Impact of a Six‐Month Walking Program on Cognitive and Functional Abilities in Older Tunisian Adults: A Quasi‐Experimental Study

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Sai K., Douzi W., Moula S., Dergaa I., Ammar A., CEYLAN H. İ., ...More

Balneo and PRM Research Journal, vol.17, no.2, 2026 (ESCI, Scopus)

  • Publication Type: Article / Article
  • Volume: 17 Issue: 2
  • Publication Date: 2026
  • Doi Number: 10.12680/balneo.2026.1042
  • Journal Name: Balneo and PRM Research Journal
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Keywords: aging, cognitive function, functional independence, older adults, physical endur-ance, quasi‐experimental, walking program
  • Open Archive Collection: AVESIS Open Access Collection
  • Ataturk University Affiliated: Yes

Abstract

Regular physical activity is a key modulator of healthy aging, yet its multidomain effects on cognition, functional independence, and physical capacity remain understudied in North African populations. This study investigated the effects of a six‐month structured walking program on cognitive performance, functional independence, and cardiorespira‐tory endurance in older Tunisian adults. A quasi‐experimental study with a matched pairs design was conducted. Fifty two adults (mean age: 70.98 ± 4.55 years; 26 per group) participated in a six-month walking program held three sessions per week. Cognitive function was assessed with the Digit Symbol Substitution Test (DSST), functional independence with the Lawton Instru‐mental Activities of Daily Living Scale (IADL), cardiorespiratory endurance with the Six Minute Walk Test (6MWT), and perceived exertion with the Borg Scale. Assessments were conducted at baseline (T1), three months (T2), and six‐month (T3). The exercise group showed significant improvements in DSST scores (p < 0.001; η2p = 0.561), IADL scores (p < 0.001; η2p = 0.816), and 6MWT distance (p < 0.0001; η2p = 0.927). Perceived exertion decreased significantly (p < 0.001; η²p = 0.126), reflecting cadiovascular adaptation. The control group showed no significant changes. Strong positive correlations emerged between DSST, IADL, and 6MWT scores at T2 and T3 (all p < 0.001). A structured six‐month walking program significantly improves cognitive function, functional independence, and physical endurance in older Tunisian adults. These findings support the integration of walking‐based interventions into routine health strategies for aging populations.