Potential Indicators of Transition to Cognitive Decline in Older Men: A Longitudinal Analysis of Multiple Sensory, Balance, and Gait Changes

Background/Objectives: Early detection of cognitive decline is crucial for preventing dementia. Conventional diagnostic approaches, including neuropsychological test batteries, laboratory tests, neuroimaging, and cerebrospinal fluid analysis, may have limitations related to accessibility, cost, invasiveness, and the early detection of pathological changes. Dementia-related pathology can affect neural networks involved in sensory and motor functions, suggesting that changes in these functions may provide non-invasive indicators of subsequent cognitive decline. Therefore, this study aimed to investigate potential indicators associated with longitudinal cognitive decline by integrating multiple sensory and motor functions. Methods: Cognitive, sensory, balance, and gait function were measured longitudinally over two years in community-dwelling older adult men (≥65 years). Generalized estimating equations were applied to explore potential indicators by examining the association between longitudinal changes in multiple sensory and motor functions and the transition to cognitive decline. Results: Older age, lower uncorrected contrast sensitivity at 4 m, a lower binaural average sentence recognition score, poorer olfactory discrimination, shorter limits of stability test time, de-creased gait velocity, a reduced loading response proportion, and an increased proportion of pre-swing were related to higher odds of longitudinal cognitive decline. Conclusions: These results showed that specific sensory and motor functions were associated with longitudinal cognitive decline and suggested that their integration may provide information that could contribute to risk stratification for cognitive decline in older adults. Further studies with larger sample sizes and multiple cohorts are needed.