Associations between handgrip strength and mild cognitive impairment in middle‐aged and older adults in six low‐ and middle‐income countries

Abstract

Objectives A number of small‐scale, single‐country studies have suggested that muscular weakness may be a biomarker for cognitive health, mild cognitive impairment (MCI), and dementia. However, multinational, representative studies are lacking, particularly from low‐ and middle‐income countries (LMICs). Thus, we assessed the association between muscular strength (measured by maximal handgrip) and MCI in six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), using nationally representative data. Methods Cross‐sectional, community‐based data on individuals aged 50 years or older from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. MCI was defined according to the National Institute on Aging‐Alzheimer's Association criteria. Weak handgrip strength was defined as less than 30 kg for men and less than 20 kg for women using the average value of two handgrip measurements of the dominant hand. Multivariable logistic regression analysis was conducted to assess the association between muscular strength and MCI. Results A total of 32 715 participants were included (mean age 62 ± SD 15.6 y and 51.7% female). The prevalence of MCI and weak handgrip strength was 15.3% (95% CI, 14.4%‐16.3%) and 46.5% (95% CI, 43.6%‐49.5%), respectively. After adjustment for potential confounders, weak handgrip strength was associated with 1.41 (95% CI, 1.23‐1.61) times higher odds for MCI. The corresponding figures for those aged 50 to 64 years and 65 years or older were 1.35 (95% CI, 1.14‐1.60) and 1.54 (95% CI, 1.27‐1.86), respectively. Conclusions Muscular weakness may provide a clinically useful indicator of MCI risk. Increasing our understanding of the connection between muscular and cognitive function could ultimately lead to the development and broader implementation of resistance training interventions targeting both physical and cognitive health.

Meta-analysis: Resistance Training Improves Cognition in Mild Cognitive Impairment

“…An insufficient duration per session may be the factor for the differing results, which suggests that resistance training with an adequate duration per session may be more effective. A cross-sectional survey also revealed a relationship between muscle strength and the incidence of MCI; in other words, resistance training that increases muscle strength may prevent MCI [25]. Another study shows that the potential of resistance training to improve general cognitive function in MCI patients may be associated with a high level of insulin-like growth factor-1, which promotes neuronal growth, survival and differentiation and improves cognitive performance [13].…”

“…Some studies have linked resistance training with improved cognition in MCI patients. A recent cross-sectional study suggests that lower muscle strength may be associated with the incidence of MCI and that resistance training to enhance muscle strength can reduce the incidence of MCI [25]. Previous reviews have also shown that resistance training is good for cognition in the elderly [26].…”

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

“…51 Vancampfort et al recently reported that among middle-aged and older adults, weak grip strength was associated with increased odds of having mild cognitive impairment. 52 Others have shown a correlation between grip strength and the Mini-Mental State Examination scores of geriatric inpatients, 53 information processing speed and executive functioning of patients attending a memory clinic, 54 Stroop Task and 6item Cognitive Impairment Test scores of physically active adults, 55 visual memory,and reaction time of patients with schizophrenia, 56 and Animal Fluency Test and Digital Symbol Substitution Test scores of cancer survivors. 57 A link between grip strength and depression has been demonstrated among residents of 6 low and middle income countries 58 as well as Brazil 59 and Korea.…”

What are the association patterns between handgrip strength and adverse health conditions? A topical review

“…48 Another cross-sectional study of 32,715 adults aged 62.0 ± 15.6 years revealed that weakness was associated with 1.41 greater odds (p < 0.05) for mild cognitive impairment. 49 Although crosssectional study designs provide insights into the association of HGS and cognitive impairment, longitudinal study designs will help to reveal temporal inferences.…”