Comorbidity, Cognition, Gait Speed, and Respiratory Muscle Strength in Older Adults

Maximal inspiratory pressure(MIP) will be measured in the seated position using a portable digital respiratory pressure measurement device. A nose clip will be used to prevent air leakage. At least three and no more than five maneuvers will be performed, with at least one minute of rest between maneuvers. The highest value sustained for at least one second will be recorded in centimeters of water pressure (cmH2O).

Gait Speed Assessed by the 4-Meter Walk Test: Gait speed will be assessed over a marked, unobstructed 4-meter walking course. Participants will be instructed to walk at their usual daily walking speed. The test will be performed three times, with rest provided between trials when needed. The best performance will be recorded as gait speed in meters per second (m/s). Higher values indicate faster gait speed.

Maximal expiratory pressure(MEP) will be measured in the seated position using a portable digital respiratory pressure measurement device. A nose clip will be used to prevent air leakage. At least three and no more than five maneuvers will be performed, with at least one minute of rest between maneuvers. The highest value sustained for at least one second will be recorded in centimeters of water pressure (cmH2O).

Functional mobility will be assessed using the Timed Up and Go Test. Participants will be instructed to stand up from a chair, walk three meters at a safe and usual speed, turn, walk back to the chair, and sit down. The test will be performed three times, and the best completion time will be recorded in seconds. A shorter completion time indicates better functional mobility.

Handgrip strength will be measured using a Jamar hand dynamometer. Participants will be seated upright with the shoulder adducted, the elbow flexed to 90 degrees, and the forearm in a neutral position. Three measurements will be performed with one-minute rest intervals, and the highest value will be recorded in kilograms (kg).

Comorbidity burden will be assessed using the Charlson Comorbidity Index during a face-to-face interview. Questions will be administered to the participant, responses will be recorded by the researcher, and the total index score will be used in the analyses. Higher scores indicate a greater comorbidity burden.

Cognitive function will be assessed using The Montreal Cognitive Assessment (MoCA) in a quiet environment under the supervision of a researcher. The assessment will include standardized verbal questions and paper-and-pencil tasks. The total score will be recorded, with higher scores indicating better cognitive performance.

Montreal Cognitive Assessment's total score ranges from 0 to 30, with higher scores indicating better cognitive function.The total score will be analyzed as a continuous variable and will not be used alone to establish a clinical diagnosis.

Cognitive function will be assessed using the Mini-Mental State Examination in a quiet environment under the supervision of a researcher. The assessment will include standardized verbal questions and paper-and-pencil tasks. The total score will be recorded, with higher scores indicating better cognitive performance.

Mini-Mental State Examination's total score ranges from 0 to 30, with higher scores indicating better global cognitive function; total score will be analyzed as a continuous variable and will not be used alone to establish a clinical diagnosis.

Physical activity level will be assessed using the Physical Activity Scale for the Elderly during a face-to-face interview. Questions will be administered to the participant, responses will be recorded by the researcher, and the total score will be used in the analyses. Higher scores indicate a higher level of physical activity.