Optimizing Cognitive and Physical Gains in Older Adults: Benefits of a Psychomotor Intervention Program Based on Functional Level

<i>Background and Objectives:</i> Aging is associated with heterogeneous declines in cognitive and physical functions, yet little is known about how baseline functional levels influence the effectiveness of intervention programs. This study analyzed the effects of a psychomotor intervention program on cognitive and physical functions in community-dwelling older adults, considering their baseline functional levels. <i>Materials and Methods:</i> Fifty-one participants (75.4 ± 5.6 years) were divided into an experimental group, which underwent the intervention, and the control group. The experimental group was further divided into lower-functioning (LFG) and higher-functioning (HFG) subgroups based on baseline assessments. Participants were assessed at baseline, 24-week post-intervention, and after a 12-week follow-up. <i>Results:</i> Significant improvements were observed in both experimental subgroups, particularly LFG, in processing speed, executive functions, reaction time, attention, lower-body strength, balance, and mobility (<i>p</i> < 0.05). Cognitive gains persisted post-follow-up, while physical gains were reversed, especially in LFG (<i>p</i> < 0.05). Effect sizes ranged from medium to large in both lower- and higher-functioning groups. <i>Discussion:</i> The intervention improved cognitive and physical functions in both lower- and higher-functioning groups. Although older and less educated, the lower-functioning group showed greater gains but also more decline after follow-up. These findings emphasize that older adults with diverse baseline functional levels can improve substantially, highlighting the need for tailored psychomotor interventions to maximize benefits and address individual variability. The study was registered at ClinicalTrials.gov (NCT03446352).