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Association of grip strength, upper arm circumference, and waist circumference with dementia in older adults of the wise study: A cross-sectional analysis

Abstract

Objective

We examined the associations of handgrip strength, upper arm circumference, and waist circumference with dementia among Singapore older adults.

Design

Cross-sectional epidemiological study.

Setting

Residential homes, day care centres, nursing homes and institutions.

Participants

2,565 men and women aged 60 years and above who participated in the Well-being of the Singapore Elderly (WiSE) study in 2013.

Measurements

Socio-demographic correlates, dietary habits, health behaviours, grip strength, upper arm circumference, and waist circumference were collected. Grip strength was measured using a hand dynamometer with the dominant hand. Upper arm circumference was measured using a measuring tape around the thickest part of the upper arm while waist circumference measured in centimetres was measured at the narrowest part of the body between the chest and hips for women, and measured at the level of the umbilicus for men. Dementia was diagnosed using the 10/66 dementia diagnostic criteria.

Results

Mean grip strength was 13.07 kg (SE=0.60) for people with dementia and 21.98 kg (SE=0.26) for people without dementia. After adjusting for all factors, grip strength remained significantly associated with dementia (p <0.0001). Upper arm circumference was associated with dementia (p <0.0001) but this association was only significant in the univariate analysis. Waist circumference was not significantly associated with dementia.

Conclusions

Lower grip strength was independently associated with dementia in the older adult population in Singapore. Further research needs to be done to ascertain whether this association exists for specific types of dementia and look into the relationship of other anthropometric measurements with dementia in Singapore.

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References

  1. 1.

    World Health Organization [WHO]. Facts about ageing. 2014 30 September 2014 [cited 2015; Available from: http://www.who.int/ageing/about/facts/en/.

  2. 2.

    Statistics, S.D.o. Statistics Singapore Population Trends. 2015 02 Sept 2015]; Available from: http://www.singstat.gov.sg/docs/default-source/default-documentlibrary/publications/publications_and_papers/reference/monthly_digest/mdsjul15. pdf.

  3. 3.

    Singapore Department of Statistics. Population Trends 2014. 2014 September 2014 [cited 2015; Available from: http://www.singstat.gov.sg/docs/default-source/defaultdocument-library/publications/publications_and_papers/population_and_population_ structure/population2014.pdf.

  4. 4.

    Prince, M., R. Bryce, E. Albanese, A. Wimo, W. Ribeiro, and C.P. Ferri, The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement, 2013. 9(1): p. 63–75e2.

  5. 5.

    Buchman, A.S., R.S. Wilson, P.A. Boyle, J.L. Bienias, and D.A. Bennett, Grip strength and the risk of incident Alzheimer’s disease. Neuroepidemiology, 2007. 29(1-2): p. 66–73.

  6. 6.

    Camina Martín, M.A., B. de Mateo Silleras, L. Nescolarde Selva, S. Barrera Ortega, L. Domínguez Rodríguez, and M.P. Redondo Del Río, Bioimpedance vector analysis and conventional bioimpedance to assess body composition in older adults with dementia. Nutrition (Burbank, Los Angeles County, Calif.), 2015. 31(1): p. 155–159.

  7. 7.

    Thomas, V.S. and P.A. Hageman, Can neuromuscular strength and function in people with dementia be rehabilitated using resistance-exercise training? Results from a preliminary intervention study. The journals of gerontology.Series A, Biological sciences and medical sciences, 2003. 58(8): p. 746–M751.

  8. 8.

    Rogers, S.D. and S.E. Jarrot, Cognitive impairment and effects on upper body strength of adults with dementia. J Aging Phys Act, 2008. 16(1): p. 61–8.

  9. 9.

    Roriz, A.K., L.C. Passos, C.C. de Oliveira, M. Eickemberg, A. Moreira Pde, and L.R. Sampaio, Evaluation of the accuracy of anthropometric clinical indicators of visceral fat in adults and elderly. PLoS One, 2014. 9(7): p. e103499.

  10. 10.

    Hanisah, R., S. Shahar, and F.S. Lee, Validation of screening tools to assess appetite among geriatric patients. The journal of nutrition, health & aging, 2013. 16(7): p. 660–665.

  11. 11.

    Kerr, A., H.E. Syddall, C. Cooper, G.F. Turner, R.S. Briggs, and A.A. Sayer, Does admission grip strength predict length of stay in hospitalised older patients? Age and Ageing, 2006. 35(1): p. 82–84.

  12. 12.

    Sallinen, J., Hand-grip strength cut points to screen older persons at risk for mobility limitation. J Am Geriatr Soc, 2010. 58(9): p. 1721–1726.

  13. 13.

    Dong, H.-J., J. Marcusson, E. Wressle, and M. Unosson, Obese very old women have low relative handgrip strength, poor physical function, and difficulties in daily living. The journal of nutrition, health & aging, 2015. 19(1): p. 20–25.

  14. 14.

    Rantanen, T., J.M. Guralnik, and D. Foley, Midlife hand grip strength as a predictor of old age disability. JAMA [H.W.Wilson -GS], 1999. 281(6): p.558.

  15. 15.

    Ramlagan, S., K. Peltzer, and N. Phaswana-Mafuya, Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa. BMC Research Notes, 2014. 7(1): p. 8-8.

  16. 16.

    Taekema, D.G., J. Gussekloo, A.B. Maier, R.G. Westendorp, and A.J. de Craen, Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing, 2010. 39(3): p. 331–7.

  17. 17.

    Alfaro-Acha, A., S. Al Snih, M.A. Raji, Y.F. Kuo, K.S. Markides, and K.J. Ottenbacher, Handgrip strength and cognitive decline in older Mexican Americans. J Gerontol A Biol Sci Med Sci, 2006. 61(8): p. 859–65.

  18. 18.

    Taekema, D.G., et al., Temporal relationship between handgrip strength and cognitive performance in oldest old people. Age and Ageing, 2012. 41(4): p. 506–512.

  19. 19.

    Sultan, P., M.A. Hamilton, and G.L. Ackland, Preoperative muscle weakness as defined by handgrip strength and postoperative outcomes: a systematic review. BMC anesthesiology, 2012. 12(1): p. 1-1.

  20. 20.

    Metter, E.J., L.A. Talbot, M. Schrager, and R. Conwit, Skeletal muscle strength as a predictor of all-cause mortality in healthy men. The journals of gerontology.Series A, Biological sciences and medical sciences, 2002. 57(10): p. B359–B365.

  21. 21.

    Santos, J.L., et al., Anthropometric measurements in the elderly population of Santiago, Chile. Nutrition, 2004. 20(5): p. 452–457.

  22. 22.

    Coqueiro Rda, S., A.R. Barbosa, and A.F. Borgatto, Anthropometric measurements in the elderly of Havana, Cuba: age and sex differences. Nutrition, 2009. 25(1): p. 33–9.

  23. 23.

    De Rouvray, C., et al., The nutritional status of older people with and without dementia living in an urban setting in Central Africa: the EDAC study. J Nutr Health Aging, 2014. 18(10): p. 868–75.

  24. 24.

    Taylor, C.L., E. Albanese, and R. Stewart, The association of dementia with upper arm and waist circumference in seven low-and middle-income countries: the 10/66 cross-sectional surveys. J Gerontol A Biol Sci Med Sci, 2012. 67(8): p. 897–904.

  25. 25.

    Subramaniam, M., et al., Prevalence of Dementia in People Aged 60 Years and Above: Results from the WiSE Study. J Alzheimers Dis, 2015. 45(4): p. 1127–38.

  26. 26.

    American Psychiatric Association. Task Force on, D.-I. and A. American Psychiatric, Diagnostic and statistical manual of mental disorders: DSMIV. Vol. 4th. 1994, Washington, D.C U6 -ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions. com&rft_val_fmt=info:ofi/fmt:kev:mtx:book&rft.genre=book&rft. title=Diagnostic+and+statistical+manual+of+mental+disorders&rft.date=1994-01-01&rft.pub=American+Psychiatric+Association&rft.externalDocID=b18486010&par amdict=en-US U7 -Book: American Psychiatric Association.

  27. 27.

    Prince, M., D. Acosta, H. Chiu, M. Scazufca, M. Varghese, and G. Dementia Research, Dementia diagnosis in developing countries: a cross-cultural validation study. The Lancet, 2003. 361(9361): p. 909–917.

  28. 28.

    10/66 Dementia Research Group. Population–based epidemiological studies (prevalence phase): methods. 31 May 2015]; Available from: http://www.alz.co.uk/1066/pop_based_ep_studies_prevalence_phase_methods.php.

  29. 29.

    Norman, K., N. Stobaus, M.C. Gonzalez, J.D. Schulzke, and M. Pirlich, Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr, 2011. 30(2): p. 135–42.

  30. 30.

    Horowitz, B.P., R. Tollin, and G. Cassidy, Grip Strength. Physical & Occupational Therapy in Geriatrics, 1997. 15(1): p. 53–64.

  31. 31.

    MacInnis, R.J., et al., Predictors of increased body weight and waist circumference for middle-aged adults. Public Health Nutr, 2014. 17(5): p. 1087–97.

  32. 32.

    Ardebili, H.E., F.L. Boloki, A. Jazayeri, M. Ariaei, and M. Minaei, Nutritional status of elderly people. Journal of School of Public Health and Institute of Public Health Research, 2014. 12(2): p. 67–76.

  33. 33.

    Lim, W., P. Ong, and M. Lee, 2014, How Strong is Our Grip?: Comparison of Singapore Community Dwellers with Consolidated Norms. Paper presented at Singapore Health & Biomedical Congress 2104: Redefining Healthcare for the Future-Educating, Innovating & Leading for Progress, Singapore: Singapore.

  34. 34.

    Rantanen, T., K. Masaki, D. Foley, G. Izmirlian, L. White, and J.M. Guralnik, Grip strength changes over 27 yr in Japanese-American men. Journal of applied physiology, 1998. 85(6): p. 2047–2053.

  35. 35.

    Sternäng, O., C.A. Reynolds, D. Finkel, M. Ernsth-Bravell, N.L. Pedersen, and A.K. Dahl Aslan, Factors associated with grip strength decline in older adults. Age and Ageing, 2015. 44(2): p. 269–274.

  36. 36.

    Chu, L.-W., et al., Late-life body mass index and waist circumference decrease progressively in amnestic mild cognitive impairment and Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 2009. 5(4): p. P131-P131.

  37. 37.

    Ghaderpanahi, M., et al., Association Between Late-Life Body Mass Index, Waist Circumference, and Dementia: Kahrizak Elderly Study. Journal of the American Geriatrics Society, 2012. 60(1): p. 173–174.

  38. 38.

    Power, B.D., H. Alfonso, L. Flicker, G.J. Hankey, B.B. Yeap, and O.P. Almeida, Body adiposity in later life and the incidence of dementia: the health in men study. PloS one U6 -ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.

  39. 39.

    Gatz, M., C.A. Reynolds, D. Finkel, N.L. Pedersen, and E. Walters, Dementia in Swedish Twins: Predicting Incident Cases. Behavior genetics, 2010. 40(6): p. 768–775.

  40. 40.

    Shin, H.Y., S.W. Kim, J.M. Kim, I.S. Shin, and J.S. Yoon, Association of grip strength with dementia in a Korean older population. Int J Geriatr Psychiatry, 2012. 27(5): p. 500–5.

  41. 41.

    Albers, M.W., et al., At the interface of sensory and motor dysfunctions and Alzheimer’s disease. Alzheimers Dement, 2015. 11(1): p. 70–98.

  42. 42.

    Di Lazzaro, V., et al., Motor cortex hyperexcitability to transcranial magnetic stimulation in Alzheimer’s disease. J Neurol Neurosurg Psychiatry, 2004. 75(4): p. 555–9.

  43. 43.

    Buchman, A.S., P.A. Boyle, R.S. Wilson, T.L. Beck, J.F. Kelly, and D.A. Bennett, Apolipoprotein E e4 Allele is Associated With More Rapid Motor Decline in Older Persons. Alzheimer Disease & Associated Disorders, 2009. 23(1): p. 63–69.

  44. 44.

    Kim, J.M., R. Stewart, I.S. Shin, S.W. Kim, S.J. Yang, and J.S. Yoon, Associations between head circumference, leg length and dementia in a Korean population. Int J Geriatr Psychiatry, 2008. 23(1): p. 41–8.

  45. 45.

    Narazaki, K., E. Matsuo, T. Honda, Y. Nofuji, K. Yonemoto, and S. Kumagai, Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems. Journal of sports science & medicine, 2014. 13(3): p. 590–596.

  46. 46.

    Mielke, M.M., et al., Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo Clinic Study of Aging. J Gerontol A Biol Sci Med Sci, 2013. 68(8): p. 929–37.

  47. 47.

    Vermeulen, J., J.C. Neyens, M.D. Spreeuwenberg, E. van Rossum, D.J. Hewson, and L.P. de Witte, Measuring Grip Strength in Older Adults: Comparing the Grip-ball With the Jamar Dynamometer. J Geriatr Phys Ther, 2015. 38(3): p. 148–53.

  48. 48.

    Cooper, R., B.H. Strand, R. Hardy, K.V. Patel, and D. Kuh, Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study. BMJ, 2014. 348(apr28 7): p. g2219.

  49. 49.

    Leong, D.P., et al., Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet, 2015.

  50. 50.

    Alencar, M.A., J.M. Dias, L.C. Figueiredo, and R.C. Dias, Handgrip strength in elderly with dementia: study of reliability. Rev Bras Fisioter, 2012. 16(6): p. 510–4.

  51. 51.

    Blankevoort, C.G., M.J. van Heuvelen, and E.J. Scherder, Reliability of six physical performance tests in older people with dementia. Phys Ther, 2013. 93(1): p. 69–78.

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Correspondence to Hui Lin Ong.

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Ong, H.L., Chang, S.H.S., Abdin, E. et al. Association of grip strength, upper arm circumference, and waist circumference with dementia in older adults of the wise study: A cross-sectional analysis. J Nutr Health Aging 20, 996–1001 (2016). https://doi.org/10.1007/s12603-015-0643-4

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Key words

  • Grip strength
  • arm circumference
  • waist circumference
  • dementia
  • Singapore