John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
Arch Gerontol Geriatr. 2023 Apr;107:104903. doi: 10.1016/j.archger.2022.104903. Epub 2022 Dec 13.
To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period.
Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates.
US-born and foreign-born participants in the 4 quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1 (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3 and 4 HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3 and 4 HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates.
Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.
在一项为期 20 年的研究中,检查 65 岁以上、基线时认知功能正常或较高的墨西哥裔美国人中,握力(HGS)与认知障碍之间的关系在出生地上的差异。
这是一项前瞻性队列研究,纳入了来自西班牙裔老年人流行病学研究中的 2155 名非住院的墨西哥裔美国人,他们在基线时的 Mini 精神状态检查(MMSE)中得分≥21。测量包括社会人口统计学、体重指数、身体状况、抑郁症状、身体功能、残疾、HGS 四分位数(性别调整)和 MMSE。我们使用广义估计方程模型来估计认知障碍(MMSE<21)的比值比(OR)和 95%置信区间(CI),作为出生地点和调整协变量的 HGS 四分位的函数。
与 HGS 四分位中最低的一组相比,在基线时 HGS 四分位最高的美国出生和外国出生的参与者随着时间的推移,认知障碍的可能性更低(OR=0.95,95%CI=0.90-0.99 和 OR=0.93,95%CI=0.89-0.98),在控制了所有协变量后。当我们将 HGS 四分位数作为时变变量进行分析时,我们发现,在美国出生的参与者中,HGS 三分位和四分位的认知障碍可能性分别降低了 25%和 30%,而在外国出生的参与者中,HGS 三分位和四分位的认知障碍可能性分别降低了 27%和 49%,在控制了所有协变量后。
与美国出生的老年墨西哥裔美国人相比,HGS 表现较高的外国出生的老年墨西哥裔美国人随着时间的推移,认知障碍的可能性降低了 7%。