The association between cerebral blood flow and standing dual task performance is dependent upon age group and cognitive load

Azizah J. Jor’dan; Iloputaife, Ikechukwu; Yu, Wanting; Zhou, Junhong; Bean, Jonathan F.; Manor, Brad · 2025 · Crossref

DOI: 10.1038/s41598-025-26619-4

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Summary

This study investigates the relationship between cerebral blood flow (CBF) and postural control during standing dual-task performance, specifically examining how age and cognitive load influence this association. While aging is known to diminish both dual-task performance and CBF, it remained unclear whether CBF dynamics during task execution correlate with performance metrics or if age alters the nature of this relationship. The authors hypothesized that older adults would exhibit a stronger dependence on CBF for dual-task performance compared to younger adults. The researchers recruited 47 healthy participants, comprising 23 younger adults (mean age 26) and 24 older adults (mean age 76). Participants performed an n-back executive function task while standing. CBF velocity in the middle cerebral artery was measured using transcranial Doppler ultrasound, and postural sway was recorded via wearable inertial sensors. Cognitive performance was indexed by the Balanced Integration Score (BIS), which accounts for speed-accuracy trade-offs. The protocol included a low-demand "Identify X" (IdX) task and a higher-demand "2-back" task. Statistical analyses included ANOVAs to assess main effects of age and task condition, and multiple linear regressions to examine interactions between age group, CBF, and performance metrics. Results indicated that older adults exhibited significantly lower CBF, greater postural sway (elliptical area and path length), and less efficient cognitive performance (higher BIS) than younger adults, regardless of task condition. The relationship between CBF and performance varied by age and task difficulty. During the low-demand IdX task, the association between CBF and postural path length differed by age: younger adults showed a nonsignificant negative trend, while older adults showed a positive trend. During the high-demand 2-back task, greater CBF was associated with longer postural path length across all participants. Furthermore, for the 2-back task, higher CBF was associated with better cognitive efficiency (lower BIS) in older adults only, whereas no such association existed for younger adults. These findings demonstrate that dual-task postural control relies on CBF, but the nature of this relationship is dependent on both age and cognitive load. Older adults appear to have a greater dependence on CBF regulation for maintaining balance and cognitive performance, particularly under high cognitive demand. The results suggest that older adults may strategically prioritize cognitive tasks, recruiting prefrontal resources at the expense of postural stability, a mechanism less prevalent in younger adults during low-demand tasks. This study highlights the importance of considering cerebrovascular function in understanding age-related declines in balance and cognitive-motor integration, offering insights for future interventions aimed at improving neurophysiological responses in aging populations.

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• mental demand