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Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans

  • Ryan McGrathEmail author
  • Brenda M. Vincent
  • Kyle J. Hackney
  • Soham Al Snih
  • James Graham
  • Laura Thomas
  • Diane K. Ehlers
  • Brian C. Clark
Original Article
  • 32 Downloads

Abstract

Background

Discovering how certain health factors contribute to functional declines may help to promote successful aging.

Aims

To determine the independent and joint associations of handgrip strength (HGS) and cognitive function with instrumental activities of daily living (IADL) and activities of daily living (ADL) disability decline in aging Americans.

Methods

Data from 18,391 adults aged 50 years and over who participated in at least one wave of the 2006–2014 waves of the Health and Retirement Study were analyzed. A hand-held dynamometer assessed HGS and cognitive functioning was examined with a modified version of the Telephone Interview of Cognitive Status. IADL and ADL abilities were self-reported. Participants were stratified into four distinct groups based on their HGS and cognitive function status. Separate covariate-adjusted multilevel models were conducted for the analyses.

Results

Participants who were weak, had a cognitive impairment, and had both weakness and a cognitive impairment had 1.70 (95% confidence interval (CI) 1.57–1.84), 1.97 (CI 1.74–2.23), and 3.13 (CI 2.73–3.59) greater odds for IADL disability decline, respectively, and 2.26 (CI 2.03–2.51), 1.26 (CI 1.05–1.51), and 4.48 (CI 3.72–5.39) greater odds for ADL disability decline, respectively.

Discussion

HGS and cognitive functioning were independently and jointly associated with IADL and ADL disability declines. Individuals with both weakness and cognitive impairment demonstrated substantially higher odds for functional decline than those with either risk factor alone.

Conclusions

Including measures of both HGS and cognitive functioning in routine geriatric assessments may help to identify those at greatest risk for declining functional capacity.

Keywords

Dementia Epidemiology Geriatrics Muscle strength Nervous system 

Notes

Funding

RMs effort on this research was partially funded by the College of Human Sciences and Education at North Dakota State University. The authors would like to thank those who anecdotally contributed to this research (TMM).

Compliance with ethical standards

Conflict of interest

BCC has received research funding or consulting fees from the NIH, Regeneron Pharmaceuticals, Astellas Pharma Global Development, RTI Health Solutions, Osteopathic Heritage Foundations, Regeneron Pharmaceuticals, Abbott Laboratories, and the Gerson Lehrman Group. Additionally, BCC is co-founder with equity, and serves as the Chief of Aging Research for AEIOU Scientific. The other authors declare no conflicts of interest.

Statement of human and animal rights

HRS protocols were approved by the university’s Behavioral Sciences Committee Instructional Review Board.

Informed consent

Written informed consent was provided by participants before entering the HRS.

Supplementary material

40520_2019_1351_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)
40520_2019_1351_MOESM2_ESM.docx (17 kb)
Supplementary material 2 (DOCX 17 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ryan McGrath
    • 1
    Email author
  • Brenda M. Vincent
    • 2
  • Kyle J. Hackney
    • 1
  • Soham Al Snih
    • 3
  • James Graham
    • 4
  • Laura Thomas
    • 5
  • Diane K. Ehlers
    • 6
  • Brian C. Clark
    • 7
    • 8
    • 9
  1. 1.Department of Health, Nutrition, and Exercise SciencesNorth Dakota State UniversityFargoUSA
  2. 2.Department of StatisticsNorth Dakota State UniversityFargoUSA
  3. 3.Division of Rehabilitation SciencesUniversity of Texas Medical BranchGalvestonUSA
  4. 4.Department of Occupational TherapyColorado State UniversityFort CollinsUSA
  5. 5.Department of PsychologyNorth Dakota State UniversityFargoUSA
  6. 6.Department of Neurological SciencesUniversity of Nebraska Medical CenterOmahaUSA
  7. 7.Ohio Musculoskeletal and Neurological InstituteOhio UniversityAthensUSA
  8. 8.Department of Geriatric MedicineOhio UniversityAthensUSA
  9. 9.Department of Biomedical SciencesOhio UniversityAthensUSA

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