Muscari A, et al. - Researchers looked for the most relevant predictors of cognitive impairment assessed by Mini Mental State Examination (MMSE) and their impact on MMSE categories in a cohort of older adults. Step test duration was identified as the most relevant predictor of cognitive impairment. The MMSE categories mostly found to be related to step test duration were orientation, attention, calculation and language, while memory appeared to be poorly or not affected.

• This is a cross-sectional and longitudinal study, wherein, data from 1116 older adults (72.6 ± 5.6 years, 579 female) were used, with 7 years follow-up in 350.
• The following variables were collected at baseline: personal data, marital status, occupation, anthropometric measures, risk factors, previous cardiovascular events, self-rated health and physical activity during the last week.
• Researchers performed routine laboratory tests, abdominal echography and a step test (with measurement of the time needed to ascend and descend two steps 20 times).
• Using logistic regression models, the associations of these variables with cross-sectional cognitive deficit (MMSE < 24) and longitudinal cognitive decline (decrease of MMSE score over 7 years of follow-up) were determined.

• Findings showed an independent association of cross-sectional cognitive deficit with school education ≤ 5 years, prolonged step test duration, having been blue collar or housewife (P ≤ 0.0001 for all) and, with lower significance, with advanced age, previous stroke and poor recent physical activity (P < 0.05).
• Researchers noted that longitudinal cognitive decline was primarily related to step test duration (P=0.0001) and diastolic blood pressure (P=0.0002).
• The following MMSE categories were found to be mostly related to step test duration: orientation, attention, calculation and language, while memory appeared to be poorly or not affected.