By Kathryn Doyle
NEW YORK (Reuters Health) - Older adults who tried special brain training computer games had better gait and balance than their peers afterward, in a new study.
Walking requires people pay attention and use other thinking skills. In theory, slips and falls are more common for older people not only due to physical frailty, but to mental aging as well.
"Participants in this study were on average 83 years old," Renae L. Smith-Ray said. "Because we know that degradation occurs with aging, in older participants we often consider interventions successful when they prevent or slow future decline."
Smith-Ray led the study at the Center for Research on Health and Aging at the University of Illinois at Chicago. She found the computer games did just that: they slowed the decline of people's balance and walking speed.
The researchers randomly split 51 men and women age 70 and older into two groups. People in one group used the computer-based brain training program InSight for 10 weeks. Those in the other group were monitored but didn't do anything new.
Participants in the computer group played three games: "Road Tour," "Jewel Diver" and "Sweep Seeker." The games were designed to train visual and spatial memory and quick decision-making.
"Walking is a relatively automated task for younger adults but becomes less automated for older adults," Smith-Ray told Reuters Health.
"For instance, when walking down a busy street visuospatial processing is required to identify cracks or tripping hazards in the sidewalk, inhibition is required to tune out the distraction of children running and throwing a ball down the block and attention is required while watching traffic and responding to signals."
The computer group met in a classroom three times a week for one-hour sessions with the games.
At the end of ten weeks, participants who played the games were able to get up from a seated position and begin walking a couple of seconds faster than those in the comparison group, on average. They had been in similar shape at the beginning of the study.
But the computer game players didn't walk a 10-meter (33-foot) course any faster than other participants, whether they were distracted or not, at the end of the study.
The researchers also looked specifically at 30 of the slowest walkers, who initially took nine seconds or longer to walk 10 meters.
For slow walkers, walking speed and walking speed while distracted were both better in the computer game group at the end of the study, according to results published in The Journals of Gerontology: Series B.
Still, the researchers can't yet say if this improvement would be noticeable for most people in their daily lives or if the games would actually help prevent falls.
They also didn't include people with dementia or known learning problems in the study, so the results can't be widely generalized, Dr. Alfonso Fasano said.
Fasano studies Parkinson's disease and age-related conditions at the Neurology Institute of Università Cattolica del Sacro Cuore in Rome. He was not involved in the new research.
"Another important limitation of this study is that the outcomes were assessed immediately post-training, but the major obstacle to training in elderly is the decay of the improvement over time," Fasano told Reuters Health.
"The authors should have seen the long-term outcome, also assessing the number of falls and near-falls," he said.
The InSight program was developed by scientists for Posit Science. The InSight program for two people can be purchased commercially for $90.
"Executive functions are the cognitive processes that make us uniquely human and control our ability to plan, set goals and make good decisions," Smith-Ray said.
"The cognitive training program we used targets executive functions, which is why participants who were randomized to the intervention performed better on walking while distracted and balance than participants randomized to the control group," she said.
"Another important feature of any good cognitive training program, including the Posit Science program, is that it adapts to the users' performance: when the participant becomes better at the task, the task becomes more difficult so that the participant is constantly challenged."
But that's still only one part of the picture, Smith-Ray said.
Physical changes in the brain influence mobility, and there is also evidence for a "cognitive reserve," she said. That means years of regular physical and social activity can help to slow cognitive decline.
"The best way to enable healthy cognitive aging is by regularly challenging your brain," she said.
SOURCE: http://bit.ly/1aJPBxm The Journals of Gerontology: Series B, online November 5, 2013.