Influential factors affecting age-related self-overestimation of step-over ability: focusing on frequency of going outdoors and executive function

Abstract

Objective: Self-overestimation of step-over ability among older adults may result in a potential fall risk. However, the behavioral causal factor(s) of older adults' self-overestimation is unclear. We examined whether older adults' overestimation of step-over ability was mediated by an inactive lifestyle and/or poor executive function.

Methods: A sample of 194 community-dwelling older adults was assigned to either a high (HG, once a day or more) or low (LG, every 2-3 days or less) frequency of going outdoors group. Executive function was determined by the Trail-Making Test (TMT). Both the HG and LG participants performed Step-Over Tests (SOT) in two ways: self-estimation of step-over ability and the actual step-over task. During the self-estimation task, participants observed the horizontal bar at a distance of 7 m and predicted the self-estimated maximum height (EH) of successful SOT trials. The motor task was then performed, determining the actual maximum height (AH) of successful trials.

Results: A total of 36.1% of LG participants failed to successfully perform SOT trials at their EH (i.e., overestimation), whereas only 11.3% of HG participants failed. A multiple linear regression analysis showed that SOT overestimation was associated with an inactive lifestyle (low frequency of going outdoors) but not with executive function. Analyses of fall experience showed that both executive function and lifestyle significantly correlated with SOT overestimation among fallers, whereas only lifestyle was significantly correlated among non-fallers.

Conclusion: Our results suggest that an inactive lifestyle is a possible correlate of SOT overestimation among older adults, while executive function further influenced overestimation only among fallers.

Keywords: Aging; Cognitive function; Going outdoors; Overestimation; Self-estimation; Stepping-over.