Abstract

BackgroundWe evaluated the associations of handgrip strength and cognitive function in cancer survivors ≥ 60 years old using data from the National Health and Nutrition Examination Survey (NHANES).MethodsData in two waves of NHANES (2011–2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value achieved using either hand. Two cognitive function tests were conducted among adults 60 years and older. The Animal Fluency Test (AFT) examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) assesses processing speed, sustained attention, and working memory. Survey analysis procedures were used to account for the complex sampling design of the NHANES. Multiple linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depressive symptoms and leisure time physical activity).ResultsAmong 383 cancer survivors (58.5% women, mean age = 70.9 years, mean BMI = 29.3 kg/m2), prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). In women, each increase in kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed an inverted U-shape association where cognitive function peaked at handgrip strength of 40–42 kg.ConclusionsHandgrip strength, a modifiable factor, appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to address their causal relationship.

Highlights

  • Cancer- and cancer treatment-related cognitive impairments are prevalent among cancer survivors [1]

  • We evaluated the associations of handgrip strength and cognitive function in cancer survivors ! 60 years old using data from the National Health and Nutrition Examination Survey (NHANES)

  • Low serum level of brain-derived neurotrophic factor (BDNF) [3] was found to be associated cognitive impairments, and genetic variations in the BDNF gene [4] were found to protect against cognitive impairments in cancer patients receiving chemotherapy

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Summary

Introduction

Cancer- and cancer treatment-related cognitive impairments are prevalent among cancer survivors [1]. Recent data have shown that detectable cognitive impairments are more prevalent in cancer survivors than aged matched cancer-free controls. The prevalence of cognitive impairment among cancer survivors is approximately 30% before cancer treatments, and up to 75% during- and approximately 35% post-cancer treatments [2]. This phenomenon is worse in older cancer survivors possibly owing to lower physical and cognitive reserves compared to younger survivors [1]. The modalities of preventing and treating cancer- and cancer-treatment related cognitive impairments are lacking because its aetiology is not well understood [2]. We evaluated the associations of handgrip strength and cognitive function in cancer survivors ! 60 years old using data from the National Health and Nutrition Examination Survey (NHANES)

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