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.

Research from JAMA Internal Medicine — The Effect of Obesity on Disability vs Mortality in Older Americans

Objectives. We examined the prevalence of frailty among Mexican American older adults and explored the correlates associated with becoming frail to determine their affect on disability and morbidity in this population. Methods. We studied the trajectory of frailty over 10 years in 2049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. We constructed a frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity and collected data on sociodemographic and health status, comorbidities, and functional measures of performance. Results. The sample was 58% female, with a mean age of 74.43 years (SD = 6.04) at baseline. Fifty-five percent of participants at baseline and 75% of the surviving sample at follow-up (n = 777) were classified as prefrail or frail. Of persons identified as frail at baseline, 84% died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up (R² = 0.29; P < .05). Conclusions. Further research into ways to reduce the number of Mexican American older adults who become frail and disabled and therefore lose their independence is needed. Future studies should continue to examine the trajectory of frailty as a dynamic process that includes psychosocial and cognitive components.