Reactive Agility and Motor-Cognitive Assessments for Distinguishing Community-Dwelling Older Adults with and Without a History of Falls: a Dual-Centre Cross-Sectional Study.

Although motor and cognitive functions are closely interconnected in daily life, they are typically assessed separately in fall assessments. This dual-center cross-sectional, observational study examined the discriminative performance of agility and motor-cognitive assessments to distinguish between community-dwelling older adults with and without a history of falls, compared with established motor and cognitive tests. A total of 231 participants (103 with a history of falls; age 71.9 ± 7.5 years) completed a SKILLCOURT test battery, including the Random Star Run (unplanned, reactive changes of direction; agility) and motor-cognitive stepping tasks involving reactive responses while standing to simple and choice reaction, task-switching, 2-back, and Stroop word-color stimuli. Motor tests included the Timed-Up-and-Go (TUG), Sit-to-Stand, and walking speed, each performed under both single- and dual-task conditions. Seated PC-based cognitive tests assessed reaction speed and executive functions corresponding to the SKILLCOURT tasks. Age- and study location-adjusted general linear models identified significant group effects after Holm adjustment for the Random Star Run (η2p = 0.04, p = .050) and the simple stepping reaction task (η2p = 0.03, p = .048), with faster completion and response times for participants without a history of falls, whereas established assessments showed no relevant group differences (η2p = 0.001–0.013, p > .05). Z-standardised adjusted logistic regression analyses revealed significant associations between Random Star Run performance and fall history (Odds Ratio; OR = 1.82 per 1 SD increase, p = .009), with longer completion times associated with higher odds of having a history of falls. The adjusted model yielded an AUC value of 0.73, with 70