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July 12, 2021Frontiers in MedicineOpen Access

Cognitive and Motor Cortical Activity During Cognitively Demanding Stepping Tasks in Older People at Low and High Risk of Falling

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Key result

Older adults at high fall risk exhibited significantly greater dorsolateral prefrontal cortex activity and increased stepping response time variability during a cognitively demanding Stroop stepping task compared to those at low fall risk.

Why the study?

Little is known about the neural mechanisms underlying impaired stepping and associated fall risk in older people.

Does a cognitively demanding stepping task elicit different cortical activity and stepping performance in older people at high versus low risk of falling?

Comparison

Stroop stepping task vs choice stepping reaction time test, and low vs high fall risk

Design

Cross-sectional comparative study

Authors

PPPaulo Henrique Silva PelicioniSLStephen R. LordDSDaina L. Sturnieks

Discussion

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Overview

May identify cortical correlates of stepping impairment in older adults; leaves open whether fNIRS metrics predict falls or inform interventions.

Study Design

Type

Cross-Sectional (n=95)

Multicenter

No

Structured PICO

Does a cognitively demanding stepping task elicit different cortical activity and stepping performance in older people at high versus low risk of falling?

P
Population
95 healthy community-dwelling older adults aged 65 years or older, categorized into low and high fall risk groups, assessed for cortical activity during cognitively demanding stepping tasks.
E
Exposure
Stroop stepping task (cognitively demanding stepping reaction time task)
C
Comparator
Choice stepping reaction time test (simpler task) and comparison between high vs. low fall risk groups
O
Outcome
Cortical activity in cognitive (dorsolateral prefrontal cortex) and motor (supplementary motor area and premotor cortex) regions using fNIRS, and stepping performance (response time and intra-individual variability)surrogate

Main Result

Absolute Event Rate: 0.055% vs 0.031%

p-value: p=0.047

Older adults at high risk of falling demonstrate increased prefrontal cortical activity and stepping variability during cognitively demanding tasks, suggesting a compensatory mechanism or neural inefficiency.

Limitations

  • High between-subject variability inherent to fNIRS data
  • Lack of MRI mapping for region of interest placement precision
  • Inability to completely rule out superficial blood flow contamination due to lack of short-separation channels
  • Cross-sectional categorization of fall risk based on retrospective falls and physical tests rather than prospective measurement

Cite This Study

Pelicioni et al. (2021) conducted a cross-sectional in Fall risk (n=95). High fall risk vs. Low fall risk was evaluated on Relative oxyhemoglobin (HbO2) concentration in the dorsolateral prefrontal cortex (DLPFC) during the Stroop stepping test (SST) (p=0.047). Older adults at high fall risk exhibited significantly greater dorsolateral prefrontal cortex activity and increased stepping response time variability during a cognitively demanding Stroop stepping task compared to those at low fall risk.

synapsesocial.com/papers/6a7bcc9ea540d02696c29eechttps://doi.org/10.3389/fmed.2021.554231
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A comparison of sensor-based lower extremity reaction times, walking speeds, functional performance, and activity fear in older adults with a history of falls: a cross-sectional study2026
  2. 2Utilization of central nervous system resources for preparation and performance of complex walking tasks in older adults2014 · 109 citations
  3. 3Reactive agility and motor-cognitive assessments for distinguishing community-dwelling older adults with and without a history of falls: a dual-centre cross-sectional study2026
  4. 4Hemodynamic and Behavioural Changes in Older Adults During Cognitively Demanding Dual-Tasks2020
  5. 5Age-Related Associations Between Reactive-Balance Stepping Responses, Self-Induced Stepping and Gray Matter Volume2026 · 1 citations