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

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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.

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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).

Author information

Authors and Affiliations

  1. Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept. 2620, PO Box 6050, Fargo, ND, 58108-6050, USA

    Ryan McGrath & Kyle J. Hackney

  2. Department of Statistics, North Dakota State University, Fargo, ND, USA

    Brenda M. Vincent

  3. Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA

    Soham Al Snih

  4. Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA

    James Graham

  5. Department of Psychology, North Dakota State University, Fargo, ND, USA

    Laura Thomas

  6. Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA

    Diane K. Ehlers

  7. Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA

    Brian C. Clark

  8. Department of Geriatric Medicine, Ohio University, Athens, OH, USA

    Brian C. Clark

  9. Department of Biomedical Sciences, Ohio University, Athens, OH, USA

    Brian C. Clark

Authors
  1. Ryan McGrath
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  2. Brenda M. Vincent
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  3. Kyle J. Hackney
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  4. Soham Al Snih
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  5. James Graham
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  6. Laura Thomas
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  7. Diane K. Ehlers
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  8. Brian C. Clark
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Corresponding author

Correspondence to Ryan McGrath.

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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.

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McGrath, R., Vincent, B.M., Hackney, K.J. et al. Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans. Aging Clin Exp Res 32, 1723–1730 (2020). https://doi.org/10.1007/s40520-019-01351-y

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  • DOI: https://doi.org/10.1007/s40520-019-01351-y

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