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The journal of nutrition, health & aging

, Volume 20, Issue 10, pp 996–1001 | Cite as

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

  • Hui Lin OngEmail author
  • S. H. S. Chang
  • E. Abdin
  • J. A. Vaingankar
  • A. Jeyagurunathan
  • S. Shafie
  • H. Magadi
  • S. A. Chong
  • M. Subramaniam
Article

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.

Key words

Grip strength arm circumference waist circumference dementia Singapore 

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/.Google Scholar
  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.Google Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  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.CrossRefGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  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.CrossRefGoogle Scholar
  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.Google Scholar
  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.Google Scholar
  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.PubMedGoogle Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  21. 21.
    Santos, J.L., et al., Anthropometric measurements in the elderly population of Santiago, Chile. Nutrition, 2004. 20(5): p. 452–457.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  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.PubMedGoogle Scholar
  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.Google Scholar
  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.CrossRefGoogle Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  30. 30.
    Horowitz, B.P., R. Tollin, and G. Cassidy, Grip Strength. Physical & Occupational Therapy in Geriatrics, 1997. 15(1): p. 53–64.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  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.Google Scholar
  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.PubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Leong, D.P., et al., Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet, 2015.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2016

Authors and Affiliations

  • Hui Lin Ong
    • 1
    • 3
    Email author
  • S. H. S. Chang
    • 1
  • E. Abdin
    • 1
  • J. A. Vaingankar
    • 1
  • A. Jeyagurunathan
    • 1
  • S. Shafie
    • 1
  • H. Magadi
    • 2
  • S. A. Chong
    • 1
  • M. Subramaniam
    • 1
  1. 1.Research DivisionInstitute of Mental HealthSingaporeSingapore
  2. 2.Department of Geriatric PsychiatryInstitute of Mental HealthSingaporeSingapore
  3. 3.Research DivisionInstitute of Mental HealthSingaporeSingapore

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