The association between executive function and eye–hand coordination in older adults: the partial mediation of attention, global cognition, and muscle strength

Eye‒hand coordination (EHC) integrates cognitive and motor processes and is important for daily functions in older adults. Poor EHC performance is often associated with a decline in cognitive function, namely, executive function and attention, as well as a decline in motor function. However, their relationship remains unclear. To examine the associations among executive function, attention, global cognition, muscle strength, and EHC performance in elderly individuals. In this cross-sectional study, 213 community-dwelling older adults (median age 71 years, IQR 65.5–76.0) underwent assessments of executive function (Shape Trail Test Part B, STT-B), attention (Digit Cancellation Test, DCT), global cognition (Montreal Cognitive Assessment, MoCA), EHC reaction time and accuracy (EHC-RT, EHC-ACC), right shoulder flexion strength (rSFS), and right hand grip strength (rGS). Mediation analyses were conducted via PROCESS Model 4 with 5,000 bootstrap resamples (95% CI). STT-B score was associated with EHC-RT (ρ = 0.32, p < 0.001) and remained an independent predictor of EHC-RT (β = 0.17, p = 0.03) after adjusting for other variables in a linear regression model. Significant indirect effects of STT-B on EHC-RT were observed via DCT (β = 0.09, 95% CI [0.03, 0.17]; 23.50% of the total effect), MoCA (β = 0.18, 95% CI [0.08, 0.30]; 49.73%) and rSFS (β = 0.05, 95% CI [0.01, 0.10]; 13.11%). Chain mediation analysis revealed a serial association from the STT-B via DCT and the MoCA to the EHC-RT (β = 0.03, 95% CI [0.00, 0.06]). Direct effect remained significant. Executive function was associated with EHC-RT, with attention, global cognition, and shoulder flexion strength acting as partial statistical mediators. Longitudinal or interventional studies are needed to test causal pathways. Chinese Clinical Trial Registration Center, No. ChiCTR2300073086. Registration date: June 30, 2023. https://www.chictr.org.cn/.