Health and Quality of Life Perception in Older Adults: The Joint Role of Cognitive Efficiency and Functional Mobility

Forte, Roberta; Boreham, Colin; De Vito, Giuseppe; Pesce, Caterina · 2015 · OpenAlex-citations

DOI: 10.3390/ijerph120911328

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Summary

This cross-sectional study investigates the joint role of cognitive efficiency and functional mobility in determining health-related quality of life (HRQoL) perceptions among older adults. Motivated by the need to understand how societies can support health in aging populations, the research addresses the gap in knowledge regarding how specific executive functions interact with tangible mobility experiences to influence mental and physical HRQoL. While previous studies linked general executive function to HRQoL, this study hypothesizes that the translation of cognitive efficiency into quality of life perception is moderated by the ability to perform complex, dual-task walking activities that mirror daily life demands. The study evaluated 56 healthy older adults aged 65–75 years. Participants were assessed for mental and physical HRQoL using the SF-36 questionnaire, core executive functions (inhibition, working memory updating, and cognitive flexibility) using the Random Number Generation task and Trail Making Test, and functional mobility via maximal walking speed under single and dual-task conditions. The dual-task conditions included motor-motor tasks (walking while negotiating hurdles) and motor-cognitive tasks (walking while talking). Statistical analyses included multiple regression to identify predictors of HRQoL and hierarchical regression to test whether dual-task walking performance moderated the relationship between executive functions and HRQoL, controlling for sarcopenia and maximal walking speed. The results revealed distinct patterns for mental and physical HRQoL. Inhibitory efficiency was the only significant predictor of mental HRQoL in exploratory models. However, moderated regression analyses showed that inhibitory ability significantly predicted mental HRQoL only when coupled with good performance in motor-cognitive dual tasks (walking while talking). Conversely, cognitive flexibility interacted with motor-motor dual task performance (walking while negotiating hurdles) to predict physical HRQoL. Working memory updating showed no significant association with either domain of HRQoL. Simple slope tests confirmed that high levels of dual-task walking ability amplified the positive relationship between the respective executive function and HRQoL perception. These findings suggest that executive function efficiency alone does not guarantee a positive perception of health and quality of life; rather, it must be coupled with the tangible experience of successfully managing complex mobility tasks. The study implies that interventions aimed at supporting HRQoL in older adults should be multicomponent, integrating cognitive training with functional mobility exercises that challenge dual-tasking abilities. This approach supports successful cognitive aging and functional independence, highlighting the importance of environments and training programs that foster the joint development of cognitive efficiency and locomotor competence.

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• cognitive impairment