Cognition, Physical Performance, and Fall-Related Mobility Outcomes in Healthy Older Adults: A Cross-Sectional Study

Aging entails concurrent declines in physical and cognitive domains, contributing to reduced independence, higher fall risk, and lower quality of life. Understanding how motor performance relates to cognition is crucial for prevention in community-dwelling older adults. This cross-sectional study investigated associations between physical fitness-including strength, endurance, balance, and aerobic capacity-and cognitive outcomes assessed by Trail Making Tests (TMT-A, TMT-B), the Digit Symbol Substitution Test (DSST), and dual-task cost in the Timed Up & Go Test (TUG_DTC). Thirty-four sedentary but cognitively healthy adults aged ≥60 years were evaluated. Quadriceps strength was significantly related to TUG_DTC and executive function (TMT-B), while upper-limb endurance correlated with both attentional and executive measures. Dynamic balance, particularly in posterior directions, was linked to DSST and TMT-B, and 6-min walk test performance was associated with executive functioning and processing speed. TUG_DTC itself showed strong correlations with cognitive outcomes, underscoring its sensitivity to motor-cognitive interference. These findings highlight selective motor-cognitive relationships and suggest that simple, field-based tests may serve as early markers of cognitive vulnerability. Targeting lower-limb strength, balance, and aerobic capacity could represent cost-effective strategies to promote mobility and cognitive resilience in aging populations.