA Journals |
| issn | 1873-6815 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj-art-3a046d12197340ddbb66da70e57f9b6b2025-08-20T01:51:35ZengElsevierExperimental Gerontology1873-68152025-05-0120311272610.1016/j.exger.2025.112726Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational studyThomas Jürgen Klotzbier0Julian Rudisch1Nadja Schott2Oliver Vogel3Thomas Cordes4Claudia Voelcker-Rehage5Bettina Wollesen6Department of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany; Corresponding author.Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Strasse 8, 48149 Münster, Germany; Institute of Human Movement Science and Health, Chemnitz University of Technology, Straße der Nationen 62, 09111 Chemnitz, GermanyDepartment of Sport and Exercise Science, University of Stuttgart, Stuttgart, GermanyDepartment of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148 Hamburg, GermanyDepartment of Sports Science, University of Vechta, Driverstraße 22, 49377 Vechta, GermanyDepartment of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Strasse 8, 48149 Münster, Germany; Institute of Human Movement Science and Health, Chemnitz University of Technology, Straße der Nationen 62, 09111 Chemnitz, GermanyGerman Sport University Cologne, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, 50933 Cologne, GermanyBackground: This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being with ST and DT walking performance as well as cognitive and motor DT costs (cDTC; mDTC); and (3) to examine whether depressive symptomatology and well-being mediate or moderate the association between concerns about falling and DT performance in a large sample of German nursing home residents. Methods: We analyzed data from a cross-sectional study with 449 ambulatory nursing home residents (mean age 84.1 ± 7.87 years). Performance on three cognitive tasks with different cognitive loads (serial subtraction in one's [SST_1] and three's [SST_3]; verbal fluency [VFT]; number of correctly reproduced responses) and (walking speed) was recorded each under ST and DT conditions (walking plus additional cognitive task). In addition, we assessed concerns about falling, depressive symptomatology, and psychological and physical well-being using the Falls Efficacy Scale – International (FESI), the Center for Epidemiologic Studies Depression Scale (CESD), and the Short-Form-Health Survey (SF-12), respectively. Results: We observed significant differences in ST walking and walking while performing an additional cognitive task. Walking speed was higher in ST walking than walking during the SST_1, SST_3, and VFT (all p < 0.001). In both the ST walking and the SST_1 DT condition, the concerns about falling (and physical well-being) explained a low proportion of variance in walking speed. Physical well-being had a minor but significant mediating effect on the relationship between concerns about falling and walking speed in the ST walking and SST_1 DT condition. Conclusions: Concerns about falling and physical well-being seem to exert a small yet statistically significant effect on ST walking under conditions of lower cognitive demand. The effect is diminished by increasing the cognitive load, as compensation becomes impossible. Interventions focusing on decreasing concerns about falling and maintaining physical well-being might compensate for limitations in walking performance of nursing home residents in ST and DT situations. Reducing fall concerns, promoting physical well-being, and adjusting cognitive demands can improve nursing home residents' walking performance. Trials registration: DRKS00014957 (BfArM - Deutsches Register Klinischer Studien (DRKS)).http://www.sciencedirect.com/science/article/pii/S0531556525000555Cognitive-motor interferenceWalkingOlder adultsConcern of fallingDepressionWell-being |
| spellingShingle | Thomas Jürgen Klotzbier Julian Rudisch Nadja Schott Oliver Vogel Thomas Cordes Claudia Voelcker-Rehage Bettina Wollesen Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study Experimental Gerontology Cognitive-motor interference Walking Older adults Concern of falling Depression Well-being |
| title | Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study |
| title_full | Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study |
| title_fullStr | Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study |
| title_full_unstemmed | Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study |
| title_short | Influence of cognitive and emotional factors on motor dual-task performance in nursing home residents. The mediating and moderating roles of cognition, concerns about falling, well-being, and depressive symptoms. A cross-sectional observational study |
| title_sort | influence of cognitive and emotional factors on motor dual task performance in nursing home residents the mediating and moderating roles of cognition concerns about falling well being and depressive symptoms a cross sectional observational study |
| topic | Cognitive-motor interference Walking Older adults Concern of falling Depression Well-being |
| url | http://www.sciencedirect.com/science/article/pii/S0531556525000555 |
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