Physical disability in the elderly may predict a heightened risk for Alzheimer’s and other dementias, according to new study findings.

Researchers studied 2,288 men and women aged 65 and older who did not have dementia at the beginning of the study. They assessed cognitive and physical ability every year over an average of six years. At the beginning of the study, individuals with lower physical-performance scores also had lower cognitive scores. As the study progressed, people with higher physical-performance scores were three times less likely to develop dementia than those with lower scores.

Problems with walking and balanced seemed to be the first physical indicators of a risk for dementia in people without cognitive impairment. Study participants were tested using a timed walk, several balance assessments, and a measure of grip strength, as well as other evaluations.

The study was published in the May 22 Archives of Internal Medicine.