Introduction Previous research has yielded inconclusive results regarding the influence of cognitive decline, as in neurocognitive disorders on rhythmic performance during sensorimotor synchronisation (SMS; Bangert & Balota, 2012; von Schnehen et al., 2022), and SMS to tempo-changing sequences has never been studied in this group. This study aimed to investigate the impact of age and cognitive decline, as assessed by the Mini-Mental State Examination (MMSE), on SMS consistency using musical and metronomic sequences with and without tempo changes. Methods We recruited 51 older adults (mean age = 81 years) with diverse neurocognitive profiles (MMSE range: 19-30) from a French memory clinic. Participants first performed a spontaneous, unpaced tapping task. Next, they tapped their hand to a metronome or the beat of a musical sequence, while watching a musician on a screen perform the same task. Auditory stimuli were manipulated to have a constant tempo (89 bpm or 81 bpm), or shift between the two every 15 seconds. Results In our sample of older adults, the mean spontaneous tapping rate was 715 ms (SD 468 ms). In paced tapping, MMSE scores negatively predicted consistency. Furthermore, an interaction between age and audio indicated that consistency decreased with age when tapping to music but remained constant when tapping to a metronome. Contrary to our initial hypotheses, we did not find an interaction between MMSE scores and tempo stability. Conclusion Our findings demonstrate that cognitive decline has a significant effect on tapping consistency. Contrary to our predictions, this effect was global and not specific to tapping at changing tempi. We discuss several methodological limitations that might explain this lack of specificity. Based on our results, we suggest that beat induction may decline with age, while beat maintenance remains relatively intact.