Association of dual impairment in physical performance and cognition with cognitive change over two years in older adults

Abstract

AbstractBackgroundDementia has a great impact in the ageing world. Much of the growing will happen in low and middle income regions, especially in Asia and Africa. Identifying the target population before clinical symptoms is most important for early intervention of preventing dementia. Recently, the concept of motoric cognitive risk syndrome has been introduced. However, the analogue of this syndrome is poorly evaluated. Therefore, we aim to explore the association of dual impairment in physical performance and cognition with cognitive impairment.MethodThis cohort study is part of the ongoing Taiwan Initiative of Geriatric Epidemiological Research. A total of 315 participants aged 65 and older were identified between 2015 and 2017 at the University Taiwan University hospital with a two‐ year follow‐up (2017‐2019). Dual impairment were defined as the concurrence of slow gait speed (< 1 m/s) and poor cognitive domain or low grip strength (< 28kg for men and < 18kg for women) and poor cognitive domain. Cognitive impairment was defined as the lowest tertile of the change of Taiwanese version of Montreal Cognitive Assessment (MoCA‐T) over 2 years. Logistic regression models were used to evaluate the association between dual impairment and the change of cognitive function adjusted for age, sex, education, and apolipoprotein e4 status.ResultThe mean age of this population was 75.17 years old. Forty‐eight participants (15.24%) with dual impairment of low handgrip strength and low verbal fluency were identified. Multivariable analyses showed that dual impairment of low grip strength and low verbal fluency increased the risk of cognitive decline [adjusted odds ratios (aOR)=2.42, 95% confidence interval (CI)=1.20−4.88]. However, dual impairment of slow gait speed and low verbal fluency were not associated with cognitive decline (aOR=1.62, 95% CI=0.94–2.78).ConclusionOur findings indicate that older adults with dual impairment of low grip strength and low verbal fluency were at a higher risk of cognitive impairment, which emphasizes the importance of complexity in pre‐dementia syndrome. Further research is warranted to clarity the underlying mechanisms of cognitive impairment and opportunities for early intervention.