握力减弱和不对称与运动认知风险综合征发病的关联：中国健康与养老追踪调查。
Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study.
机构信息
From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu.
出版信息
Neurology. 2023 Jun 6;100(23):e2342-e2349. doi: 10.1212/WNL.0000000000207308. Epub 2023 Apr 19.
BACKGROUND AND OBJECTIVES
Motoric cognitive risk (MCR) syndrome is a type of pre-dementia. It is defined as the co-occurrence of subjective cognitive complaints and a slow gait speed. A recent study found that handgrip strength (HGS) asymmetry is associated with an increased risk of neurodegenerative disorders. We aimed to investigate the associations of HGS weakness and asymmetry separately and together with MCR incidence among older Chinese adults.
METHODS
Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. HGS values <28 kg for male participants and <18 kg for female participants were considered HGS weaknesses. HGS asymmetry was assessed by the ratio of nondominant to dominant HGS. We used 3 different cutoff values of HGS ratio to define asymmetry, including 10%, 20%, and 30%. Specifically, HGS ratios <0.90 or >1.10 (10%), <0.80 or >1.20 (20%), and <0.70 or >1.30 (30%) were classified as asymmetry. The participants were classified into 4 groups: neither weakness nor asymmetry (neither), asymmetry only, weakness only, and weakness and asymmetry (both). The association between baseline HGS status and 4-year incidence of MCR was examined using logistic regression analyses.
RESULTS
A total of 3,777 participants 60 years and older were included in the baseline analysis. The prevalence of MCR at the baseline was 12.8%. Participants with asymmetry only, weakness only, and both showed significantly increased risk of MCR. After excluding participants with MCR at baseline, 2,328 participants were included in the longitudinal analysis. There were 111 MCR cases (4.77%) over the 4-year follow-up period. Participants with HGS weakness and asymmetry together at baseline had increased odds of incident MCR (HGS ratio at 10%: odds ratio [OR] 4.48, < 0.001; HGS ratio at 20%: OR 5.43, < 0.001; HGS ratio at 30%: OR 6.02, < 0.001).
DISCUSSION
These results show that the presence of both HGS asymmetry and weakness is associated with MCR incidence. The early recognition of HGS asymmetry and weakness may be helpful in the prevention and treatment of cognitive dysfunction.
背景与目的
运动认知风险（MCR）综合征是一种前驱痴呆症。它被定义为主观认知主诉和步态缓慢的同时发生。最近的一项研究发现，手握力（HGS）不对称与神经退行性疾病的风险增加有关。我们旨在研究 HGS 减弱和不对称性分别以及与中国老年人 MCR 发病率之间的关系。
方法
本研究使用了 2011 年和 2015 年中国健康与退休纵向研究的数据。男性参与者的 HGS 值<28kg，女性参与者的 HGS 值<18kg 被认为是 HGS 减弱。通过非优势手与优势手的 HGS 比值评估 HGS 不对称性。我们使用了 3 个不同的 HGS 比值截断值来定义不对称性，包括 10%、20%和 30%。具体来说，HGS 比值<0.90 或>1.10（10%）、<0.80 或>1.20（20%）和<0.70 或>1.30（30%）被归类为不对称性。参与者被分为 4 组：既无减弱也无不对称性（均无）、仅有不对称性、仅有减弱、减弱和不对称性（均有）。使用逻辑回归分析检查基线 HGS 状态与 4 年 MCR 发生率之间的关联。
结果
共纳入 3777 名 60 岁及以上的参与者进行基线分析。基线时 MCR 的患病率为 12.8%。仅有不对称性、仅有减弱和均有的参与者发生 MCR 的风险显著增加。排除基线时患有 MCR 的参与者后，2328 名参与者被纳入纵向分析。在 4 年的随访期间，有 111 例 MCR 病例（4.77%）。基线时同时存在 HGS 减弱和不对称性的参与者发生 MCR 的几率增加（HGS 比值为 10%：比值比[OR]4.48，<0.001；HGS 比值为 20%：OR 5.43，<0.001；HGS 比值为 30%：OR 6.02，<0.001）。
讨论
这些结果表明，HGS 不对称和减弱的同时存在与 MCR 发病率有关。早期识别 HGS 不对称和减弱可能有助于认知功能障碍的预防和治疗。
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