Background. Cognitive decline and dementia are associated with disability and premature death in old age. We examined whether low handgrip strength predicts subsequent cognitive decline in older Mexican Americans. Methods. We worked with a 7-year prospective cohort of 2160 noninstitutionalized Mexican Americans aged 65 years or older from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE) who had a Mini-Mental State Examination (MMSE) score ≥ 21 at baseline. Measures included: (i) sociodemographic factors (age, gender, and education), handgrip strength, and near and distant visual impairment from baseline interview; and (ii) MMSE, body mass index (BMI), and medical conditions (stroke, heart attack, diabetes, depression, and hypertension) from four waves of data collection. Results. Using general linear mixed models, we found a significant trend with scores in the lowest quartile of handgrip strength at baseline to be associated with lower MMSE scores over time (estimate = −1.28, standard error = 0.16; p <.0001). There was a significant handgrip Strength-by-Time interaction with MMSE scores. Participants in the lowest handgrip strength quartile had a greater cognitive decline over time (estimate = −0.26, standard error = 0.07; p <.001) than did those participants in the highest quartile. This association remained statistically significant after controlling for potential confounding factors. Conclusion. Older Mexican Americans with reduced handgrip strength at baseline demonstrated a statistically significant decline in cognitive function over a 7-year period. By contrast, participants in the highest handgrip strength quartile maintained a higher level of cognitive function.

The incidence of both dementia and cancer increases with age. For those aged 65 years and older, the prevalence of dementia is about 1 in 10.¹ Approximately 4.5 million Americans have Alzheimer dementia, and the number is projected to triple by the year 2050.^1,2 Similarly, for those aged 60 to 79 years, the probability of developing invasive cancer is 1 in 3 for men and 1 in 4 for women.³ Thus, the probability of co-occurrence of both dementia and cancer in the same patient rises with increasing age.

Because cognitive impairment and frailty share common risk factors (eg, high proinflammatory cytokines), we examined whether poor cognition predicts subsequent risk of frailty in initially nonfrail Mexican Americans aged 67 years and older. Frailty was defined as meeting one or more of the following components: (a) unintentional weight loss of >10 pounds, (b) weakness, (c) self-reported exhaustion, and (d) slow walking speed. Sociodemographic factors, Mini-Mental State Examination, medical conditions (stroke, heart attack, diabetes, arthritis, cancer, and hypertension), and depressive symptoms were obtained. Main outcome measure was risk of becoming frail over 10 years. Out of 942 participants who were nonfrail at baseline (1995–1996), 57.8% were women and the mean age was 73.7 years (SD = 5.3). In general estimation equation models testing the relationship between Mini-Mental State Examination (<21 vs. ≥21) and the risk of becoming frail over a 10-year period, there was a significant association (odds ratio = 1.09, 95% confidence interval = 1.00–1.19; p = .0310)] between the cognition-by-time interaction and odds of becoming prefrail or frail over time. This association was independent of age, sex, marital status, education, time, and medical conditions, indicating that nonfrail participants with poor cognition had a 9% odds per year of becoming frail over time compared with those with good cognition. Low Mini-Mental State Examination score was independently associated with increased risk of frailty over a 10-year period in older Mexican Americans. Low Mini-Mental State Examination score may be an early marker for future risk of frailty.

Background. Optimal mental health (cognitive and emotional functioning) is an important factor for maintaining physical function. This study investigated the effects of cognitive and emotional status on subsequent lower body function in a population-based sample of older Mexican Americans. Methods. A 2-year prospective cohort study included Mexican Americans aged 65 and older who scored 18 or higher on the Mini-Mental State Examination (MMSE) at baseline interview and for whom complete data on a summary performance measure of lower body function were available at the 2-year follow-up interview (n = 2068). In-home interviews in 1993–1994 and 1995–1996 assessed sociodemographic variables, physical health conditions, cognitive function, emotional health, and lower body function. Results. In a multivariate analysis, continuous MMSE (b = 0.06; SE 0.02, p = .004) and Center for Epidemiological Studies–Depression (CES-D) (b = −0.53; SE 0.17, p = .002) scores at baseline were significantly associated with a summary performance measure of lower body function 2 years later, controlling for age, gender, marital status, education, selected medical conditions, and baseline summary performance score. A significant MMSE–by–CES-D interaction (p = .002) on summary performance score was also found after adjustments were made for age, gender, marital status, education, chronic health conditions, and baseline summary performance score. After adjusting for age, gender, marital status, education, selected medical conditions, and baseline summary performance score, subjects with low cognition (MMSE score 18–21) and high depressive symptoms (CES-D score ≥ 16) were the most likely to have poor summary performance scores 2 years later (b = −0.95, SE 0.36, p = .008), followed by subjects with high cognition (MMSE score > 21) and high depressive symptoms (CES-D score ≥ 16) (b = −0.57, SE 0.19, p = .003), and those with low cognition (MMSE score 18–21) and low depressive symptoms (CES-D score < 16) (b = −0.47, SE 0.22, p = .03), with high cognition (MMSE score > 21) and low depressive symptoms (CES-D score < 16) used as the reference. Conclusions. Our results confirm prior investigations showing both cognitive function and emotional health predict subsequent lower body function, and extend these findings to older Mexican Americans. In addition, our results indicate that good emotional health moderates the impact of low cognition on subsequent physical function.