Continuous Cognitive Task Promotes Greater Postural Stability than an Internal or External Focus of Attention in Older Adults.

Background/Study Context: Recent evidence suggests that removing attention from postural control using either an external focus or a cognitive task will improve stability in healthy young adults. Due to increases in attentional requirements of upright stance in older adults, it is unclear if similar benefits would be observed in this population. The aim of the present study was to examine the effect of attentional focus and of a continuous cognitive task on postural control in older adults.

METHODS: Sixteen healthy older adults (71.9 ± 4.32 years) were asked to stand quietly on a force platform with feet together in three different conditions: internal focus (minimizing movement of the hips), external focus (minimizing movement of markers placed on the hips), and cognitive task (silently counting the occurrence of a single digit in a 3-digit number sequence). A one-way analysis of variance with repeated measures on condition was performed for each postural control measure.

RESULTS: Hypotheses were partially supported because the cognitive task led to greater stability than both focus conditions, as evidenced by a smaller sway area (p < .01, ηp(2) = .41), reduced sway variability (anterior-posterior: p = .001, ηp(2) = .37; medial-lateral: p < .0001, ηp(2) = .49), and higher mean power frequency in the anterior-posterior direction (p = .01, ηp(2) = .78). However, no difference was observed between internal and external focus conditions.

CONCLUSIONS: A continuous, attention-demanding cognitive task significantly improved stability in older adults compared with an internal or external focus of attention. This suggests that older adults were able to effectively allocate their attention away from postural control, allowing a more automatic type of control to operate. Future studies should investigate a variety of cognitive tasks to determine the degree of postural improvement that can be observed in older adults.