A simple movement test may provide new insight into an older adult’s future health, according to TPS-IL. New research suggests that the time it takes to begin walking after a signal—particularly while performing a second mental task—may serve as an early indicator of declining independence and an increased risk of death.

Globally, the World Health Organization (WHO) estimates that tens of millions of falls occur each year that are serious enough to require medical attention. Earlier identification of individuals at higher risk could allow healthcare providers to introduce targeted balance rehabilitation and cognitive-motor training programs aimed at preserving mobility and independence.

The study, led by researchers from Ben-Gurion University of the Negev and published in the peer-reviewed journal *Gerontology*, followed 120 community-dwelling older adults over a period of up to 17 years. It found that slower step initiation under dual-task conditions was associated with a higher risk of death during the follow-up period.

Led by Prof. Yitzhak Meltzer from the Department of Physiotherapy at Ben-Gurion University of the Negev, the researchers analyzed balance and mobility data collected between 2005 and 2011.

Participants underwent both static balance assessments and a dynamic “voluntary step” test triggered by an electronic cue. The test measured how quickly participants initiated a step after a signal, both under normal conditions and while performing a concurrent mental task.

During the dual-task condition, participants were asked to step quickly while also naming the ink color of words printed in incongruent colors, a standard cognitive exercise used to assess attention and processing load.

Researchers found that each 0.1-second delay in step initiation under dual-task conditions was associated with an approximately 28% increase in mortality risk over the follow-up period.

“The voluntary step test is a simple and accessible assessment that can help identify reduced functional vitality and increased fall risk,” Meltzer said. “It integrates both neuromuscular function and cognitive processing, which are central to clinical evaluation.”

While walking speed has already been recognized as a functional indicator of health in older adults, the study highlights a more specific measure: how quickly a person can initiate movement when cognitive demands are present. According to the researchers, this may reflect early changes in brain-body coordination that are not captured by standard mobility tests.

The findings suggest the issue is not solely physical weakness. Because basic sensory detection and nerve conduction remain relatively stable between single-task and dual-task conditions, the researchers argue that delays under cognitive load are more likely linked to central processing efficiency—the brain’s ability to interpret information and initiate movement.

The authors note that the findings could help clinicians identify older adults at higher risk of falls, reduced mobility, and loss of independence at an earlier stage. They also suggest that voluntary step speed may be a modifiable ability, and that interventions combining physical balance training with cognitive tasks could help improve brain-body coordination.

“Incorporating simultaneous motor and cognitive tasks into standard clinical assessments may improve the prediction of independence and life expectancy, and support earlier intervention targeting cognitive-motor health,” Meltzer concluded.