Mediating role of cognitive status on performance in the two‐minute step test and its normative data among Malaysian community‐dwelling older persons

Abstract

The two-minute step test (2MST) has been used to estimate cardiorespiratory fitness and optimum scores are needed for performing activities of daily living with ease among older persons. However, there is limited information on the mediating role of cognitive impairment on 2MST performance and the 2MST normative data. Hence, we aim to identify the mediating role of cognitive status on performance in the 2MST among community-dwelling older adults and to establish the normative values of the 2MST.Methods: Participants aged 60 years and above were recruited through multistage random sampling from four states in Malaysia. The participants performed the 2MST using standard protocols. Mean comparison was done using an independent sample t-test or one-way analysis of variance. The 2MST normative values were then outlined descriptively.Results: Older age groups (60-69 years: 65.4 AE 21.9 times; 70-79 years: 61.7 AE 22.9 times; ≥80 years: 51.6 AE 24.5 times) had significantly lower levels of 2MST performance (p < 0.001). Women (56.6 AE 20.9 times) and participants with mild cognitive impairment (MCI) (58.7 AE 21.7 times) also had significantly lower levels of 2MST performance (p < 0.001) compared with men (69.1 AE 20.7 times) and participants with normal cognition (63.7 AE 21.6 times). Cognitive status had a significant mediation effect for age and sex on 2MST performance (p < 0.001). Therefore, the 2MST normative values were stratified according to cognitive status, sex, and age groups. Conclusion:Validation of these findings in a larger number of older populations with MCI may provide directions for cardiorespiratory fitness training to be emphasised among older persons with MCI.