Development, Validity, and Reliability of the Reactive Skill Test in Older Adults

The Reactive Skill Test will be conducted using a setup consisting of four pods, white cones, and balls that match the colors of the light signals. During the test, a ReactionX device configured with four distinct light colors (red, green, blue, and yellow) will be used. The test protocol is programmed via the ReactionX mobile application to control the sequence and display of lights. Each LED light is illuminated in a randomized order with zero delay time. Upon illumination, the participant is required to select the ball corresponding to the color of the light, place it on the matching cone, and then deactivate the LED light of the same color as the last placed ball. The test concludes once this sequence is completed for all four lights. Performance is evaluated based on parameters such as reaction time, accuracy, and total completion time. This protocol is specifically designed to assess cognitive skills such as color recognition, reaction speed, motor coordination and attention.

The Mini-Mental State Examination (MMSE) is widely recognized as one of the most commonly used tools for assessing cognitive impairment worldwide. The MMSE evaluates orientation, memory, attention, calculation, recall, language, motor function, perception, and visuospatial abilities. Its ease and rapid administration are among its main advantages. In this study, the MMSE will be used to assess cognitive function. Scores ranging from 27 to 30 are considered normal, 24 to 27 indicate mild cognitive impairment, 20 to 23 represent mild dementia, 10 to 19 correspond to moderate dementia, and scores below 10 indicate severe dementia.

The Five Times Sit-to-Stand Test is a standardized assessment used to evaluate lower extremity muscle strength and balance in older adults. Participants sit on a backless chair 45 cm in height with their arms crossed over their chest and are instructed to stand up and sit down five times as quickly as possible. Performance is measured by timing the duration from the initial seated position to the final seated position using a stopwatch. The validity of the test is supported by its correlation with measures of knee extension strength and walking performance. It assesses lower limb strength and functional mobility. Times exceeding 15 seconds are associated with a higher risk of falls. The test will be performed three times, and the average time will be recorded.

This questionnaire will be used to assess participants' physical activity levels in daily life. Participants report the types of activities performed and the time spent on each over the past seven days. Walking, sitting, moderate-intensity, and vigorous-intensity activities will be recorded based on participant self-report. The score is calculated by multiplying the MET value assigned to each activity by the duration and the number of days performed per week, resulting in a MET-minutes/week value. MET values are assigned as follows: walking = 3.3 MET, moderate activity = 4 MET, and vigorous activity = 8 MET. Based on these scores, participants will be classified into three categories: physically inactive (<600 MET-min/week), low physical activity level (600-1500 MET-min/week), and sufficient physical activity level (>1500 MET-min/week).

Hand movement reaction times will be recorded using an LED light system connected to a smartphone application (ReactionX). The ReactionX system consists of six LEDs and a wireless lighting setup. Participants will be seated with both hands placed on the table, palms down, spaced 40 cm apart (ReactionX device positioned centrally, 20 cm from each hand) and elbows flexed at 90°. When a light illuminates, participants are instructed to touch the device with the indicated hand as quickly as possible to turn off the light. Each test will be performed six times, with the best trial recorded. Results will be expressed in milliseconds (ms).