Age-Related Differences in Cognitive and Postural Performance During Dynamic Dual-Tasks

Abstract

Highlights: What are the main findings? Reaction time during executive demanding motor–cognitive dual tasks is highly sensitive to age-related cognitive decline in unimpaired adults. Center of pressure and trunk sway areas are the strongest markers of balance decline, especially during dynamic balance under high executive-demand tasks in unimpaired adults. What are the implications of the main findings? Executive-demanding motor–cognitive dual tasks combined with dynamic balance provide sensitive tools for early detection of age-related cognitive and balance decline in unimpaired adults. These outcomes provide valuable normative references for the early detection and monitoring of age-related cognitive and balance decline and may help to distinguish aging from emerging pathological changes. Age-related declines in balance and cognitive function increase fall risk and reduce quality of life in older adults and people with neurological disorders. Studying these changes in unimpaired adults provides a normative reference for identifying pathological deviations. However, most dual-task studies focus on single cognitive tasks and static conditions, specifically during gait, limiting understanding of how cognitive demand interacts with postural control while standing and during dynamic challenges. This study identified cognitive and motor outcomes most sensitive to age-related differences during motor–cognitive dual tasks of varying complexity across static and dynamic balance conditions, accounting for minimal detectable change. Sixty healthy adults performed dual-tasks ranging from simple motor activities to complex cognitive challenges (Stroop Test) while standing on a robotic platform. Cognitive performance (reaction time) and balance outcomes, including trunk and center of pressure (CoP) sway area, were assessed. Reaction time was sensitive to aging, with standardized estimates ranging from 0.014 to 0.036. The highest values occurred in the most demanding dual-task condition, enabling detection of meaningful change over short timeframes. Age effects on balance were modest under static conditions but amplified during dynamic perturbations across all dual tasks. In the SCWT 3 condition, standardized estimates for CoP sway area increased from 0.006 in the static condition to 0.047 in the passive condition, reflecting an approximately eightfold increase in age sensitivity. Trunk sway primarily reflected cognitive load, whereas CoP sway was most sensitive to balance perturbations and exceeded minimal detectable thresholds over only a couple of years. These findings support sensitive task–condition combinations for early detection and monitoring of age-related cognitive and balance decline.