, Volume 36, Issue 1, pp 373-381

First online:

Performance variance on walking while talking tasks: theory, findings, and clinical implications

  • Roee HoltzerAffiliated withFerkauf Graduate School of Psychology, Yeshiva UniversityDepartment of Neurology, Albert Einstein College of Medicine, Yeshiva University Email author 
  • , Cuiling WangAffiliated withDepartment of Epidemiology, Albert Einstein School of Medicine, Yeshiva University
  • , Joe VergheseAffiliated withDepartment of Neurology, Albert Einstein College of Medicine, Yeshiva UniversityDepartment of Medicine, Yeshiva University

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Dual tasks that involve walking and cognitive interference tests are commonly used in mobility assessments and interventions. However, factors that explain variance in dual-task performance costs are poorly understood. We, therefore, examined the moderating effects of two putative constructs, postural reserve and hazard estimate, on performance on a walking while talking paradigm. Participants were 285 non-demented older adults (mean age = 76.9 years; %female = 54.4). Postural reserve was operationalized as the presence or absence of clinical gait abnormalities. An empirical factor, based on measures of executive functions, served as a marker for hazard estimate. The moderation effects of postural reserve and hazard estimate on dual-task costs were examined via two-way interactions in a joint linear mixed effect model. Significant dual-task costs were observed for gait speed (95% CI = 30.814 to 39.121) and cognitive accuracy (95% CI = 6.568 to 13.607). High hazard estimate had a protective effect against decline in gait speed (95% CI = −8.372 to −0.151) and cognitive accuracy (95% CI = −8.372 to −0.680). Poor postural reserve was associated with reduced decline in gait speed (95% CI = −9.611 to −0.702) but did not moderate the decline in cognitive accuracy (95% CI = −3.016 to 4.559). Assessing postural reserve and hazard estimate can help improve mobility risk assessment procedures and interventions for individuals with cognitive and movement disorders.


Dual task Postural reserve Executive functions Gait