Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA; Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA; Fargo VA Healthcare System, Fargo, ND, USA; Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA; Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
J Am Med Dir Assoc. 2023 Dec;24(12):1936-1941.e2. doi: 10.1016/j.jamda.2023.07.021. Epub 2023 Aug 24.
New absolute and normalized handgrip strength (HGS) cut-points may not yield similar predictive value for cognitive performance. We sought to determine the associations of (1) each absolute and normalized weakness cut-point, and (2) compounding weakness on future cognitive impairment in older Americans.
Longitudinal panel.
The analytic sample included 11,116 participants aged ≥65 years from the 2006 to 2018 waves of the Health and Retirement Study. Participants from the Health and Retirement Study completed detailed interviews that included physical measures and core interviews.
The modified Telephone Interview of Cognitive Status assessed cognitive function and persons scoring <11 were classified as having a cognitive impairment. A handgrip dynamometer measured HGS. Men were considered weak if their HGS was <35.5 kg (absolute), <0.45 kg/kg (body mass normalized), or <1.05 kg (body mass index normalized), whereas women were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg. Compounding weakness included those below 1, 2, or all 3 cut-points. Generalized estimating equations quantified the associations.
Persons considered weak under the absolute cut-point had 1.62 (95% CI 1.34-1.96) greater odds for future cognitive impairment, but no significant associations were observed for those classified as weak under the body mass [odds ratio (OR) 1.12, CI 0.91-1.36] and body mass index normalized (OR 1.17, CI 0.95-1.43) cut-points. Older Americans below all 3 weakness cut-points had 1.47 (CI 1.15-1.88) greater odds for future cognitive impairment, but no significant associations were found for persons classified as weak under 1 (OR 1.08, CI 0.83-1.42) or 2 (OR 1.19, CI 0.91-1.55) cut-points.
Our findings suggest that each weakness cut-point has differential prognostic value for future cognitive impairment, and aggregating weakness cut-points may improve their predictive utility. Consideration should be given to how weakness categories are uniquely linked to cognitive function.
新的绝对和标准化握力（HGS）切点可能不会对认知表现产生相似的预测价值。我们旨在确定（1）每个绝对和标准化弱点切点，以及（2）老年人未来认知障碍复合弱点的切点与未来认知障碍的关联。
纵向面板。
分析样本包括来自健康与退休研究 2006 年至 2018 年波的 11116 名年龄≥65 岁的参与者。来自健康与退休研究的参与者完成了详细的访谈，其中包括身体测量和核心访谈。
改良电话认知状态测试评估认知功能，得分<11 的人被归类为认知障碍。使用握力测力计测量 HGS。如果男性的 HGS<35.5kg（绝对）、<0.45kg/kg（体重标准化）或<1.05kg（体重指数标准化），则认为其较弱，而如果女性的 HGS<20.0kg、<0.337kg/kg 或<0.79kg，则认为其较弱。复合弱点包括低于 1、2 或所有 3 个切点的人。广义估计方程量化了关联。
根据绝对切点被认为较弱的人未来认知障碍的几率增加了 1.62（95%置信区间 1.34-1.96），但根据体重[比值比（OR）1.12，置信区间 0.91-1.36]和体重指数标准化（OR 1.17，置信区间 0.95-1.43）切点分类为较弱的人没有观察到显著关联。低于所有 3 个弱点切点的美国老年人未来认知障碍的几率增加了 1.47（置信区间 1.15-1.88），但对于被归类为低于 1（OR 1.08，置信区间 0.83-1.42）或 2（OR 1.19，置信区间 0.91-1.55）个切点的人，没有发现显著关联。
我们的研究结果表明，每个弱点切点对未来认知障碍都有不同的预后价值，并且聚集弱点切点可能会提高其预测能力。应该考虑弱点类别如何与认知功能独特地联系起来。
