Undiagnosed Dementia Is Associated with Poor Physical Function in Older Adults

Abstract

Background: Older adults with a cognitive impairment, including those not yet diagnosed, may have deficits in their physical function. Objective: We sought to determine the associations of cognitive impairment consistent with dementia (CICD) diagnosis status on handgrip strength, gait speed, and functional disability in older adults. Methods: The analytical sample included 8,383 adults aged ≥65-years without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010–2016 waves of the Health and Retirement Study. A handgrip dynamometer measured handgrip strength. Men with handgrip strength <26 kg and women <16 kg were weak. Gait speed was timed across a 2.5-m course and those with slowness had gait speed <0.8 m/s. Participants with difficulty or an inability in completing any basic activities of daily living had a functional disability. The adapted Telephone Interview of Cognitive Status evaluated cognitive function. Persons with scores <7 had a CICD. Healthcare provider dementia-related diagnosis was self-reported. Undiagnosed CICD was defined as no reported dementia-related diagnosis but had CICD, while diagnosed CICD was classified as reporting a dementia-related diagnosis. Covariate-adjusted logistic models were used for the analyses. Results: Persons with undiagnosed CICD had 1.37 (95% confidence interval (CI): 1.04–1.80) greater odds for weakness and 2.02 (CI: 1.39–2.94) greater odds for slow gait speed. Older adults with diagnosed CICD had 2.29 (CI: 1.32–3.97) greater odds for slowness and 1.85 (CI: 1.19–2.90) greater odds for functional disability. Conclusion: Screening for CICD could be recommended when defects in physical function are observed in older adults.