Associations between handgrip strength and mild cognitive impairment in middle-aged and older adults in six low- and middle income countries

Objectives: A number of small scale, single country studies have suggested that muscular weakness may be a biomarker for cognitive health, mild cognitive impairment (MCI) and dementia. However, multinational, representative studies are lacking, particularly from low- and middle-income countries (LMICs). Thus, we assessed the association between muscular strength (measured by maximal handgrip) and MCI in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), using nationally representative data. Methods: Cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. MCI was defined according to the National Institute on Ageing-Alzheimer’s Association criteria. Weak handgrip strength was defined as <30kg for men and <20 kg for women using the average value of two handgrip measurements of the dominant hand. Multivariable logistic regression analysis was conducted to assess the association between muscular strength and MCI. Results: 32,715 participants were included (mean age 62.± SD 15.6 years and 51.7% female). The prevalence of MCI and weak handgrip strength were 15.3% (95%CI=14.4%-16.3%) and 46.5% (95%CI=43.6%-49.5%) respectively. After adjustment for potential confounders, weak handgrip strength was associated with 1.41 (95%CI=1.23-1.61) times higher odds for MCI. The corresponding figures for those aged 50-64 years and ≥65 years were 1.35 (95%CI=1.14-1.60) and 1.54 (95%CI=1.27-1.86) respectively. Conclusions: Muscular weakness may provide a clinically useful indicator of MCI risk. Increasing our understanding of the connection between muscular and cognitive function could ultimately lead to the development and broader implementation of resistance-training interventions targeting both physical and cognitive health.