Combination of poor gait and weak hand grip may indicate dementia risk: ASPREE research shows

Walking speed and grip strength could be early indicators of dementia before the onset of noticeable symptoms, new findings from the ASPREE trial reveals.

Researchers found slow walking speed combined with weak hand grip was a stronger predictor of cognitive decline and dementia in older adults than either measure alone.

The study of data from more than 18,000 ASPREE participants in Australia and the USA, mostly aged 70 and older, revealed that a combined poor gait speed and grip strength was linked to a 79% increased risk of dementia and a 43% increased risk of cognitive decline.

Over time, the risk for dementia or cognitive decline was shown to be highest when both gait and grip declined together over the study period of nearly 5 years, with an 89% increased risk of dementia and 55% increased risk of cognitive decline.

It’s the first time the two physical measures have been studied together to assess their combined link with changes in cognitive function (thinking and memory).

During the course of the ASPREE trial, 2773 participants in this analysis developed cognitive decline and 558 dementia.

The findings have significant implications for dementia diagnosis, early intervention and treatment. Globally, the number of people living with dementia is expected to almost triple in three decades, from 57.4 million in 2019, to 152.8 million by 2050.

Above: Dr Suzanne Orchard is a Senior Research Fellow, Investigator and Director of the ASPREE-XT study in Australia.

Lead author Dr Suzanne Orchard (left), Australian Director of ASPREE-XT, School of Public Health and Preventive Medicine, Monash University, said the research showed an important link between age-related cognitive and physical decline.

“Poor physical function may be a marker for future risk of cognitive decline and dementia, and thus, understanding this association could enhance early detection and prevention strategies,” says Dr Orchard.

“While there are currently no cures for dementia, these two simple measures could help health care providers to possibly identify dementia risk early and start treatment to improve patient outcomes.

“Older adults identified as being at risk of cognitive decline and dementia may benefit from physical, social and mentally stimulating activities, having a healthy diet, good control of blood pressure and diabetes, not smoking and reducing other risk factors for dementia.”

Dr Orchard said weakening grip strength and a slower walking speed did not necessarily lead to cognitive decline or dementia.

“It is also important to know that cognitive and physical function can be affected by many factors, including pain, joint disease and poor sleep,” says Dr Orchard.

Participants’ grip strength and gait speed were measured upon entry to ASPREE and repeated during an average of 4.7 years.

Gait speed was timed walking at normal pace over a distance of three metres, while grip strength was assessed using a hand-held device to measure force. Researchers then compared these physical benchmarks against participants’ cognition, measured in exercises that examine functions such as memory and mental processing speed.

Researchers did account for differences in age, gender, education, ethnicity/race, starting cognitive level, depression, smoking, alcohol, living situation and diabetes.

This paper was published in the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring. 

Read the paper: http://dx.doi.org/10.1002/dad2.12353

The ASPREE trial was funded by the National Institute on Aging (NIA) and National Cancer Institute (NCI), branches of the NIH (National Institutes of Health, USA), NHMRC, Monash University, and the Victorian Cancer Agency.