Cardiovascular disease (CVD) and cognitive impairment are concomitant conditions which differentially impact Latino older adults. Maximal isometric handgrip strength is a simple and valid measure of muscle strength, and may reflect frailty. In past studies, decreased handgrip strength has emerged as a risk factor for cognitive impairment among the general public but not among older Latino adults with CVD whom are at greater risk. The objective of this study was to evaluate the association between handgrip strength and cognitive function among a sample of community dwelling older Latino adults with CVD.
Methods:
The Sacramento Area Latino Study of Aging (SALSA) study was conducted in the Sacramento Area of California from between 1996 and 2008. The main objective of the project was to track the incidence of physical and cognitive impairment among a cohort of Latino older adults. The main outcomes of the study have been reported elsewhere. This secondary data analysis of the included individuals with past history of CVD and excluded those with stroke, dementia, and Parkinson’s disease. In brief, participants were interviewed in their homes and handgrip strength was measured in kilograms using a handheld dynamometer in the dominant writing hand. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. The Modified Mini Mental State Exam (3MS) was used as a brief 0-100 point-scale of global cognition and screening tool for cognitive impairment. The following cut-offs were determined for 3MS scores based on the literature: 0-49 points sever cognitive impairment, 49-77 points moderate impairment, 78-100 points normal cognitive function. Due to the negative skew, 3MS data was transformed using base log10. Descriptive statistics of the sample are provided and linear regression was used to assess relation between handgrip strength and cognitive function among the CVD sub-sample with the following covariates: age, level of education, depression, and body mass index (BMI).
Results:
±±±±10.1kg. On the univariate level, maximal isometric handgrip strength was able to explain 11.2% of the variance in 3MS scores (B=0.002; p=0.001; 95% CI 0.001-0.003). On the multivariate level, a 10kg increase in maximal isometric handgrip strength was associated with a 2.0% increase in overall cognitive function after adjustment for age, level of education, depression, and BMI (p=0.036; 95% CI 0.001-0.003). The multivariate model explained 29.2% of the variance in 3MS scores.
Conclusion:
In this secondary data analysis of the SALSA study, maximal isometric handgrip strength was associated with poorer cognitive function among Latino older adults with CVD. Increases in handgrip strength was associated with a small increase in cognitive function, it may be an adjunct tool in addition to other measures of cognitive function among high-risk populations such as the Latino older adult population with CVD. Maximal isometric handgrip strength is associated with overall frailty, and reducing frailty may serve as a means for future intervention development to sustain normal cognitive function among the CVD population.