A Prospective Study on the Association Between Grip Strength and Cognitive Function Among Middle-Aged and Elderly Chinese Participants

Abstract

ObjectiveTo study the efficacy of grip strength (GS) as a predictor of cognitive function in a large, nationwide sample of Chinese participants aged 45 years and above.MethodsWe used data from three waves (W1, W2, and W3) fielded by the China Health and Retirement Longitudinal Study (CHARLS). Cognitive function was tested biennially and calculated using two categories: episodic memory and mental intactness. Demographics, health behaviors, and medical conditions were considered potential confounders. Using multivariate linear regression models (MLRMs), we examined the association between baseline GS (measure in W1) and cognitive function in W3. Using a generalized estimating equation (GEE), we examined baseline GS as a predictor of cognitive function change.ResultsTotal 9,333 individuals (53.2% women), with a mean baseline episodic memory score of 6.5, mean baseline mental intactness score of 7.2, and aged over 45 years (mean age = 58.6), were selected. The mean follow-up time was 4.0 years (range: 3.3–5.0 years). Using MLRMs and comparing the lowest GS score with the highest baseline GS score, we observed a significant correlation with a higher global cognitive function in both women (β = 1.061, p < 0.001) and men (β = 1.233, p < 0.001). After adjusting baseline global cognition, the highest GS level was still statistically significant in both women (β = 0.543, p < 0.05) and men (β = 0.742, p < 0.001). GEE suggested that the participants in the highest GS quartile had better cognitive performance over time in both women (β = 0.116, p = 0.030) and men (β = 0.143, p = 0.008) than those in the lowest quartile.ConclusionHigher baseline level of GS was significantly related to better cognitive function and slowed the rate of its decline. Thus, it is an independent predictor of better cognitive status in middle-aged and elderly Chinese.

The association between health‐related factors, physical and mental diseases, social activities, and cognitive function in elderly Koreans: a population‐based cross‐sectional study

“…hand grip, toe grip, gait) support this argument. [37][38][39] Sociodemographic variables, such as age, education, and marital status, have been found to be significant predictors of cognitive decline in previous studies. In particular, age was a powerful predictor of cognitive impairment.…”

“…7,35 Interestingly, some researchers have argued that hand grip strength is a preventive factor of cognitive decline. [36][37][38] The similarities in the brain areas and networks involved in cognition and muscle strength (e.g. hand grip, toe grip, gait) support this argument.…”

Challenging the relationship of grip strength with cognitive status in older adults

“…In fact, over 210 large‐scale longitudinal studies archived in the Inter‐university Consortium for Political and Social Research (ICPSR) report at least one wave of grip strength data in their samples. Although it is generally accepted as a measure of physical or motor function, there is a growing number of studies that have demonstrated its statistically significant relationship to cognition, either cross sectionally/at baseline 2–9 or longitudinally 2,3,7,10–14 in both non‐demented and demented samples. This statistical relationship has coined the phrase, ‘People who grip better, think better’, 8 and suggests that motor or physical function (i.e., neural drive to skeletal muscle) and certain cognitive functions share overlapping neurological processes.…”

“…For example, grip strength has been shown to predict decline in several cognitive abilities in non‐demented older adults 4,16 . As a result, it has been interpreted that ‘maximum grip strength testing provides a discriminating measure of neurological function’, making it a potentially valuable motor measure that may track with, 2,7 or even precede, 2,3,12,16,17 declines in cognition, perhaps as early as middle‐age 11 …”

The Importance of Exercise in Alzheimer’s Disease and the Minds in Motion® Program: An Editorial

“…It is likely a combination of the two scenarios. There is evidence that poor muscle strength (measured by handgrip) and slow gait speed are good predictors of AD development in future years [ 9 , 10 , 11 ]. This data suggests that poor indices of strength and physical function occur prior to AD diagnosis.…”