A weak hand grip may be a sign of impending dementia in older adults, according to a recent study from Australia published in the Journal of Cachexia Sarcopenia and Muscle.¹

Researchers evaluated grip strength and carried out Timed Up and Go (TUG) test to measure muscle strength in 152 older women with a mean age 75 years at the time of their enrolment and after 5 years. Data for the study was obtained from the Perth Longitudinal Study of Ageing in Women. The study objective was to explore the association of muscle strength with dementia events in older women, either dementia-related hospitalization or death. The TUG test measures the time taken by the person to get up from a chair, walk for a distance of 3 m from the chair and then turn around and walk back to the chair and sit down again.

Results showed that nearly 17% of women had a late-life dementia event during the follow-up period. The risk of experiencing a late-life dementia event was doubled in women with the weakest grip strength (16.0 kg) compared to those with the highest grip strength (25.8 kg) with hazard ratio (HR) of 2.27.  Women who were slowest on the TUG test (12.4 sec vs 7.4 sec) were also at risk of a late-life dementia event with HR of 2.10. The combination of a weak hand grip (<22 kg) or slow TUG test (>10.2 sec) was indicative of the presence of an APOE â„‡ 4 allele in nearly 23% women. Women with muscle weakness and APOE â„‡ 4 allele were 3-times more likely to have a late-life dementia event compared vis a vis women without the allele and who had adequate muscle strength with HR of 3.19. A similar risk was observed for women with slowness and presence of the APOE â„‡ 4 allele (HR 2.59).

Women who showed the maximum decline in grip strength over 5 years were at higher risk of a late-life dementia event within the next decade with HR of 1.94. A similar trend was noted for decline in slowness in TUG test (HR 2.52).

Declining grip strength and mobility, indicative of muscle weakness, are a risk factor for dementia in older women as shown in this study. They manifest much before the symptoms of severe dementia appear and may be considered as a warning sign of the process. Hence, testing hand grip strength and TUG test may be used to screen persons at risk of late-life dementia and institute measures aimed at modifiable risk factors such as exercise and physical activity, diet, smoking. Those found to be at risk should be monitored carefully for cognitive decline

Reference

1. Radavelli-Bagatini S, et al. Impaired muscle function, including its decline, is related to greater long-term late-life dementia risk in older women. J Cachexia Sarcopenia Muscle. 2023 Apr 19. doi: 10.1002/jcsm.13227.