Grip Strength, Neurocognition, and Social Functioning in People WithType-2 Diabetes Mellitus, Major Depressive Disorder, Bipolar Disorder, and Schizophrenia

Abstract

Background: Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength (GS) is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses (SMIs). Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. Methods: Assessments of social functioning, cognitive performance, and GS (measured with an electronic dynamometer) were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates (p < 0.01). To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed (p < 0.05). Results: Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. Conclusion: GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning.

Specific metabolic syndrome components predict cognition and social functioning in people with type 2 diabetes mellitus and severe mental disorders

“…Cognitive performance was evaluated using a comprehensive battery of neuropsychological tests and subtests previously used by our group 38‐41 . Seven cognitive domains were assessed: (i) verbal learning and memory : Complutense Verbal Learning Test (TAVEC) total immediate recall, short‐term free recall and long‐term free recall variables 42 ; (ii) cognitive flexibility : Stroop Color and Word test (SCWT) color/word subtest 43 and Wisconsin Card Sorting Test (WCST) categories completed and perseverative errors 44 ; (iii) verbal fluency : FAS and animal naming test for phonemic and semantic fluency, respectively 45 ; (iv) working memory : Trail Making Test (TMT) Part B 45 and Wechsler Adult Intelligence Scale III edition (WAIS‐III) digit span backwards 46 ; (v) short ‐ term memory : TAVEC immediate recall of the first learning trial and immediate recall of the interference list 42 and WAIS‐III digit span forward 46 ; (vi) visual memory : Rey‐Osterrieth Complex Figure Test (ROCFT) figure two minutes after the copy (fRey2) and 20 minutes after the copy (fRey20) 47 ; and (vii) processing speed : finger tapping test (FTT) left unimanual, right unimanual, left bimanual, right bimanual and average four scores, 45,48 WAIS‐III digit symbol coding subtest, 46 SCWT color and word subtests 43 and TMT Part A 45 .…”

“…Cognitive performance was evaluated using a comprehensive battery of neuropsychological tests and subtests previously used by our group. [38][39][40][41] two minutes after the copy (fRey2) and 20 minutes after the copy (fRey20) 47 ; and (vii) processing speed: finger tapping test (FTT) left unimanual, right unimanual, left bimanual, right bimanual and average four scores, 45,48 WAIS-III digit symbol coding subtest, 46 SCWT color and word subtests 43 and TMT Part A. 45 A global cognitive score (GCS) was calculated by averaging the seven cognitive domain scores.…”

Immune–Inflammatory Biomarkers Predict Cognition and Social Functioning in Patients With Type 2 Diabetes Mellitus, Major Depressive Disorder, Bipolar Disorder, and Schizophrenia: A 1-Year Follow-Up Study

“…The neurocognitive performance was evaluated using a battery of cognitive tests and subtests previously used by our group ( 48 – 55 ). Test and subtests scores were grouped into the following four executive functions: (1) Cognitive flexibility: Stroop Color and Word Test (SCWT), Color/Word Subtest ( 56 ), and Wisconsin Card Sorting Test Categories Completed and Perseverative Errors scored ( 57 ); (2) verbal fluency: Verbal Fluency Tasks Semantic and Phonemic Forms ( 58 ); (3) working memory: Trail Making Test (TMT) Part B ( 59 ), and Wechsler Adult Intelligence Scale Third Edition (WAIS-III) Digit Span-B Subtest ( 60 ); and (4) processing speed: Finger Tapping Test ( 59 , 61 ), WAIS-III Digit Symbol Coding Subtest ( 60 ), SCWT Color and Word Subtests ( 56 ), and TMT Part A ( 59 ).…”

Transdiagnostic neurocognitive deficits in patients with type 2 diabetes mellitus, major depressive disorder, bipolar disorder, and schizophrenia: A 1-year follow-up study

“…Social functioning was evaluated using: (i) the Functional Assessment Short Test (FAST), [17] (ii) the Short Form-36 Health Survey questionnaire (SF-36), [18] and (iii) the WHO Quality of Life-BREF (WHOQOL-BREF). [19] Neurocognitive performance was evaluated using a battery of cognitive tests and subtests previously used by our group [20][21][22][23][24]. Test and subtests scores were divided into seven neurocognitive domains: 1) Learning and verbal memory (L&VM) [(i) Complutense Verbal Learning Test (TAVEC) V3, V8, and V10 variables, [25]] 2) Cognitive Flexibility (CF) [(ii) Stroop Color and Word test (SCWT) Color/Word subtest, [26] and (iii) Wisconsin Card Sorting Test (WCST) Categories Completed and Perseverative Errors scores, [27]] 3) Verbal Fluency (VF) [(iv) Verbal Fluency Tasks (VFT) Semantic and Phonemic forms, [28][29] [(viii) Finger Tapping Test (FTT), [30,33] WAIS-III Digit Symbol Coding subtest, [31] SCWT Color and Word subtests, [26] and TMT Part A, [30]] and three neurocognitive indices, including the Global Cognitive Score (GCS), which was calculated by averaging the seven neurocognitive domain scores; the premorbid Intelligence Quotient (IQ), which was calculated using the WAIS-III vocabulary subtest, considered a classical measure of the level of intelligence prior to the onset of a mental disorder [34]; and the Cognitive Reserve (CR), which was estimated based on the results of the WAIS-III Vocabulary subtest and the number of years of formal education.…”