Weakness Thresholds Are Differentially Linked to Cognitive Function by Obesity Status in Older Americans

Date

2024

Authors

Batesole, J.
Tomkinson, G.R.
Erickson, K.I.
Jurivich, D.
Lang, J.J.
McGrath, B.M.
Robinson-Lane, S.G.
Smith, A.E.
McGrath, R.

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Journal of Alzheimer's Disease Reports, 2024; 8(1):601-608

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<h4>Background</h4>Weakness can be operationalized with several thresholds, which in turn, could impact associations with cognitive impairment when considering obesity status.<h4>Objective</h4>We examined the associations of absolute, normalized, and collective weakness thresholds on future cognitive impairment by obesity status in older adults.<h4>Methods</h4>We performed a secondary data analysis on the 2006-2018 waves of the Health and Retirement Study. A spring-type dynamometer collected handgrip strength (HGS). Males were categorized weak if their HGS was <35.5-kg (absolute), <0.45-kg/kg (body mass normalized), or <1.05-kg/kg/m<sup>2</sup> (body mass index (BMI) normalized), while females were defined as weak if their HGS was <20.0-kg, <0.337-kg/kg, or <0.79-kg/kg/m<sup>2</sup>. The modified Telephone Interview of Cognitive Status examined cognitive function. Persons scoring ≤10 had a cognitive impairment. Obesity was categorized as BMI ≥30 kg/m<sup>2</sup>.<h4>Results</h4>We included 7,532 and 3,584 persons aged ≥65-years living without and with obesity, respectively. Those without obesity but beneath the absolute weakness threshold had 1.54 (95% confidence interval (CI): 1.24-1.91) greater odds for future cognitive impairment. Persons with obesity and beneath each threshold also had greater odds for future cognitive impairment: 1.89 (95% CI: 1.28-2.78) for absolute, 2.17 (95% CI: 1.02-4.62) for body mass normalized, and 1.75 (95% CI: 1.10-2.80) for BMI normalized. Older Americans without obesity but underneath all the weakness thresholds had 1.32 (95% CI: 1.00-1.74) greater odds for impairment in cognitive function, while persons with obesity had 2.76 (95% CI: 1.29-5.93) greater odds.<h4>Conclusions</h4>There should be consideration for how body size and different weakness thresholds may influence future cognitive outcomes.

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Copyright 2024 The authors. Published by IOS Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License. (https://creativecommons.org/licenses/by-nc/4.0/)

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