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Journal of Speech, Language, and Hearing Research : JSLHR logoLink to Journal of Speech, Language, and Hearing Research : JSLHR
. 2023 Sep 6;66(10):4052–4065. doi: 10.1044/2023_JSLHR-23-00198

An Exploratory Study of Walking, Listening, and Remembering in Younger and Middle-Aged Adults

Karen S Helfer a,✉, Richard van Emmerik b, Richard L Freyman a, Jacob J Banks b
PMCID: PMC10713016  PMID: 37672796

Abstract

Purpose:

The purpose of this study was to assess how needing to listen and remember information while walking affects speech perception, memory task performance, and gait in younger and middle-aged adults.

Method:

Four gait parameters (stride duration, step variability, whole-body center of mass acceleration, and mediolateral head acceleration) were measured when younger and middle-aged participants stood or walked on a treadmill while they simultaneously completed a speech-on-speech perception task and a preload memory task, singly and in combination.

Results:

Speech perception was significantly poorer for middle-aged than for younger participants. Performance on the speech perception measure did not differ significantly between walking and standing for either group of participants, but the additional cognitive load of the memory task reduced performance on the speech perception task. Memory task performance was significantly poorer when combined with the speech perception task than when measured in isolation for both participant groups, but no further declines were noted when participants were also walking. Mediolateral head acceleration, which has been linked to loss of balance, was significantly greater during multitask trials, as compared to when participants were only walking without being required to listen or remember. Post hoc analysis showed that dual- and multitask influences on mediolateral head acceleration were more prominent for middle-aged than for younger participants. Stride duration was longer in the multitask condition than when participants were only walking.

Conclusions:

Results of this exploratory study indicate that gait may be impacted when individuals (both younger and middle-aged) are listening and remembering while walking. Data also substantiate prior findings of early age-related declines in the perception of speech in the presence of understandable speech maskers.

People who are middle aged often report more difficulty with speech understanding in real-world environments than would be expected based on their clinical and laboratory test results (Bainbridge & Wallhagen, 2014; Helfer et al., 2017). One possible reason for this discrepancy is that listening is more effortful for middle-aged adults than for younger adults—they may be able to achieve normal or near-normal performance on clinical tests but need to exert more effort to do so.

Multiple experimental paradigms can be used to assess listening effort, including subjective ratings, deterioration in performance when simultaneously completing a secondary task (dual-task costs), and pupillometry. Research suggests that each of these approaches taps into different dimensions of listening effort (e.g., Alhanbali et al., 2019; Strand et al., 2018). The current work focuses on dual-task measures. The premise for using a dual-task paradigm as a means of assessing effort is that individuals have a limited pool of cognitive resources. The more resources one task consumes, the fewer are available to support successful completion of another task (Broadbent, 1958; Kahneman, 1973). For example, prior work has found reductions in performance on secondary tasks when presented concurrently with a speech perception task for middle-aged adults (e.g., Cramer & Donai, 2019; Degeest et al., 2015). Critically, performance on the speech perception task (which participants typically are instructed to prioritize) changes little with the addition of the secondary task.

Many secondary tasks used in dual-task studies of listening effort, such as recognizing a pattern presented vibrotactically to the skin (Gosselin & Gagné, 2011) or tracking a moving object on a touch screen with a finger (Xia et al., 2015), fulfill the primary experimental purpose of estimating listening effort but are not relevant to real-life situations. However, conversation often takes place while people are engaged in other normal activities of daily life. This study focuses on the fact that people are often in motion (i.e., walking) while listening. Specifically, we ask whether walking mechanics are affected when participants need to understand and recall speech while they are walking.

Walking under attention-demanding conditions (such as on irregular surfaces or in the presence of obstacles) can lead to instability and falling as people age (e.g., Hausdorff et al., 1997; Verghese et al., 2009). A relatively large body of research has demonstrated that safe walking also may be challenged when individuals (especially older adults) are completing a concurrent cognitive task (see comprehensive reviews by Al-Yahya et al., 2011, and Smith et al., 2017) and that gait changes during dual-tasking are associated with risk of falls in older adults (e.g., Herman et al., 2010; Kressig et al., 2008). Examples of cognitive tasks that may interfere with walking include serial subtraction (Brustio et al., 2017; Commandeur et al., 2018), verbal fluency (Dubost et al., 2006), serial recall (Lindenberger et al., 2000), and spelling words backward (Bonetti et al., 2019; Hollman et al., 2007). Most relevant to this study is recent work documenting that speech understanding while walking also negatively impacts walking mechanics in older adults (Nieborowska et al., 2019).

Relatively little work in this area has been conducted with middle-aged adults, even though speech perception in challenging acoustic environments (especially those with competing talkers) can be more difficult and effortful for middle-aged adults, as compared to younger adults (e.g., Başkent et al., 2014; Cameron et al., 2011; Helfer & Freyman, 2014, 2016). Changes in postural control and walking mechanics also can be demonstrated in middle-aged adults (Choy et al., 2003; Goossens et al., 2017; Ku et al., 2016; Park et al., 2016; Van Emmerik et al., 2005). Collectively, these findings lead us to question what happens when people in this age range are asked to perform speech perception and motor control tasks at the same time. Prior work from our lab has established that dual-task costs in postural control measured while standing can be seen in middle-aged adults when they are concurrently completing a difficult listening task (Helfer, Freyman, et al., 2020; Helfer, van Emmerik, et al., 2020). These results extend the work of others that have noted larger dual-task costs involved in walking while completing a cognitive task in middle-aged (vs. younger) adults (Brustio et al., 2017; Hollman et al., 2007; Lindenberger et al., 2000). The purpose of this study was to further expand this line of questioning to examine walking while listening.

While there is a body of work documenting dual-task costs associated with listening, relatively little attention has been paid to multitasking, that is, completing more than one additional task along with listening. A recent paper by Devesse et al. (2020) assessed dual- and multitask performance in middle-aged adults. Auditory–visual speech perception in noise was the primary task, which was measured in isolation and with one, two, or three other tasks: an auditory localization task, a task requiring detection of the direction of movement of an auditory stimulus, and a visual short-term memory task. Performance of middle-aged participants with normal hearing was compared to that of younger adults. Results indicated that middle-aged adults performed more poorly than younger adults during multitask (but not dual-task) conditions for the visual memory task and for the auditory localization task. Similar results were found by this research group in a follow-up study with older adults (Devesse et al., 2021). Interestingly, the negative impact of dual- and multitasking did not differ between groups of older participants with and without hearing loss.

The present study incorporated a preload memory task at the onset of some trials in order to examine multitask performance. In a preload memory task, participants see or hear stimuli that they must hold in memory while completing another task. Prior work has shown that preload memory tasks can increase extrinsic cognitive load and can have an adverse effect on speech understanding (e.g., Hunter & Pisoni, 2018; Mattys & Wiget, 2011). In addition to depleting the available resources needed to successfully complete the second task, preload memory paradigms also limit the extent to which individuals can rehearse the to-be-remembered stimuli.

Justification for including a preload memory task in this study is supported by results of a meta-analysis showing that dual-task costs while walking are most apparent when using tasks that require mentally holding information that later needs to be recalled (Smith et al., 2016). We hypothesized that overall task demands would be higher on trials that include the memory task, thereby making it easier to identify changes in walking mechanics that occur from listening while walking. And because short-term memory changes can be demonstrated in middle-aged adults (e.g., Vercammen et al., 2017), we anticipated that the addition of the memory task would be particularly impactful for these participants. Although we incorporated the memory task primarily to increase the overall cognitive load during some trials, it should be noted that it is not uncommon for people to conduct mentally engaging tasks while walking (e.g., needing to remember information a friend tells you while you are taking a walk).

The experiment described in this article was a novel, exploratory study that roughly simulated this type of real-life communication situation. Younger and middle-aged participants' understanding of sentences presented in the presence of competing speech was assessed while they were standing and while they were walking at a comfortable pace on a treadmill. During some trials, a preload memory task also was incorporated in which a sequence of to-be-remembered numbers and letters was presented visually before the onset of the speech stimuli. Based on previous research, we hypothesized that performance on the listening task would be relatively unaffected by walking but would be compromised during multitask trials that incorporated the preload memory task. We also predicted that the preload memory task would interfere with walking, especially during multitask trials when the concurrent speech perception task was made more difficult by decreasing the signal-to-noise ratio (SNR), consistent with results from our lab demonstrating that balance was more greatly influenced when a concurrent listening task was completed at a more difficult SNR (Helfer, van Emmerik, et al., 2020). Finally, we hypothesized that any negative impact of listening and remembering on walking mechanics would be more apparent for middle-aged than for younger adults.

Materials and Method

Participants

Participants were recruited via advertisements within the university and the surrounding communities. Potential participants were prescreened (via a questionnaire) for neurologic, otologic, or other disorders that can affect hearing, balance, or walking. All participants reported that English was their first language and had self-reported normal or corrected-to-normal vision. This project was approved by the University of Massachusetts Institutional Review Board (Protocol ID# 1041). Each participant provided informed written consent.

Two groups of individuals participated in this study. Each group initially had 14 participants. However, data from one of the younger participants could not be scored because of technical issues, so this article describes results from 13 younger participants and 14 middle-aged participants (it should be noted that the COVID-19 pandemic impeded data collection for this study). The middle-aged group consisted of adults 46–63 years of age (M = 55.50 years; two men). The better ear high-frequency pure-tone average (HFPTA; thresholds 2 kHz to 6 kHz) for this group ranged from −1 to 33 dB HL (M = 13.48 dB HL). The second group consisted of young adults 19–25 years of age (M = 21.23 years; two men). Young adult participants all had normal pure-tone thresholds (with better ear HFPTA ranging from −5 to 14 dB HL; M = 1.23 dB HL). Figure 1 shows composite pure-tone thresholds for the two age groups.

Figure 1.

Two graphs of d B H L versus frequency in kilohertz for young adults and middle-aged adults. Graph 1 for young adults. The values range between 0 and 10. The highest is 25 at 3, and the lowest is negative 10 at 2. Graph 2 for middle-aged adults. The line is constant at 10 from 0.25 to 2. It drops 20at 6 and to 28 at 8. The highest value is 65 and the lowest is 5. Values are estimated.

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Mean pure-tone thresholds (black solid lines) for the younger (top panel) and middle-aged (bottom panel) groups. Hatched marks represent the highest and lowest values.

Procedure

Participants completed three experimental tasks, singly and in combination. Speech perception was measured using the TVM-C sentences (Helfer et al., 2016). Each of these sentences has the same syntactic structure, with four key words used for scoring (e.g., “Victor found the green ticket and the cute smile here,” with key words underlined). Sentences were recorded from three male and three female talkers (see Helfer et al., 2016, for additional details about this corpus). Stimuli were presented from three loudspeakers (front, 45° to the right, and 45° to the left) adjusted to each participant's standing ear height. Target sentences were presented from the front loudspeaker. The masker also consisted of TVM-C sentences, one presented from the right loudspeaker and another from the left loudspeaker. On each trial, the three sentences presented (i.e., one target and two maskers) were from three different talkers, all either male or female. The maskers were presented in a looped fashion in which each sentence began at a random point in a sentence, with the beginning of the sentence appended to the end. Target sentences were presented at 68 dBA, and maskers were presented at levels (total combined across the two maskers) of 68 and 74 dBA to create two SNRs of 0 and −6 dB, respectively. Participants were instructed to repeat back the target sentence. Their responses were audio-recorded and analyzed off-line.

A preload memory task was incorporated on some trials. Participants were shown a sequence of four alternating letters and numbers (e.g., N6R2) on a video monitor, mounted on a wall approximately 1.25 m away from the participant at eye level, immediately before the presentation of the target and masking speech stimuli. During these trials they were instructed to first repeat back the target sentence and then recall the visually presented letter/number sequence. Participants were told to put equal effort into the speech perception task and the memory task.

Speech perception and memory task performance were assessed while participants were walking on a treadmill (WOODWAY Pro 27) and while they were standing. During standing trials, participants stood on a board that straddled the running treadmill belt in order to account for the noise produced by the treadmill. All walking trials were conducted at each participant's preferred speed. Preferred walking speed was determined by completing a protocol (Ducharme et al., 2018; Jordan et al., 2007) in which the treadmill belt speed was gradually increased from 0 m/s until the participant indicated that this was their preferred walking speed, defined as the pace they would walk if they were neither rushing nor taking a leisurely stroll. The speed was then increased by 0.13 m/s and decreased in 0.04-m/s decrements until participants again judged that they were walking at their preferred speed. This procedure was repeated until two values of preferred speed within 0.13 m/s were determined for each participant.1 Once a preferred walking speed was established, participants then walked for 2 min at their preferred speed to acclimatize to the treadmill.

Gait metrics were measured with inertial sensors (APDM Wearable Technologies) placed on participants' forehead and posteriorly over the spinous process of the L5 vertebrae using elastic straps. The L5 vertebrae location was selected to generally represent the whole-body center of mass (CoM). Each sensor obtained and recorded the linear acceleration from three orthogonal axes. To reach a steady gait, participants began walking approximately 30 s before the first item in a block of sentences was presented. Participants were instructed to look forward during the entire experiment.

Prior to data collection, a practice block of four trials was conducted with all three tasks (speech perception, memory, and walking). The practice trials were followed by the presentation of six types of experimental conditions: (a) speech perception while standing, (b) speech perception + walking, (c) speech perception + memory while standing, (d) speech perception + memory + walking, (e) walking only, and (f) memory + walking. Trials that incorporated the speech perception task were presented in blocks of 12 sentences, corresponding to 48 key words used to calculate percent correct performance in each condition. Walking-only and memory + walking blocks were 150 s, approximately the same duration as blocks that incorporated speech perception. Each of the six types of conditions was completed using two different masker levels (68 and 74 dBA). One block of 12 sentences was completed in each of the 12 conditions (6 condition types × 2 noise levels), and blocks were presented in random order.

Data Analysis

Speech perception was quantified as the proportion of correctly repeated key words from the target sentences. Performance on the memory task was considered correct if participants recalled all four numbers/letters in any order and was deemed incorrect if they missed one or more numbers/letters in the sequence.

Several gait parameters were assessed that reflect possible lower and upper body changes changes during walking: stride duration (in seconds), step variability (in seconds), CoM acceleration (in meters/second2 [m/s2]), and mediolateral head acceleration (m/s2). Stride duration and step variability are overall gait measures that have been shown to be sensitive to age-related changes (Hausdorff et al., 1997). CoM and head acceleration were assessed in the mediolateral direction, as this has been associated with age-related loss of balance (Maki et al., 1994). To calculate these measures, accelerations were first filtered using a zero-lag 3.5-Hz low-pass fourth-order Butterworth filter. Each step was then estimated from the peak-to-peak timing of the resultant acceleration. Average stride duration was defined as twice the average step duration. Step variability was calculated as the standard deviation of all step times. CoM and mediolateral head acceleration measures were calculated as their root-mean-square value. All gait parameters were calculated for the duration of each condition. Outliers in the gait variable metrics that were greater than 2 SDs from the mean were eliminated prior to analysis.

Results of the statistical analyses can be found in Appendix A. Data for the speech perception and gait metrics were analyzed using repeated-measures analysis of variance (ANOVA) with task type (performance on the measure of interest when it was performed alone or when it was completed with one or two of the other tasks) and SNR (0 or −6 dB) as within-subject factors and participant group (younger or middle-aged) as a between-subjects factor. Effect sizes were estimated via Cohen's d. Significant effects (α < .05) were further explored post hoc using paired-samples t tests (Bonferroni corrected for multiple comparisons). Memory task data were found to be significantly skewed and were therefore analyzed using nonparametric statistics (Mann–Whitney U test and Wilcoxon signed-ranks test).

Results

Speech Perception

Performance on the speech recognition task is shown in Figure 2. A repeated-measures ANOVA was completed with task type (speech perception only while standing vs. speech perception while standing + memory task vs. speech perception + walking vs. speech perception + walking + memory task) and SNR (0 and −6 dB SNR) as within-subject factors and participant group as a between-subjects factor. All three main effects (i.e., task type, SNR, and group) were statistically significant, with no significant interactions. Speech recognition scores were, on average, 20 percentage points poorer in middle-aged participants than in younger participants, F(1, 24) = 34.01, p < .001, ηp2 = .57. As anticipated, performance was significantly poorer at −6 dB SNR versus 0 dB SNR, F(1, 24) = 128.27, p < .001, ηp2 = .84. The effect of task type also was significant, F(3, 22) = 5.53, p = .006, ηp2 = .43. Post hoc paired-samples t tests (corrected for multiple comparisons) indicated that adding the memory task to the speech perception task led to a reduction in performance during both standing, t(25) = −4.08, p < .001, ηp2 = .80, and walking, t(25) = 3.52, p < .001, ηp2 = .69.

Figure 2.

Two box-and-whisker plots for speech perception performance by task condition. 1. Speech perception negative 6 d B S N R. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. Middle age. S P only. 40, 39.5, 29, 48, 20, 61. S P + memory. 32, 30, 23, 40, 7, 50. S P + walking. 43, 45, 38, 50, 29, 61. S P + memory + walking. 43, 45, 38, 50, 29, 61. Younger. S P only. 62, 62, 51, 73, 40, 80. S P + memory. 57, 55, 41, 71, 40, 80. S P + walking. 59, 60, 50, 71, 41, 77. S P + memory + walking. 59, 60, 50, 71, 41, 77. 2. Speech perception 0 d B S N R. Middle age. S P only. 63, 63, 56, 72, 40, 79. S P + memory. 50, 50, 39, 60,31, 80. S P + walking. 60, 60, 55, 67, 38, 78. S P + memory + walking. 52, 50, 44, 60, 31, 80. Younger. S P only. 80, 79, 72, 88, 68, 91. S P + memory. 71, 71, 68, 82, 58, 90. S P + walking. 76, 79, 73, 80, 65, 86. S P + memory + walking. 75, 80, 65, 82, 55, 91. All values are approximated.

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Speech perception performance by task condition measured at −6 dB SNR (top panel) and 0 dB SNR (bottom panel). Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “×” within each box, and the horizontal line within each box shows the median. Whiskers indicate the range of nonoutlier values. SP = speech perception; Mem = memory task; Walk = walking.

Memory Task

Percent correct memory task performance for the letter/number sequences is shown in Figure 3. Performance on this task was near ceiling for both groups when participants were not also asked to perform the speech recognition task. Because memory task scores were not normally distributed, Mann–Whitney U tests were used to determine whether the two groups differed in any condition. Results indicated that all comparisons were nonsignificant, with p values between .094 and .720 (see Appendix A). However, memory task performance was influenced by task type. Wilcoxon signed-ranks tests comparing performance between conditions found that memory task scores decreased significantly when participants were also completing the speech perception task (see Appendix A). Neither SNR nor walking significantly affected memory task scores.

Figure 3.

Two box-and-whisker plots. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. 1. Memory task negative 6 d B S N R. Middle age. Walking + memory. 90, 91, 91, 100, 82, 100. S P + memory. 35, 34, 25, 41, 18, 50. Walking + S P + memory. 40, 39, 25, 51, 18, 68. Younger. Walking + memory. 95, 91, 91, 100, 82, 100. S P + memory. 45, 50, 25, 59, 0, 76. Walking + S P + memory. 45, 50, 32, 59, 18, 68. 2. Memory task 0 d B S N R. Middle age. Walking + memory. 89, 96, 92, 100. S P + memory. 37, 38, 22, 50, 9, 50. Walking + S P + memory. 39, 41, 31, 50, 25, 68. Younger. Walking + memory. 96, 91, 100. S P + memory. 50, 50, 25, 70, 9, 91. Walking + S P + memory. 56, 50, 38, 79, 18, 91. All values are approximated.

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Memory task performance by task condition measured at −6 dB SNR (top panel) and 0 dB SNR (bottom panel). Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “×” within each box, and the horizontal line within each box shows the median. Whiskers indicate the nonoutlier minimum and maximum values. SP = speech perception; Mem = memory task; Walk = walking.

Walking Metrics

Stride Duration

Figure 4 shows stride duration as a function of task and SNR across the two participant groups. Repeated-measures ANOVA indicated a significant effect of task, F(3, 23) = 4.20, p = .017, ηp2= .35, with stride duration longer in the multitask condition than when participants were just walking, t(26) = −3.67, p < .001, ηp2 = .71. None of the main or interaction effects involving SNR or group were significant.

Figure 4.

Two box-and-whisker plots. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. 1. Stride Duration negative 6 d B S N R. Middle age. Walk. 1.18. 1.18. 1.11. 1.23. 1.01. 1.35. Walk + S P. 1.18. 1.18. 1.10. 1.23. 1.01. 1.32. Walking + memory. 1.17. 1.18. 1.13. 1.22. 1.00. 1.29. Walking + S P + memory. 1.18. 1.16. 1.10. 1.27. 1.02 1.32. Younger. Walk. 1.15. 1.16. 1.10. 1.18. 1.04. 1.21. Walk + S P. 1.15. 1.16. 1.10. 1.20. 1.07. 1.24. Walking + memory. 1.15. 1.15. 1.11. 1.20. 1.05. 1.24. Walking + S P + memory. 1.15. 1.16. 1.10. 1.22. 1.05. 1.24. 2. Stride duration 0 d B S N R. Middle Age. Walk. 1.18. 1.18. 1.12. 1.23. 1.01. 1.29. Walk + S P. 1.18. 1.18. 1.15. 1.24. 1.09. 1.32. Walking + memory. 1.17. 1.17. 1.12. 1.23. 0.99. 1.29. Walking + S P + memory. 1.19. 1.19. 1.13. 1.23. .103. 1.32. Younger. Walk. 1.15. 1.16. 1.10. 1.18. 1.05. 1.21. Walk + S P. 1.14. 1.14. 1.10. 1.21. 1.06. .1.22. Walking + memory. 1.14.1.14. 1.10. 1.21. 1.07. 1.24. Walking + S P + memory. 1.15. 1.16. 1.10. 1.22. 1.15. 1.23. All values are estimated.

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Stride duration by task condition measured at −6 dB SNR (top panel) and 0 dB SNR (bottom panel). Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “×” within each box, and the horizontal line within each box shows the median. Whiskers indicate the nonoutlier minimum and maximum values. SP = speech perception; Mem = memory task; Walk = walking.

Step Variability

The ANOVA on the step variability data indicated that none of the main or interaction effects were significant. Performance on this task can be seen in Appendix B.

CoM Acceleration

Although there was a significant three-way interaction between task type, SNR, and group, F(3, 23) = 4.00, p = .020, ηp2 = .34, for the CoM data, post hoc t tests indicated that none of the comparisons of interest reached statistical significance. CoM data can be found in Appendix C.

Mediolateral Head Acceleration

Mediolateral head acceleration data are shown in Figure 5. The main effect of task type was significant, F(3, 22) = 11.91, p < .001, ηp2 = .53, with head acceleration in the multitask condition being greater than when participants were only walking, t(26) = 2.69, p = .006, ηp2 = .52. While SNR did not significantly impact head acceleration, the main effect of group approached statistical significance (p = .064). We suspected that using a complex statistical model obscured what appeared to be important group differences in head acceleration. We therefore conducted a post hoc analysis of mediolateral head acceleration in the two participant groups separately. While repeated-measures ANOVA for the young participant group showed no significant findings, the effect of task type was significant for middle-aged participants, F(3, 11) = 11.91, p < .001, ηp2 = .77. Post hoc t tests indicated that, in this group, adding the memory task while participants were walking increased mediolateral head acceleration, relative to when they were only walking, t(13) = 3.27, p = .003. Moreover, in the middle-aged group, mediolateral head acceleration in the multitask condition was greater than when participants were only walking, t(13) = 4.67, p < .001.

Figure 5.

Two box-and-whisker plots. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. 1. Head acceleration negative 6 d B S N R. Middle age. Walk. 0.90. 0.95. 0.70. 1.05. 0.50. 1.05. Walk + S P. 1.00. 1.00. 0.90. 1.10. 0.65. 1.30. Walking + memory. 0.95. 0.90. 0.80. 1.15. 0.65. 1.65. Walking + S P + memory. 1.15. 1.15. 0.85. 1.20. 0.60. 1.65. Younger. Walk. 0.75. 0.65. 0.50. 0.90. 0.45. 1.30. Walk + S P. 0.80. 0.80. 0.60. 1.10. 0.40. 1.40. Walking + memory. 0.80. 0.85. 0.40. 1.10. 0.35. 1.30. Walking + S P + memory. 1.10. 1.10. 0.90. 1.21. 0.60. 1.50. 2. Head acceleration 0 d B S N R. Middle Age. Walk. 0.80. 0.90. 0.65. 0.90. 0.45. 1.10. Walk + S P. 0.90. 0.90. 0.85. 1.00. 0.60. 1.20. Walking + memory. 0.90. 0.95. 0.80. 1.10. 0.60. 1.40. Walking + S P + memory. 1.10. 1.10. 0.90. 1.25. 0.60. 1.50. Younger. Walk. 0.75. 0.70. 0.50. 0.95. 0.45. 1.20. Walk + S P. 0.80. 0.80. 0.60. 1.00. 0.50. 1.40. Walking + memory. 0.80. 0.80. 0.70. 0.90. 0.45. 1.15. Walking + S P + memory. 0.90. 0.95. 0.65. 1.10. 0.35. 1.40. All values are estimated.

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Head acceleration by task condition measured at −6 dB SNR (top panel) and 0 dB SNR (bottom panel). Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “×” within each box, and the horizontal line within each box shows the median. Whiskers indicate the nonoutlier minimum and maximum values. SP = speech perception; Mem = memory task; Walk = walking.

Discussion

We initially hypothesized the following: Performance on the listening task would not be influenced by walking but would be adversely affected during multitask trials; adding the memory task would negatively influence gait, and this effect would be more apparent when participants were listening in the more adverse SNR condition; and we would be more likely to identify negative effects of listening and remembering on walking in middle-aged (rather than in younger) adults. Results of this study provide only partial support for our hypotheses.

First, as predicted, performance on the speech perception task was not impacted by the addition of the walking task. This result is consistent with other work indicating that during dual-task studies with middle-aged adult participants, speech perception typically is unaffected (Cramer & Donai, 2019; Degeest et al., 2015; Devesse et al., 2020). In this study, the walking metrics also did not significantly change between walking-only and speech perception + walking trials. Moreover, decreasing the SNR did not impact walking metrics. The lack of an effect of SNR on gait is in opposition to both our predictions and previous work that showed greater dual-task costs on walking and balancing tasks when listening was made more difficult by changing the SNR (Devesse et al., 2021; Helfer, van Emmerik, et al., 2020). Perhaps the most parsimonious explanation for this lack of an effect is that walking at a comfortable pace on a treadmill is not taxing enough to detect any changes in listening effort brought about by a more adverse SNR. It also is possible that difficulty of the listening task did not influence walking metrics because walking and listening tap into different domains of resources, leading to a lack of interference (although, as noted above, other studies have found dual-task costs when listening is combined with motor control tasks).

A somewhat different story emerges when examining the effect of adding the preload memory task. Speech perception performance declined when participants were asked to also complete the memory task. Moreover, memory task performance was much poorer when participants were also completing the speech perception task, regardless of whether participants were standing or walking. Walking did not further increase the toll from completing the speech perception task and the memory task together, again perhaps because our walking task was not difficult enough or because our paradigm did not produce cross-modal interference.

Two of the gait metrics were found to be sensitive to the multitask condition. Stride duration was shorter when participants were only walking versus when they were walking while also completing both the memory task and the speech perception task. Mediolateral head acceleration also increased as task demands increased, with the largest values found in the multitask condition for both participant groups. However, post hoc analyses suggested that this finding was driven by data from middle-aged participants, who also showed significant dual-task increases in mediolateral head acceleration in the walking + memory condition. Increased acceleration of the body in the mediolateral direction has been associated with age-related loss of balance (Maki et al., 1994). In addition, Cole et al. (2010) showed that in individuals with Parkinson's disease, those with a propensity for falls had greater mediolateral head motion compared to either those with Parkinson's disease and no history of falls or healthy controls. Our results are consistent with the idea that balance may be compromised in cognitively challenging conditions involving memory and speech perception, especially in middle-aged adults. This finding supports our earlier work showing that, in middle-aged adults, balance while standing is negatively affected when individuals are performing challenging listening tasks (Helfer, Freyman, et al., 2020; Helfer, van Emmerik, et al., 2020).

Of note is that our middle-aged participants (who, for the most part, had no more than mild pure-tone threshold elevation) performed significantly poorer than our younger participants on the speech perception task. An increasingly large body of work supports the idea that listening in the presence of a small number of intelligible speech maskers is more taxing for middle-aged adults than for younger adults, even among people who have clinically normal hearing sensitivity (e.g., Başkent et al., 2014; Cameron et al., 2011; Füllgrabe et al., 2015; Glyde et al., 2013; Goossens et al., 2017; Hannula et al., 2011; Helfer & Freyman, 2014, 2016; Helfer et al., 2018; Helfer & Jesse, 2015; Helfer et al., 2016; Helfer & Vargo, 2009; Shinn-Cunningham et al., 2013; Tremblay et al., 2015; Wiley et al., 1998).

One limitation of our results that needs to be considered is that our gait data were obtained while participants were walking on a treadmill, potentially restricting the ability to find significant differences between groups and conditions. For example, the treadmill did not allow us to examine adjustments to gait speed, which previous work has shown to be particularly sensitive to the effects of dual-task measures (e.g., Smith et al., 2016). It also should be noted that dual-task costs are greater for overground than for treadmill walking, likely because treadmill walking requires less cognitive control (Wrightson et al., 2020).

In summary, results of the current work provide partial support for the idea that gait may be affected when individuals need to listen and remember while walking. While listening itself did not modify gait mechanics in either middle-aged or younger adults, two measures of gait (mediolateral acceleration of the head and stride duration) were impacted when participants needed to both listen to a message and remember information while walking. The present study also found that mediolateral head acceleration was influenced by the memory task alone in middle-aged, but not in younger, participants. Consistent with a body of prior work, speech perception in the presence of intelligible speech maskers was significantly poorer in our middle-aged participants than in our younger participants even though, on average, the middle-aged listeners had no more than a mild pure-tone hearing loss. Future research in this area should focus on further increasing the realism and complexity of motor control paradigms (e.g., with participants walking overland instead of on a treadmill) and test larger participant cohorts to provide a broader understanding of the impact of early aging on the ability to navigate simultaneous communication and motor control tasks.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Acknowledgments

This work was supported by National Institute of Deafness and Other Communication Disorders Grant R01 DC012057, awarded to Karen S. Helfer. The authors thank Michael Rogers and Michael Clauss for their assistance with this project.

Appendix A

Results of Repeated-Measures Analyses of Variance for the Speech Perception and Gait Metrics, and Nonparametric Tests for Memory Task Performance

Variable F p ηp2
Speech recognition
 Task 5.53 .006 .43
 SNR 128.27 < .001 .84
 Group 34.01 < .001 .57
 Task × SNR 0.65 .591 .08
 SNR × Group 0.23 .639 .01
 Task × Group 0.41 .745 .05
 Task × Group × SNR 1.43 .260 .16
Stride duration
 Task 4.20 .017 .35
 SNR 2.24 .147 .08
 Group 1.04 .317 .04
 Task × SNR 0.85 .479 .10
 SNR × Group 0.40 .531 .02
 Task × Group 0.38 .772 .05
 Task × Group × SNR 2.33 .101 .23
Step variability
 Task 1.26 .313 .15
 SNR 0.72 .404 .03
 Group 3.11 .090 .12
 Task × SNR 0.41 .747 .05
 SNR × Group 0.30 .587 .01
 Task × Group 1.35 .284 .16
 Task × Group × SNR 1.51 .239 .17
Center of mass acceleration
 Task 0.14 .933 .02
 SNR 0.17 .684 .01
 Group 0.58 .454 .02
 Task × SNR 0.50 .686 .06
 SNR × Group 0.07 .789 .00
 Task × Group 0.36 .783 .05
 Task × Group × SNR 4.00 .020 .34
Head acceleration
 Task 8.20 < .001 .53
 SNR 0.54 .468 .02
 Group 3.76 .064 .14
 Task × SNR 0.64 .598 .08
 SNR × Group 2.31 .141 .09
 Task × Group 0.98 .420 .12
 Task × Group × SNR 0.39 .765 .05
Variable
Memory task
Between-subjects tests (Mann–Whitney U test) U p
 SP + Mem 0 dB SNR 124.50 .105
 SP + Mem −6 dB SNR 125.50 .094
 Walk + Mem 0 dB SNR 110.00 .375
 Walk + Mem −6 dB SNR 83.50 .720
 Walk + SP + Mem 0 dB SNR 123.50 .116
 Walk + SP + Mem −6 dB SNR 110.00 .350
Within-subjects tests (Wilcoxon signed-ranks test) z p
 SP + Mem 0 dB SNR vs. SP + Mem −6 dB SNR 0.675 .500
 Walk + Mem 0 dB SNR vs. Walk + Mem −6 dB SNR 0.321 .748
 Walk + SP + Mem 0 dB SNR vs. Walk + SP + Mem −6 dB SNR 1.476 .140
 SP + Mem 0 dB SNR vs. Walk + Mem 0 dB SNR 4.428 < .001
 SP + Mem −6 dB SNR vs. Walk + Mem −6 dB SNR 4.402 < .001
 SP + Mem 0 dB SNR vs. Walk + SP + Mem 0 dB SNR 1.225 .221
 SP + Mem −6 dB SNR vs. Walk + SP + Mem −6 dB SNR 0.834 .405
 Walk + Mem 0 dB SNR vs. Walk + SP + Mem 0 dB SNR 4.309 < .001
 Walk + Mem −6 dB SNR vs. Walk + SP + Mem −6 dB SNR 4.337 < .001
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Note. SP + Mem = speech perception + memory; Walk + Mem = walking + memory; Walk + SP + Mem = walking + speech perception + memory; SNR = signal-to-noise ratio.

Appendix B

Step Variability by Task Condition Measured at −6 dB SNR (Top Panel) and 0 dB SNR (Bottom Panel)

Two box-and-whisker plots. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. 1. Step variability negative 6 d B S N R. Middle age. Walk. 0.01. 0.01. 0.01. 0.02. 0.01. 0.03. Walk + S P. 0.02. 0.02. 0.01. 0.02. 0.01. 0.02. Walking + memory. 0.02. 0.02. 0.01. 0.02. 0.01. 0.02. Walking + S P + memory. 0.02. 0.02. 0.01. 0.02. 0.01. 0.02. Younger. Walk. 0.02. 0.02. 0.02. 0.03. 0.01. 0.03. Walk + S P. 0.02. 0.02. 0.01. 0.02. 0.01. 0.03. Walking + memory. 0.02. 0.02. 0.01. 0.02. 0.01. 0.03. Walking + S P + memory. 0.02. 0.02. 0.01. 0.03. 0.01. 0.04. 2. Step variability 0 d B S N R. Middle Age. Walk. 0.02. 0.02. 0.01. 0.02. 0.01. 0.03. Walk + S P. 0.02. 0.02. 0.01. 0.02. 0.01. 0.02. Walking + memory. 0.02. 0.02. 0.01. 0.02. 0.01. 0.03. Walking + S P + memory. 0.02. 0.02. 0.02. 0.01. 0.01. 0.03. Younger. Walk. 0.02. 0.02. 0.01. 0.03. 0.01. 0.04. Walk + S P. 0.02. 0.02. 0.01. 0.02. 0.01. 0.04. Walking + memory. .02. 0.02. 0.01. 0.02. 0.01. 0.03. Walking + S P + memory. 0.02. 0.02. 0.01. 0.03. 0.01. 0.03. All values are estimated.

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Note. Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “x“ within each box, and the line within each box shows the median. Whiskers indicate the nonoutlier minimum and maximum values. SP = speech perception; Mem = memory task; Walk = walking.

Appendix C

Center of Mass (CoM) Accelaration by Task Condition Measured at −6 dB SNR (Top Panel) and 0 dB SNR (Bottom Panel)

Two box-and-whisker plots. The following values are given for mean, median, twenty fifth percentile, seventy fifth percentile, minimum and maximum. 1. C o M acceleration negative 6 d B S N R. Middle age. Walk. 1.10. 1.10. 0.90. 1.15. 0.70. 1.50. Walk + S P. 1.00. 1.00. 0.90. 1.10. 0.80. 1.40. Walking + memory. 1.00. 1.00. 0.90. 1.10. 0.70. 1.40. Walking + S P + memory. 1.10. 1.10. 0.80. 1.20. 0.70. 1.50. Younger. Walk. 1.05. 1.10. 1.00. 1.20. 0.90. 1.50. Walk + S P. 1.10. 1.10. 1.00. 1.25. 0.70. 1.50. Walking + memory. 1.10. 1.10. 1.05. 1.20. 0.80. 1.35. Walking + S P + memory. 1.00. 1.00. 0.95. 1.25. 0.85. 1.15. 2. C o M acceleration 0 d B S N R. Middle Age. Walk. 1.00. 1.00. 0.85. 1.20. 0.60. 1.40. Walk + S P. 1.10. 1.10. 1.00. 1.20. 0.70. 1.50. Walking + memory. 1.00. 1.00. 0.80. 1.20. 0.65. 1.50. Walking + S P + memory. 1.00. 1.00. 0.90. 1.15. 0.80. 1.50. Younger. Walk. 1.10. 1.10. 0.90. 1.35. 0.50. 1.70. Walk + S P. 1.10. 1.00. 0.70. 1.20. 0.80. 1.60. Walking + memory. 1.10. 1.10. 0.90. 1.30. 0.60. 1.40. Walking + S P + memory. 1.10. 1.15. 0.75. 0.30. 0.80. 1.70. All values are estimated.

Open in a new tab

Note. Each box is bounded by the 25th and 75th percentiles. The mean value is denoted by the “x“ within each box, and the horizontal line within each box shows the median. Whiskers indicate the minimum and maximum values. SP = speech perception; Mem = memory task; Walk = walking.

Funding Statement

This work was supported by National Institute of Deafness and Other Communication Disorders Grant R01 DC012057, awarded to Karen S. Helfer.

Footnote

1

Preferred walking speed did not differ between groups (younger participants: 1.05 m/s; middle-aged participants: 1.08 m/s; F(1, 26) = 0.14, p = .714, ηp2 = .005).

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Articles from Journal of Speech, Language, and Hearing Research : JSLHR are provided here courtesy of American Speech-Language-Hearing Association

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