Physical Activity and Cognitive Function in Elderly Prospective Hajj Pilgrims

Background: Population ageing has increased the number of elderly Indonesian Hajj pilgrims, in whom cognitive impairment may compromise safe Hajj performance. Physical activity is a modifiable protective factor, yet evidence in this population is scarce. Objective: This study assessed the association between physical activity (International Physical Activity Questionnaire, IPAQ) and cognitive function (Indonesian Montreal Cognitive Assessment, MoCA-INA), with age and sex as potential confounders. Methodology: A cross-sectional study was conducted using secondary data from the pre-departure health examination of prospective pilgrims aged 50 years or older in 2026. Ninety-two participants with complete data were analyzed. MoCA-INA score was the dependent variable, IPAQ category the exposure, and age and sex the covariates. Kruskal–Wallis, Mann–Whitney, Spearman correlation, multiple linear regression and analysis of covariance (ANCOVA) were applied at α = 0.05. Results: Participants had a mean age of 61.07 ± 7.00 years and a mean MoCA-INA score of 22.34 ± 3.59; 72 participants (78.26%) scored below the cut-off of 26. MoCA-INA scores did not differ significantly across low, moderate and high activity categories (p = 0.260). Age correlated negatively with MoCA-INA score (rho = −0.248; p = 0.017). After adjustment for age and sex, physical activity remained non-significant (F = 0.768; p = 0.467) and only age was significantly associated with MoCA-INA score (B = −0.113 per year; p = 0.045). Conclusion: physical activity was not independently associated with cognitive function, whereas age was the dominant predictor; pre-Hajj screening should therefore priorities older pilgrims. Keywords: cognitive function; physical activity; elderly Hajj pilgrims