Muscular Function as an Alternative to Identify Cognitive Impairment: A Secondary Analysis From SABE Colombia

Elkin Garcia-Cifuentes; Felipe Botero-Rodríguez; Felipe Ramirez Velandia; Angela Iragorri; Isabel Marquez; Geronimo Gelvis-Ortiz; María-Fernanda Acosta; Alberto Jaramillo-Jimenez; Francisco Lopera; Carlos Alberto Cano-Gutiérrez

doi:10.3389/fneur.2022.695253

Muscular Function as an Alternative to Identify Cognitive Impairment: A Secondary Analysis From SABE Colombia

Front Neurol. 2022 Feb 18:13:695253. doi: 10.3389/fneur.2022.695253. eCollection 2022.

Authors

Affiliations

¹ Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia.
² Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia.
³ Departamento de Epidemiologia Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia.
⁴ Facultad de Medicina, Grupo Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia.
⁵ Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.
⁶ Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
⁷ Facultad de Medicina, Grupo Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia.
⁸ Facultad de Medicina, Semillero de Investigación SINAPSIS, Universidad de Antioquia, Medellín, Colombia.
⁹ Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia.

Abstract

Background: Identification of cognitive impairment is based traditionally on the neuropsychological tests and biomarkers that are not available widely. This study aimed to establish the association between motor function (gait speed and handgrip strength) and cognitive performance in the Mini-Mental State Examination, globally and by domains. A secondary goal was calculating a cut-off point for gait speed and handgrip strength to classify older adults as cognitively impaired.

Methods: This is a secondary analysis of SABE Colombia (Salud, Bienestar & Envejecimiento), a survey that was conducted in 2015 on health, wellbeing, and aging in Colombia. This study used linear regression models to search for an association between motor function and cognitive performance. The accuracy of motor function measurements in identifying cognitive impairment was assessed with receiver operating characteristic (ROC) curves. This study also analyzed other clinical and sociodemographical variables.

Results: Gait speed was associated with orientation (r ² = 0.16), language (r ² = 0.15), recall memory (r ² = 0.14), and counting (r ² = 0.08). Similarly, handgrip strength was associated with orientation (r ² = 0.175), language (r ² = 0.164), recall memory (r ² = 0.137), and counting (r ² = 0.08). To differentiate older adults with and without cognitive impairment, a gait speed cut-off point of 0.59 m/s had an area under the curve (AUC) of 0.629 (0.613-0.646), and a weak handgrip (strength below 17.5 kg) had an AUC of 0.653 (0.645-0.661). The cut-off points for handgrip strength and gait speed were significantly higher in male participants.

Conclusions: Gait speed and handgrip strength are similarly associated with the cognitive performance, exhibiting the most extensive association with orientation and language domains of the Mini-Mental State Examination. Gait speed and handgrip strength can easily be measured by any clinician, and they prove to be useful screening tools to detect cognitive impairment.

Keywords: biomarker; cognitive impairment; gait speed; handgrip strength; motor dysfunction; pre-clinical dementia.