By Lisa Rapaport

(Reuters Health) – Older women with thinning bones may have a steadier gate and a lower risk of falls when they practice balance training and thinking tasks at the same time, a small Swedish study suggests.

Walking becomes less automatic and requires more concentration as people age, the researchers note in Gait & Posture. And as older adults devote more attention to walking itself, they can be more apt to miss things around them like an icy patch of sidewalk or a loose carpet that might cause a fall.

For the current study, researchers tested the effects of dual-task balance training, or exercises that demand both physical and mental attention, like walking on uneven services while doing math problems. The 95 women who enrolled in the study all had osteoporosis and a fear of falling or a history of falls. Researchers randomly assigned them either to do dual-task balance training three times weekly for 12 weeks, or to stick with usual physical activities.

At the end of the experiment, women who did dual-task balance training could walk faster than participants in the control group. In particular, they showed improvement in the rhythm of their walking gait, with reduced time between steps.

The dual-task balance training produced greater improvements in gait for situations requiring both coordination and sustained attention, like stepping around obstacles, than it did for “single-task” situations like walking in a straight line in an empty room.

The results “support the notion of the role of cognitively demanding balance training for the maintenance of safe and efficient gait in older women with osteoporosis,” said study coauthor David Conradsson of the Karolinska Institute in Stockholm, Sweden.

“Performing two tasks at the same time (e.g. walking and a cognitive task) is a promising training modality to exercise the brain and the body at the same time,” Conradsson said by email. “In daily life, this could be achieved by solving cognitive tasks during a daily walk or a daily activity.”

While older men can develop osteoporosis, or thinning bones that are more easily fractured, women are particularly vulnerable because of hormonal changes as they age. Lower estrogen production during menopause and afterward can curb production of new bone tissues, increasing the risk of osteoporosis over time.

All of the women in the current study were at least 65 years old and lived independently. Researchers excluded women with cognitive impairment or recent fractures.

Beyond its small size, another limitation of the study is that many women failed to complete the experiment. There were 95 participants to start and just 68 by the end. The study also focused on which aspects of gait the dual-task training improved, and did not test the effect of single-task balance training.

Even so, the results add to the evidence already suggesting that balance training can help improve balance and mobility in women with osteoporosis, said Saija Karinkanta, a researcher at the UKK Institute for Health Promotion Research in Tampere, Finland, who wasn’t involved in the study.

“Dual-task balance and gait training is useful for everyone, especially when getting older or having mobility problems,” Karinkanta said by email.

“People with osteoporosis should include balance training in their weekly training program, and at least part of the balance exercise should be done using dual-task situation,” Karinkanta advised.

People who haven’t tried balance training before might want to focus first on mobility and coordination before layering on cognitive tasks, Karinkanta said.

“Regular and progressive multi-component exercise, including balance, muscle strength and aerobic exercise, is the assured way to improve physical functioning and prevent falls and injuries,” Karinkanta added.

SOURCE: Gait & Posture, online January 4, 2019.