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. 2025 Jul 3:16:1572650.
doi: 10.3389/fneur.2025.1572650. eCollection 2025.

Handgrip strength is associated with cognitive function in patients with head injury with loss of consciousness: results from the NHANES 2011-2014

Bilian Guo #  1   2 , Weihui He #  3 , Ni Zeng  4 , Xiang Xu  1   2 , Zhipeng Yan  1   2
Affiliations

Handgrip strength is associated with cognitive function in patients with head injury with loss of consciousness: results from the NHANES 2011-2014

Bilian Guo et al. Front Neurol. .

Abstract

Background: We evaluated the relationship between handgrip strength (HGS) and cognitive function in patients with head injury with loss of consciousness (HIC) using National Health and Nutrition Examination Survey (NHANES) data.

Methods: Utilizing the 2011-2014 NHANES database, we screened participants who completed the HIC questionnaire and extracted relevant variables. Key variable was the sum of maximum bilateral HGS. Cognitive function encompassed global cognitive function, Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Weighted multivariate linear regression analyzed the relationship. Gender-stratified analyses explored differences. Restricted cubic spline models elucidated the dose-response curves of HGS on cognitive function.

Results: Among 283 American HIC patients, HGS significantly correlated positively with global cognitive function, IRT, DRT, and DSST. Gender-stratified analysis showed that HGS enhancement significantly improved DRT and DSST scores in males, while females primarily benefited in Global cognitive function and AFT. Restricted cubic spline analysis confirmed a consistent linear dose-response relationship between HGS and cognitive function indicators, valid in both genders.

Conclusion: Our study reveals a positive correlation between HGS and cognitive function in HIC patients, with gender differences, offering a novel perspective for cognitive status assessment. Future large-scale, multidimensional studies are needed to deepen understanding of the complex HGS-cognitive function relationship.

Keywords: NHANES; cognitive function; gender; handgrip strength; head injury with loss of consciousness.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagrammatic representation of the participant selection process.
Figure 2
Figure 2
The dose–response association between HGS and cognitive in overall HIC patients based on RCS analysis. (A) Represents global cognitive function. (B) Represents IRT. (C) Represents DRT. (D) Represents AFT. (E) Represents DSST.
Figure 3
Figure 3
The dose–response association between HGS and cognitive in male HIC patients based on RCS analysis. (A) Represents global cognitive function. (B) Represents IRT. (C) Represents DRT. (D) Represents AFT. (E) Represents DSST.
Figure 4
Figure 4
The dose–response association between HGS and cognitive in female HIC patients based on RCS analysis. (A) Represents global cognitive function. (B) Represents IRT. (C) Represents DRT. (D) Represents AFT. (E) Represents DSST.
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