Physical activity (PA) is regarded as a non-pharmacological preventive strategy against cognitive decline. This study aimed to examine the relationship between PA and cognitive function in cognitively normal older Malaysian adults from a multi-ethnic, urban-dwelling community. Participants completed a questionnaire with questions on demographic details, socioeconomic status, health conditions, and short form of the International Physical Activity Questionnaire (IPAQ). Bivariate analyses and hierarchical linear regression were conducted to examine the relationship between IPAQ and Montreal Cognitive Assessment (MoCA) scores. Among the 382 participants (median age = 66 years), 51.6% were female. Median MoCA score was 24
and IPAQ levels were 28%, 39% and 33% 'Low', 'Moderate' and 'High' respectively. Bivariate analysis showed MoCA scores significantly differed across IPAQ levels (p-value <
0.002). Pairwise comparisons showed significant differences between MoCA scores and 'High' and 'Low' (p-value <
0.002) and 'Moderate' and 'Low' (p-value = 0.002) IPAQ levels. Hierarchical regression of potential confounding factors showed that while lower PA, being older, being Malay and hypertension were initially associated with lower MoCA scores, the association was explained by the greater influence of education and savings. Additional research is required to gain a more comprehensive understanding of these relationships.