Neuromuscular screening and cognitive function in older adults: A cross-sectional exploratory study

Abstract

Age-related decline in both cognitive and neuromuscular function negatively affects independence and quality of life in older adults. Understanding the interplay between cognitive performance and physiological markers may support early identification of functional deterioration. This cross-sectional study examined associations between cognitive function and selected physiological parameters in community-dwelling adults aged 65 years and older. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Additional measures included handgrip strength, body composition (bioelectrical impedance analysis), physical activity level (IPAQ-SF), and electrically evoked neuromuscular responsiveness using a custom-built diagnostic device. The average MoCA score was 25.5 ± 2.1, with 50% of participants scoring below the commonly used clinical threshold. Handgrip strength was strongly correlated with skeletal muscle mass (r = 0.64), but only weakly associated with cognitive function (r = 0.22). Neuromuscular responsiveness, specifically the slope at 60 Hz stimulation, showed a moderate negative correlation with MoCA scores (r = –0.35), accounting for 20% of its variance (R2 = 0.20; p = 0.088). Physical activity levels were generally low and not significantly related to cognitive or muscular parameters. Electrically evoked neuromuscular markers may serve as complementary indicators to traditional strength assessments and could support early detection of neuromuscular and cognitive decline in older adults.