Editorial: Cognitive Aging, Sensory and Physical Function, Mental Health, and Related Risk Factors

Panagiotis (Panos) Alexopoulos^1*Maria Basta²Chinedu Udeh-Momoh³

• ¹Mental Health Services, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece, Patras, Greece
• ²Panepistemio Kretes, Rethimno, Greece
• ³Global Brain Health Institute, San Francisco, United States

Age-related sensory loss is a strong and possibly causal predictor of cognitive decline, and early detection-even via self-report-is feasible and valuable. Auditory loss has a considerable impact on cognition as shown by cross-sectional data deriving from the AD-HEARING study (https://doi.org/10.3389/fpsyt.2025.1494197), as well as from genomic and epidemiological investigations in the Genome-wide association studies database and in communities in China, respectively (https://doi.org/10.3389/fnagi.2024.1380145). In addition, visual dysfunction is likewise implicated in cognitive impairment and impairment of daily living activities in people with MCI (https://doi.org/10.3389/fnagi.2025.1505815). Of note, in older individuals without cognitive impairment, subjective visual impairment complaints are positively related to visual performance, whereas in those carrying the APOE e4 allele such complaints pertain to attention, processing speed and executive function (https://doi.org/10.3389/fnagi.2024.1465812). Thus, it becomes evident that assessment of sensory function embodies a component of the diagnostic workup of cognitive decline in ageing (https://doi.org/10.3389/fnagi.2024.1465812). Pragmatic and effective tools are urgently needed for facilitating the early detection of sensory loss. An ultra-brief screening tool based on demographic data, one item of the Hearing Handicap Inventory for the Elderly (HHIE) and one of the HHIE for the communication partner is here presented. It may help the greater integration of hearing assessment and can complement the cognitive function assessment with simple and quickly administered tests like the ten-words recall test (https://doi.org/10.3389/fpsyt.2024.1429934), in community and primary healthcare settings where the preponderance of older people in fact seek care (Aggeletaki et al., 2024) (https://doi.org/10.3389/fnagi.2025.1504358). Of note, Lei Kei et al unveiled that the combined effect of sensory loss and low physical performance on cognitive function is additive and this effect is mitigated by participation in social activities such as interacting with friends, playing chess or cards and being involved in voluntary or charity work (https://doi.org/10.3389/fnagi.2024.1498354).Mounting evidence points to the protective influence of physical activity, muscle strength, and overall physical performance on cognitive function in ageing.Recreational physical activity of moderate to high intensity is associated with better performance on semantic fluency, executive function and processing speed and this relationship is partly mediated by depressive symptoms (https://doi.org/10.3389/fnagi.2025.1470256). Moreover, in another paper of this research topic, grip strength and performance on the 30-second sit-to-stand test, assessing lower body strength, balance and endurance, were shown to relate with processing speed, sustained attention and general cognition (https://doi.org/10.3389/fnagi.2025.1496725) (Benedict et al., 2017;Hagenaars et al., 2017). Interestingly, EEG markers were shown to reflect both muscle strength and information processing. They provide valuable insights into their potential utility in deciphering the neuropathophysiological interplay between muscle strength and cognitive function. A systematic review and network meta-analysis provide evidence for the optimal dose and type of exercise to improve cognitive function in people with mild neurocognitive disorder, commonly embodying a pre-dementia stage in people with neurodegenerative disorders (Guo et al., 2013) (https://doi.org/10.3389/fpsyt.2024.1436499). In particular, 12-24 week-, multicomponent exercise sessions with 60-85% of maximum heart rate which last 30 minutes and take place 3-4 times per week are beneficial for global cognition, while sessions lasting 30-61 minutes, 3-4 times per week for 25 weeks or longer, show greater effectiveness in enhancing executive function. Nonetheless, no consensus can be reached yet regarding the optimal dose of physical exercise, since in another study, even though individuals with a longer history of exercise were less likely to experience cognitive decline, prolonged exercise duration was found to increase the risk of cognitive decline, since it may overload the body (https://doi.org/10.3389/fnagi.2025.1496677).Physical health and healthy dietary habits are crucial for maintaining cognitive function in ageing. For instance, calf circumference, a screening method for sarcopenia (Piodena-Aportadera et al., 2022), and bone mineral density, a marker of osteoporosis, are both associated with global cognition in women. Notably, in females correlations between both calf circumference and bone mineral density and global cognition and several neuropsychological scores, i.e. executive function, memory, attention, and brain speed were detected (https://doi.org/10.3389/fnagi.2025.1473135; https://doi.org/10.3389/fnagi.2024.1372583). Moreover, previous reports highlight the role of insulin in amyloid β peptide clearance, tau phosphorylation, and the modulation of vascular function, which pertain to cognitive decline and progression to dementia (Kellar and Craft, 2020). In line with that, triglyceride-glucose index, a marker of insulin resistance, was found to be associated with impairment in both basic and complex activities of daily living (https://doi.org/10.3389/fnagi.2025.1488124). Depressive symptoms and sleep disturbances have emerged as consistent risk factors for cognitive decline in ageing, while they even serve as mediators in the relationship between physical/medical factors and cognitive decline. Depression in old adults, which often manifests with physical discomfort and somatic symptoms (https://doi.org/10.3389/fpsyt.2024.1478359), has increasingly attracted attention from researchers (https://doi.org/10.3389/fnagi.2024.1393110). Besides its relation to intrinsic capacity, which refers to the set of all the physical and mental capabilities (https://doi.org/10.3389/fnagi.2024.1456167), depression partially mediates the relationship between chronic diseases, such as poor cardiovascular health, and cognitive impairment (https://doi.org/10.3389/fnagi.2024.1465310; https://doi.org/10.3389/fpsyt.2024.1404229). Even though late-onset depression is closely linked to vascular and degenerative brain changes and chronic diseases (Linnemann and Lang, 2020), social participation patterns are related to the severity of depressive symptoms particularly among frail older individuals (https://doi.org/10.3389/fpsyt.2024.1440641). In addition, sleep disturbances are increasingly considered to relate with cognitive impairment. In a cross-sectional study including a total of 3,106 individuals, subjective short sleep duration, combined with poor sleep quality and sleep medication were associated with cognitive dysfunction (https://doi.org/10.3389/fnagi.2024.1417349). It is evident that both cognitive decline and brain health maintenance are contingent on a complex interplay between a plethora of factors that should be considered to promote healthy cognitive and mental ageing.