Physical Fitness and Cognitive Performance in Preschool Children: Cross‐Sectional and Longitudinal Associations From the ELFIT Trial

ABSTRACT

Growing evidence shows that physical fitness and cognitive function might be interrelated, but evidence is mostly cross‐sectional and research in preschool children remains scarce. We aimed to analyze both cross‐sectional and longitudinal associations between fitness indicators and cognitive outcomes in preschoolers. In this secondary analysis of the ELFIT trial, 99 children (58 girls; mean age 4.8 ± 0.7 years) were assessed at baseline and after a 10‐week intervention. Physical fitness (cardiorespiratory fitness, speed‐agility, handgrip strength, and standing long jump) was measured with the PREFIT battery, whereas cognitive outcomes were assessed using selected computerized BENCI subtests. Cross‐sectional analyses revealed significant associations of cardiorespiratory fitness with verbal memory, delayed verbal memory, cued recall, and verbal fluency, whereas handgrip strength was associated with free recall, and speed‐agility and lower‐limb strength with verbal comprehension (figures) (all pFDR < 0.05). In longitudinal analyses, improvements in cardiorespiratory fitness were significantly associated with improvements in free recall (pFDR = 0.009). Improvements in handgrip strength were associated with free recall (pFDR = 0.009), cued recall (pFDR = 0.010), verbal memory (pFDR = 0.009), delayed verbal memory (pFDR = 0.042), and delayed verbal memory recognition (pFDR = 0.011). Speed‐agility was longitudinally associated with improvements in free recall (pFDR = 0.010), verbal memory (pFDR = 0.010), and verbal fluency (pFDR = 0.049). Lower‐limb strength was associated with free recall (pFDR = 0.026), verbal memory (pFDR = 0.009), and verbal fluency (pFDR = 0.049). No significant associations were observed for reaction time or visuomotor outcomes after FDR correction. Overall, these findings suggest that fitness–cognition relationships in preschool children may be selective rather than generalized across cognitive domains, with the most consistent associations involving memory‐ and language‐related outcomes.