Associations Between 24-Hour Movement Behaviours and Cognitive Abilities in Slovak Adolescents: The Role of Physical Activity, Sedentary Behaviour, and Sleep

Background: Cognitive health in adolescence is shaped by daily movement patterns, yet few studies jointly examine physical activity, sedentary behaviour, and sleep using both device-based and self-report measures, particularly in Central Europe. Methods: In this cross-sectional study, 82 Slovak adolescents (16.67 ± 1.07 years; 61% girls) wore accel-erometers for seven days to assess physical activity, sedentary time, and sleep, and completed the PAQ-A questionnaire. Cognitive abilities (IQ, sustained attention, and visual memory) were assessed with standardized tests. Results: Overall adherence to 24-hour movement guidelines was low: 11% met MVPA recommendations, about half achieved age-appropriate sleep duration, and only 23.2% met the sedentary guideline, while most accumulated more than 10 h/day of sedentary time. Girls accumulated more time in both sedentary and active behaviours than boys. PAQ-A scores overestimated accelerometer-derived MVPA (mean bias of 1.68 units), with greater bias in girls and older adolescents. Later sleep timing and longer deep sleep were positively associated with IQ and sustained attention, whereas greater total sleep duration and more time in the least active 5 h of the day were negatively related to memory; MVPA accumulated in 5–10-min bouts was inversely associated with IQ (ρ = –0.24). Sleep–MVPA profiles dif-fered significantly in memory performance (η² ≈ 0.13), while IQ and attention did not differ between profiles. Conclusions: Daily 24-hour movement patterns showed modest associations with cognitive abilities in adolescents. Combining accelerometry with self-report revealed MVPA overestimation in PAQ-A and may inform refinement of ad-olescent activity surveillance tools and movement-based strategies to support cognitive resilience.