Abstract
BackgroundThe gait speed and handgrip strength represented the core determinants of physical frailty and sarcopenia, which were reported to be associated with cognitive impairment and decline. Different physical measures might differentially affect cognitive changes, such as higher-level cognitive change and global cognitive decline. This study examined the differential associations of gait speed and handgrip strength with 10-year cognitive changes among community-dwelling older people.MethodsParticipants aged 60 years and over living in the community were invited for study. Gait speed and handgrip strength were classified into 5 groups based on quintiles at baseline. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and Digit Symbol Substitution Test (DSST) every 2 years from baseline for a period of 10 years. Linear mixed effects models were used to determine the role of gait speed and handgrip strength in the prediction of 10-year cognitive changes by adjusting covariates, including age, gender, education, depressive symptoms, marital status, smoking status, instrumental activities of daily life (IADL), Charlson Comorbidity Index (CCI), and body mass index (BMI) at baseline.ResultsA total of 1096 participants were enrolled in the study. The mean age was 69.4 ± 5.8 years and 50.9% were male. The slowest gait speed group showed a significantly greater decline in the DSST scores over 10 years than the highest group (estimate = 0.28 and P = 0.003), but not in the MMSE scores (estimate = 0.05 and P = 0.078). The lowest handgrip strength group showed a significantly greater decline in the MMSE scores than the highest group (estimate = 0.06 and P = 0.039) and in the DSST scores than the highest two quintiles (estimate = 0.20 and P = 0.033 for the fourth quintile; estimate = 0.20 and P = 0.040 for the highest quintile) over 10-year follow-up.ConclusionsA slow gait speed could predict 10-year cognitive decline using DSST, and a low handgrip strength could predict 10-year cognitive decline using MMSE in addition to DSST. Thus both physical measures are lined to cognitive decline but there may be different mechanisms between brain and physical functions.
Highlights
The gait speed and handgrip strength represented the core determinants of physical frailty and sarcopenia, which were reported to be associated with cognitive impairment and decline
The results of the analysis showed that participants with slower gait speed were older (P < 0.001), had less education (P < 0.001), showed higher depressive symptoms (P = 0.030), and had a higher Charlson Comorbidity Index (CCI) (P = 0.002), a lower Mini-Mental State Examination (MMSE) score (P = 0.025), and a lower Digit Symbol Substitution Test (DSST) score (P < 0.001) (Table 1)
The analysis showed that participants with lower handgrip strength were older (P < 0.001), had less education (P < 0.001), had a lower body mass index (BMI) (P < 0.001), had higher depressive symptoms (P = 0.009), and had a higher CCI (P < 0.001), lower MMSE score (P < 0.001), and lower DSST score (P < 0.001) (Table 2)
Summary
This study examined the differential associations of gait speed and handgrip strength with 10-year cognitive changes among community-dwelling older people. The gait speed and handgrip strength represented the core determinants of physical frailty and sarcopenia, which were reported to be associated with cognitive impairment and decline [12, 14, 15]. Previous studies have shown that physical function parameters, such as gait speed and handgrip strength, are associated with cognitive function in older people [15,16,17]. We explored gait speed and handgrip strength as physical function indicators in this study
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