Navigating the Challenges Encountered While Dual-task Walking in Real-life Environment by Elderly with Type 2 Diabetes Mellitus

Abstract

Abstract Background and Objectives: Real-life walking environment comprises various attentionally demanding activities that require intact dual-tasking ability. Dual-task cost is higher in older adults with type 2 diabetes mellitus (T2DM) while walking due to the alterations in cognition and gait. However, contextual variations in the familial, social, and environmental conditions also influence walking in real-life environments. There is a scarcity of literature exploring the challenges linked with contextual variations while dual-task walking in real-life environments for older adults with T2DM. Hence, this study aims to identify barriers and facilitators to dual-task walking in real-life environments for T2DM elderly. Methods: The study used a phenomenological approach and interviewed older adults with and without T2DM using a semi-structured interview guide. It comprised open-ended questions on walking difficulties in a real-life environment. Results: Four themes were identified which comprised individual, social, environmental, and policy-level factors influencing walking. Role transitions within the family, fear, infrastructural impediments, and overprotectiveness of family members were identified as barriers whereas health literacy, positive outlook, occupational demands, and devout engagement in religious participation were identified as facilitators to walking in the elderly. The participants expressed several policy-level challenges, and emphasis was made on outdoor modifications and the need for community programs. Conclusion: The findings of this study provide insights into various constructs close to real-life walking environment that needs to be included in dual-task cost evaluation tools and several measures that can be taken at the familial and policy levels to increase the community mobility of older adults with T2DM.