Handgrip strength asymmetry and cognitive impairment risk: Insights from a seven-year prospective cohort study.
Level 3 - non-randomized controlled study
Prospective cohort study with longitudinal follow-up
PubMed 38267160 · doi:10.1016/j.jnha.2023.100004
What was done
Researchers analyzed data from a 7-year prospective cohort (Taiwan Initiative of Geriatric Epidemiological Research, waves 3–5) of 392 dementia-free community-dwelling adults aged 65 years or older (mean age 75.8 years; 45.7% men). Handgrip strength and asymmetry (left-to-right ratio categorized into three groups) were evaluated at baseline. Cognitive tests across global and domain-specific functions were conducted biennially and evaluated using generalized linear mixed models.
What was found
Mild grip asymmetry was found in 22.4% (n = 88) and moderate asymmetry in 13.5% (n = 53) of participants. In men, having both low grip strength and grip asymmetry was associated with longitudinal cognitive decline in global cognition (β = -1.76, 95% CI: -2.79 to -0.74), memory immediate free recall (β = -0.67, 95% CI: -1.17 to -0.17), executive function via Trail Making Test-A (β = -0.54, 95% CI: -0.94 to -0.13), and attention via Digit Span-forward (β = -1.00, 95% CI: -1.46 to -0.54). Associations were not clearly reported or significant for women in the abstract.
Why it matters
Measuring grip asymmetry in conjunction with absolute grip strength may serve as a non-invasive, low-cost screening marker for identifying older men at elevated risk of multi-domain cognitive impairment.
Limits
The sample size is relatively modest (n = 392) from a single cohort in Taiwan, limiting generalizability. Significant associations were restricted to men, and exact risk estimates for women were omitted from the abstract. Observational designs cannot establish causality or rule out unmeasured confounders like subclinical neurological disorders.