Physical performance tests for preliminary cognitive screening in older adults: A systematic review of strength, walking, and balance assessments

Objective: The aim of this systematic review is to determine which physical tests, particularly those assessing strength, walking abilities and balance stability, can provide the most pertinent information for a preliminary screening of cognitive status, facilitating further cognitive evaluation. Methods: A systematic search was conducted using the PubMed and Web of Science databases. Studies that assessed both strength or balance stability and cognitive state in community-dwelling adults aged >= 60 years old were selected for inclusion. Results: The search strategy identified a total of 864 studies. After removing duplicates and applying inclusion and exclusion criteria, ten studies comprising a total of 6868 subjects were included in the review. According to the GRADE system, the studies were classified as low quality. Cognitively healthy individuals exhibited better balance, higher strength levels, greater gait speed and higher instrumental activities of daily living scores compared to those with mild cognitive impairment or cognitive impairment. Conclusion: The assessment of physical function in older adults may serve as a useful tool in identifying impairments associated with physical frailty, sarcopenia, and cognitive decline. Early screening based on physical performance could assist healthcare professionals in determining the need for further cognitive assessment, potentially aiding in the prevention or early detection of cognitive decline.