Nativity differences in the relationship between handgrip strength and cognitive impairment in older Mexican Americans over 20 years of follow-up

Abstract

Purpose: To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period.

Methods: Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates.

Results: US-born and foreign-born participants in the 4^th quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1^st (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3^rd and 4^th HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3^rd and 4^th HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates.

Conclusion: Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.

Keywords: Cognitive function; Hand grip strength; Mexican Americans; Nativity.

Figure 1.

Adjusted mean of MMSE scores by HGS quartiles and nativity over a 20-year period (N=2,155). Note: MMSE=Mini Mental State Examination; HGS=Hand Grip Strength; BMI=body mass index (kg/m2); CES-D=Center for Epidemiologic Studies Depression Scale; ADL=Activities of Daily Living; SPPB=Short Physical Performance Battery. Mean of MMSE scores were adjusted for age at baseline (≥ 75 years), sex, education, language of interview (Spanish), BMI, medical conditions (hypertension, arthritis, diabetes, heart attack, stroke, cancer, hip fracture), depressive symptoms (CES-D >16), any ADL disability, and SPPB.