Training effects on motor–cognitive dual-task performance in older adults

Wollesen, Bettina; Voelcker-Rehage, Claudia · 2014 · Crossref

DOI: 10.1007/s11556-013-0122-z

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Summary

This systematic review investigates whether healthy older adults benefit from training interventions in motor–cognitive dual-task (DT) situations and identifies which specific intervention aspects contribute to these benefits. The research is motivated by the increased fall risk associated with age-related declines in DT performance, where older adults struggle to manage simultaneous motor and cognitive demands. The authors aim to determine the most effective training methodologies—comparing general versus specific training and single-task versus dual-task protocols—to improve balance and gait in complex daily life scenarios. The authors conducted a systematic search of Medline, EMBASE, and PsycINFO databases, identifying 13 studies that met strict inclusion criteria: investigations of healthy older adults, experimental-control or age-comparison designs, pre-post assessment of DT performance, and interventions involving standing or walking tasks. The included studies varied in methodological quality, sample size, and task complexity. Interventions were categorized into four types: general single-task (ST) motor training, specific ST motor training, general DT training, and task-related (specific) DT training. Cognitive tasks ranged from processing speed to executive control, utilizing various sensory modalities. The review found that training effects depend heavily on the type of intervention and the motor task involved. For DT standing conditions, only DT interventions improved motor performance, whereas DT walking performance benefited from both ST and DT training. Generally, DT training interventions yielded the most significant benefits for both motor and cognitive performance, while general ST training produced the lowest effects. The authors note that beneficial effects require specific conditions, including appropriate exercise load, intensity, duration, task specificity, and variable task prioritization. The heterogeneity of the included studies, particularly regarding cognitive task complexity and measurement methods, highlights the need for standardized protocols. The significance of this review lies in its implications for fall prevention and the maintenance of functional abilities in older adults. By demonstrating that motor–cognitive DT performance can be improved through targeted exercises, the findings support the development of multimodality interventions that combine motor and cognitive therapy. The results suggest that to effectively reduce fall risks and improve daily functioning, training programs should prioritize DT paradigms over general motor training, ensuring that the cognitive load and task specificity are carefully calibrated to challenge and improve the older adult’s ability to manage concurrent tasks. Further research is needed to investigate the transfer of these training effects into everyday situations.

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• older driver retraining