A statistical association between cognitive status and lower-extremity physical performance in older adults attending a day-care center appeared only under specific statistical modeling conditions and was not detected in unadjusted analyses, according to a cross-sectional study published in Aging Clinical and Experimental Research. Evaluating 106 older adults at a single day-care facility, researchers observed a statistically significant positive association between cognitive examination scores and physical performance battery scores solely in a fully adjusted direct-association model specification.
The investigation addressed the frequent coexistence of cognitive impairment and reduced physical performance among older individuals, conditions recognized in the literature as associated with frailty, functional dependence, falls, hospitalization, and other adverse health outcomes. Rather than combining these features into the broader framework of cognitive frailty, the research team evaluated cognitive status and physical performance as separate, distinct domains to clarify their direct relationship.
The study cohort comprised 106 older adults with a mean age of 83.21 ± 8.40 years, of whom 64.2 percent were women. Clinical evaluations revealed a mean Lobo Mini-Cognitive Examination (MEC-35) score of 20.77 ± 8.24 and a mean Short Physical Performance Battery (SPPB) score of 5.98 ± 2.44 among the participants.
Cognitive status was evaluated utilizing the Lobo Mini-Cognitive Examination (MEC-35), while lower-extremity physical performance was measured through the Short Physical Performance Battery (SPPB). In addition to these primary metrics, the researchers systematically recorded participants’ functional status, fall risk, chronic disease status, history of previous fractures, surgical procedures, and prior hospitalizations.
To analyze differences between groups, the investigators applied non-parametric statistical tests. The relationship between cognitive status and physical performance was further examined by fitting directed acyclic graph (DAG)-informed, double-penalized generalized additive models (GAMs) incorporating prespecified direct-association and total-association clinical adjustment sets, supplemented by bootstrap internal validation and a parsimonious sensitivity analysis.
When comparing raw scores across groups, SPPB scores did not show differences across MEC-35 categories. In regression modeling, a positive association emerged exclusively in the fully adjusted direct-association model specification (p = 0.038). Conversely, the total-association specification (p = 0.221) and an age- and sex-adjusted sensitivity model (p = 0.167) demonstrated null results. Across the full range of MEC-35 scores, model-predicted SPPB scores varied by approximately 2 points, though confidence intervals widened markedly at the extreme ends of the distribution.
Because the observed association depended entirely on the selected adjustment set and failed to replicate in either unadjusted or parsimonious analyses, the investigators emphasized that the finding must be interpreted cautiously. They noted that the data should be viewed as exploratory and hypothesis-generating rather than representing an established, stable, or causal clinical relationship.
The study concluded that while cognitive status and physical performance may be interrelated among clinically vulnerable older adults, the relationship remains model-dependent and requires confirmation in larger longitudinal cohort studies. The authors noted that multidomain geriatric assessment remains appropriate for clinical characterization, but emphasized that therapeutic or intervention implications cannot be inferred from this cross-sectional investigation.
Subject of Research: Association between cognitive status and physical performance in older adults
Article Title: Relationship between cognitive status and Short Physical Performance Battery scores in older adults
Article References: Calatayud, E., Oliván-Blázquez, B., Aguilar-Latorre, A., Cuenca-ZaldÃvar, J. N., Delgado, A., Sánchez-Romero, E. A., & Gómez-Soria, I. (2026). Relationship between cognitive status and Short Physical Performance Battery scores in older adults. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-026-03487-0
Image Credits: AI Generated
DOI: 10.1007/s40520-026-03487-0
Keywords: cognitive status, physical performance, Short Physical Performance Battery, MEC-35, geriatric assessment, older adults, cross-sectional study, generalized additive models, Relationship, between, cognitive, status
News Source: Ophelia Keating. (November 10, 2026). Study Finds Cognitive and Physical Performance Link Depends on Statistical Adjustment Models. Scienmag.
