Higher Handgrip Strength Is Linked to Better Cognitive Performance in Chinese Adults with Hypertension

Handgrip strength is associated with cognitive function in older patients with stage 3-5 chronic kidney disease: results from the NHANES

In this study, we aimed to investigate the association between handgrip strength (HGS) and cognitive performance in stage 3-5 chronic kidney disease (CKD) patients aged ≥ 60 years. This cross-sectional study analyzed data from National Health and Nutrition Examination Survey (NHANES) database 2011-2014. Three tests were used to assess the cognitive performance, including consortium to establish a registry for Alzheimer's disease (CERAD), animal fluency test (AFT), and digit symbol substitution test (DSST). The multivariate linear regression analyses adjusting for confounding factors were utilized to evaluate the association of HGS with cognitive performance. A total of 678 older stage 3-5 CKD patients were included in this study. After adjusting for multiple factors, a higher HGS was positively associated with a higher CERAD-delayed recall and DSST score. In addition, our analysis indicated that HGS probably correlated with better performance of immediate learning ability in male, while working memory, sustained attention, and processing speed in female. HGS may be an important indicator for cognitive deficits in stage 3-5 CKD patients, especially for learning ability and executive function. Further research to explore the sex-specific and domain-specific and possible mechanisms are required.

Handgrip strength asymmetry and cognitive impairment risk: Insights from a seven-year prospective cohort study

OBJECTIVES

This study aimed to explore the links of handgrip strength and asymmetry with cognitive impairment.

DESIGN

This was a seven-year prospective cohort study.

SETTING AND PARTICIPANTS

We used data from wave 3 (2015-2017) to wave 5 (2019-2022) from the ongoing Taiwan Initiative of Geriatric Epidemiological Research (TIGER), with wave 3 as the baseline (n = 446). The study included community-dwelling participants aged 65 years or older.

MEASUREMENTS

Handgrip strength was measured, and abnormalities were determined based on handgrip strength weakness and asymmetry. Handgrip strength asymmetry was categorized into three groups at baseline based on the handgrip strength ratio (left handgrip strength/right handgrip strength). Cognitive tests evaluating global and specific cognitive domains were conducted at baseline and two biennial follow-ups. Generalized linear mixed models were utilized to assess the associations of abnormal handgrip strength with global cognition and multiple cognitive domain progression over time.

RESULTS

This study included 392 dementia-free participants, with an average age of 75.8 years and 179 (45.7%) males. Mild handgrip strength asymmetry was present in 88 participants (22.4%), while 53 (13.5%) exhibited moderate asymmetry. In men, the coexistence of low handgrip strength and handgrip strength asymmetry was linked to cognitive impairment over time. These associations were observed in global cognition (β^ = -1.76, 95% CI: -2.79 to -0.74), memory (immediate free recall: β^ = -0.67, 95% CI: -1.17 to -0.17), executive function (Trail Making Test-A: β^ = -0.54, 95% CI: -0.94 to -0.13), and attention (Digit span-forward: β^ = -1.00, 95% CI: -1.46 to -0.54).

CONCLUSIONS

This study found that individuals with reduced handgrip strength and handgrip strength asymmetry had an increased risk of cognitive impairment across various domains. Moreover, this association appears to be more pronounced among men than women. Incorporating these simple assessments into regular clinical practice improves the allocation of limited screening resources and timely clinical interventions in older adults.

Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study

PURPOSE

The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults.

METHODS

This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia.

RESULTS

Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41-0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58-0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52-0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48-0.98) was associated with a lower risk of sarcopenia.

CONCLUSION

Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.

Handgrip strength is associated with learning and verbal fluency in older men without dementia: insights from the NHANES

Low handgrip strength, a hallmark measure of whole-body strength, has been linked with greater odds of cognitive decline and dementia; however, conflicting findings, which could be due to population characteristics and choice of tools, such for the assessment of handgrip strength and cognitive function domains, also exist. Therefore, we examined the relationship of handgrip strength with a comprehensive list of tests to assess domains of cognitive function using a representative sample of US older men and women without neurodegenerative disorders such as dementia. We analyzed cross-sectional data from the US National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014, with a study cohort of 777 older adults (380 men and 397 women) above 60 years of age. Handgrip strength was assessed using a handgrip dynamometer, while cognitive function was assessed through the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test (WLLT), Word List Recall Test (WLRT), Intrusion Word Count Test (WLLT-IC and WLRT-IC), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Sex-stratified multiple linear regression analyses were performed upon covariate adjustment for age, ethnicity, socio-economic status, education, medical history, body mass index, physical activity, energy, protein, and alcohol intake. Maximal handgrip strength was positively associated with cognitive function scores, including CERAD WLLT (P = 0.009, R² = 0.146) and AFT (P = 0.022, R² = 0.024) in older men, but not in women (CERAD WLLT: P = 0.253, AFT: P = 0.370). No significant associations with CERAD WLLRT (men: P = 0.057, women: P = 0.976), WLLT-IC (men: P = 0.671, women: P = 0.869), WLLRT-IC (men: P = 0.111, women: P = 0.861), and DSST (men: P = 0.108, women: P = 0.091) were observed. Dose-response curves exhibited a prominent linear relationship between all significant associations after covariate adjustment, with no indication of a plateau in these relationships. In conclusion, higher handgrip strength was independently associated with better learning ability for novel verbal information and verbal fluency in US men over the age of 60 and without dementia. Longitudinal studies are required to confirm whether muscle strength independently predicts cognitive function changes in older adults in a sex-specific manner, and whether this connection is affirmed to the possibility of reverse causation due to declines in physical activity levels in the preclinical phase of dementia.

Association of walking pace and fall-related injury among Chinese older adults: Data from the SAGE survey

OBJECTIVE

Falls are an important public health issue that poses a threat to the health of senior people and reduces their ability to maintain independence, which in turn reduces poor quality of life. Several studies have demonstrated a positive relationship between physical function and fall, it remains unclear whether there is an association between gait speed and fall-related injuries among the aging population, which represent the largest proportion of older adults in China. Therefore, the aim of this study was to examine the association between gait speed and fall-related injuries among older Chinese adults.

METHODS

Data from the Global Ageing and Adult Health Survey (2007-2010) were analyzed. A stratified multi-stage cluster sampling design was used to collect the survey data. A total of 7558 Chinese adults aged 60 or older were included in this study. A 4-m walking test was used to assess gait speed. Fall-related injuries were self-reported by study participants. The binary logistic regression model was employed to examine the association between gait speed and fall-related injuries while controlling for age, sex, education years, smoking, alcohol consumption, and chronic diseases.

RESULTS

The mean age of the sample of older Chinese adults was 69.70 ± 7.10 years (females accounted for 52.6%). The results showed that a normal gait speed was negatively correlated with fall-related injury (odds ratio = 1.20) when adjusting for all covariates. Moreover, a binary regression analysis showed that a normal gait speed was only negatively correlated with fall-related injury in male participants (odds ratio = 1.32). There were no significant results in rapid gait speed and fall-related injuries.

CONCLUSION

The results suggest that a slow gait speed may predict a higher risk of fall-related injuries among older Chinese adults, especially older male adults. Further studies are needed to verify our findings.

Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs

Purpose

This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism.

Methods

We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health.

Results

The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status.

Conclusion

This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.

Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults

BACKGROUND

With aging, the cognitive function of the prefrontal cortex (PFC) declined, postural control weakened, and fall risk increased. As a mind-body exercise, regular Tai Chi practice could improve postural control and effectively prevent falls; however, underlying brain mechanisms remained unclear, which were shed light on by analyzing the effect of Tai Chi on the PFC in older adults by means of functional near-infrared spectroscopy (fNIRS).

METHODS

36 healthy older adults without Tai Chi experience were divided randomly into Tai Chi group and Control group. The experiment was conducted four times per week for 16 weeks; 27 participants remained and completed the experiment. Negotiating obstacle task (NOT) and negotiating obstacle with cognitive task (NOCT) were performed pre- and post-intervention, and Brodmann area 10 (BA10) was detected using fNIRS for hemodynamic response. A three-dimensional motion capture system measured walking speed.

RESULTS

After intervention in the Tai Chi group under NOCT, the HbO2 concentration change value (ΔHbO2) in BA10 was significantly greater (right BA10: p = 0.002, left BA10: p = 0.001), walking speed was significantly faster (p = 0.040), and dual-task cost was significantly lower than pre-intervention (p = 0.047). ΔHbO2 in BA10 under NOCT was negatively correlated with dual-task cost (right BA10: r = -0.443, p = 0.021, left BA10: r = -0.448, p = 0.019). There were strong negative correlations between ΔHbO2 and ΔHbR under NOCT either pre-intervention (left PFC r = -0.841, p < 0.001; right PFC r = -0.795, p < 0.001) or post-intervention (left PFC r = -0.842, p < 0.001; right PFC r = -0.744, p < 0.001).

CONCLUSION

Tai Chi practice might increase the cognitive resources in older adults through the PFC bilateral activation to prioritize gait performance during negotiating obstacles under a dual-task condition.

The association between physical performance and subjective wellbeing in Chinese older adults: A cross-sectional study

Purpose

This study aimed to investigate the association between physical performance and subjective wellbeing among Chinese older adults.

Methods

Data on the Chinese population were gathered from the Study on Global Aging and Adult Health Survey (SAGE). This survey used a stratified multistage cluster sample design based on geographical location and economic status. Chinese older adults aged 65 years old or above from eight provinces (Guangdong, Hubei, Jilin, Shaanxi, Shandong, Shanghai, Yunnan, and Zhejiang) were included in this cross-sectional study. Physical performance was measured using relative handgrip strength and normal gait speed. Subjective wellbeing was measured using quality-of-life (QOL), happiness, and mood through interviews with participants. Logistic regressions were used to examine the associations between physical performance and each of the three wellbeing variables (QOL, happiness, and mood).

Results

Data of 5,421 Chinese older adults (mean age: 72.93 ± 5.89 years old, 47.1% men) were analyzed. In this sample, individuals with a higher level of relative handgrip strength (rHGS) had better mood compared to those with a lower level of rHGS (p < 0.05), and persons with lower gait speed had poorer QOL, happiness, and mood compared to those with faster gait speed (p < 0.05).

Conclusion

Our findings suggest that a higher level of relative handgrip strength predicted better mood and lower gait speed predicted poor QOL, happiness, and mood in Chinese older adults.

Associations between grip strength, brain structure, and mental health in > 40,000 participants from the UK Biobank

BACKGROUND

Grip strength is a widely used and well-validated measure of overall health that is increasingly understood to index risk for psychiatric illness and neurodegeneration in older adults. However, existing work has not examined how grip strength relates to a comprehensive set of mental health outcomes, which can detect early signs of cognitive decline. Furthermore, whether brain structure mediates associations between grip strength and cognition remains unknown.

METHODS

Based on cross-sectional and longitudinal data from over 40,000 participants in the UK Biobank, this study investigated the behavioral and neural correlates of handgrip strength using a linear mixed effect model and mediation analysis.

RESULTS

In cross-sectional analysis, we found that greater grip strength was associated with better cognitive functioning, higher life satisfaction, greater subjective well-being, and reduced depression and anxiety symptoms while controlling for numerous demographic, anthropometric, and socioeconomic confounders. Further, grip strength of females showed stronger associations with most behavioral outcomes than males. In longitudinal analysis, baseline grip strength was related to cognitive performance at ~9 years follow-up, while the reverse effect was much weaker. Further, baseline neuroticism, health, and financial satisfaction were longitudinally associated with subsequent grip strength. The results revealed widespread associations between stronger grip strength and increased grey matter volume, especially in subcortical regions and temporal cortices. Moreover, grey matter volume of these regions also correlated with better mental health and considerably mediated their relationship with grip strength.

CONCLUSIONS

Overall, using the largest population-scale neuroimaging dataset currently available, our findings provide the most well-powered characterization of interplay between grip strength, mental health, and brain structure, which may facilitate the discovery of possible interventions to mitigate cognitive decline during aging.

A Link between Handgrip Strength and Executive Functioning: A Cross-Sectional Study in Older Adults with Mild Cognitive Impairment and Healthy Controls

Older adults with amnestic mild cognitive impairment (aMCI) who in addition to their memory deficits also suffer from frontal-executive dysfunctions have a higher risk of developing dementia later in their lives than older adults with aMCI without executive deficits and older adults with non-amnestic MCI (naMCI). Handgrip strength (HGS) is also correlated with the risk of cognitive decline in the elderly. Hence, the current study aimed to investigate the associations between HGS and executive functioning in individuals with aMCI, naMCI and healthy controls. Older, right-handed adults with amnestic MCI (aMCI), non-amnestic MCI (naMCI), and healthy controls (HC) conducted a handgrip strength measurement via a handheld dynamometer. Executive functions were assessed with the Trail Making Test (TMT A&B). Normalized handgrip strength (nHGS, normalized to Body Mass Index (BMI)) was calculated and its associations with executive functions (operationalized through z-scores of TMT B/A ratio) were investigated through partial correlation analyses (i.e., accounting for age, sex, and severity of depressive symptoms). A positive and low-to-moderate correlation between right nHGS (rp (22) = 0.364; p = 0.063) and left nHGS (rp (22) = 0.420; p = 0.037) and executive functioning in older adults with aMCI but not in naMCI or HC was observed. Our results suggest that higher levels of nHGS are linked to better executive functioning in aMCI but not naMCI and HC. This relationship is perhaps driven by alterations in the integrity of the hippocampal-prefrontal network occurring in older adults with aMCI. Further research is needed to provide empirical evidence for this assumption.