Grip Strength and Sarcopenia Predict 2-Year Cognitive Impairment in Community-Dwelling Older Adults

Tao-Chun Peng; Jeng-Min Chiou; Ta-Fu Chen; Yen-Ching Chen; Jen-Hau Chen

doi:10.1016/j.jamda.2022.10.015

Grip Strength and Sarcopenia Predict 2-Year Cognitive Impairment in Community-Dwelling Older Adults

J Am Med Dir Assoc. 2023 Mar;24(3):292-298.e1. doi: 10.1016/j.jamda.2022.10.015. Epub 2022 Nov 23.

Authors

Tao-Chun Peng¹, Jeng-Min Chiou², Ta-Fu Chen³, Yen-Ching Chen⁴, Jen-Hau Chen⁵

Affiliations

¹ Division of Family Medicine and Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
² Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan; Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan.
³ Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: karenchen@ntu.edu.tw.
⁵ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: jhhchen@ntu.edu.tw.

PMID: 36435272
DOI: 10.1016/j.jamda.2022.10.015

Abstract

Objectives: Using the Asian Working Group for Sarcopenia (AWGS2019) and the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, this study examined associations of sarcopenia and its components with specific domains of cognitive impairment over time.

Design: A prospective cohort study with a 2-year follow-up.

Setting and participants: This study is part of the Taiwan Initiatives for Geriatric Epidemiological Research (TIGER), which recruited participants aged 65 years old who attended the senior health checkup program at National Taiwan University Hospital (NTUH).

Methods: Grip strength was measured using a handgrip dynamometer. Walking speed (m/s) was measured as the time required to walk 8 feet. Muscle mass was measured by performing a bioelectrical impedance analysis. Global cognition (assessed using the Taiwanese version of the Montreal Cognitive Assessment) and 4 cognitive domains (memory, executive function, verbal fluency, and attention) were assessed over time. Associations of sarcopenia and its components with cognitive impairment were evaluated after stratification by sex using generalized linear mixed models adjusted for essential covariates for cognitive impairment.

Results: Compared with robust women, those with severe sarcopenia were more likely to have a global cognitive impairment over time (β = -0.87, P = .03 based on AWGS2019 criteria and β = -1.07, P = .02 based on the EWGSOP2 criteria). Among men, low grip strength was associated with poor scores on measures of global cognition (β = -0.80, P = .03), executive function (β = -0.35, P = .001), verbal fluency (β = -0.31, P = .02), and attention (β = -0.34, P = .008) over time.

Conclusions and implications: Severe sarcopenia predicted global and specific domains of cognitive impairment in older adults. Poor grip strength predicted cognitive impairment in men but not in women. A screen for sarcopenia severity and low muscle strength may be used to identify the risk of cognitive impairment.

Keywords: Cognitive impairment; grip strength; muscle mass; sarcopenia; walking speed.

MeSH terms

Aged
Cognitive Dysfunction*
Female
Geriatric Assessment
Hand Strength / physiology
Humans
Independent Living
Male
Muscle Strength / physiology
Prevalence
Prospective Studies
Sarcopenia*