Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans
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ORIGINAL ARTICLE
Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans Ryan McGrath1 · Brenda M. Vincent2 · Kyle J. Hackney1 · Soham Al Snih3 · James Graham4 · Laura Thomas5 · Diane K. Ehlers6 · Brian C. Clark7,8,9 Received: 17 June 2019 / Accepted: 5 September 2019 © Springer Nature Switzerland AG 2019
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 selfreported. 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
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40520-019-01351-y) contains supplementary material, which is available to authorized users. 5
Department of Psychology, North Dakota State University, Fargo, ND, USA
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Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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Department of Statistics, North Dakota State University, Fargo, ND, USA
Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
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Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
Department of Geriatric Medicine, Ohio University, Athens, OH, USA
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Department of Biomedical Sciences, Ohio University, Athens, OH, USA
* Ryan McGrath [email protected] 1
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Department of Heal
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