The Influence of Fear of Falling on Cognitive-Motor Interference in Walking in Older Adults

Objectives: Fear of falling (FOF) is common among older people and may impact normal walking in this population. This study aimed to determine the effect of FOF on cognitive-motor interference in walking among older adults. Methods: Ninety older adults with the ability to walk 20 meters and without cognitive disorder participated in this study. Three groups of high FOF, low FOF, and no FOF were identified using the fall efficacy scale-international (FES-I). The cognitive-motor interference was determined for the completion time of three functional movements, namely forward walking (FW), timed up and go (TUG), and obstacle crossing (OC), as well as the correct answer rate in verbal fluency (VF) and mental tracking (MT) tasks. The difference in outcomes between the groups was determined using multivariate analysis of variance (MANOVA). The Pearson correlation coefficients determined the association between FES-I and cognitive-motor interference in subjects with FOF. Results: Dual-task cognitive performance measures, including MT + TUG, VF + OC, and MT + OC, significantly differed between the high FOF and no FOF groups (P<0.05). MT + TUG, VF + OC, and MT + OC also showed significant differences between the high FOF and low FOF groups (P<0.05). Other cognitive-motor interference measures were not significantly different between the groups. The FES-I showed a positive correlation with MT + TUG (r=0.76, P=0.001), VF + OC (r=0.72, P=0.001), and MT + OC (r=0.65, P=0.001) in individuals with FOF. Discussion: The results indicate that FOF may impair cognitive performance during dual tasks in older adults. Future studies may be needed to investigate whether reduced FOF has the advantage of dual-task improvement in older people.