The Relationship Between Muscle Strength and Cognitive Performance Across Alzheimer's Disease Clinical Continuum

Overview

Journal Front Neurol

Specialty Neurology

Date 2022 Jun 1

PMID 35645971

Authors

Marco Filardi

Roberta Barone

Giulia Bramato

Salvatore Nigro

Benedetta Tafuri

Maria Elisa Frisullo

Chiara Zecca

Rosanna Tortelli

Giancarlo Logroscino

Affiliations

Soon will be listed here.

Abstract

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a progressive cognitive decline, mostly prominent in the domain of memory, but also associated with other cognitive deficits and non-cognitive symptoms. Reduced muscle strength is common in AD. However, the current understanding of its relationship with cognitive decline is limited. This study investigates the relationship between muscle strength and cognition in patients with AD and mild cognitive impairment (MCI). We enrolled 148 consecutive subjects, including 74 patients with probable AD dementia, 37 MCI, and 37 controls. Participants underwent neuropsychological evaluation focused on attention, working memory, declarative memory and learning. Muscle strength and muscle mass were measured through hand dynamometer and bio-electrical impedance analysis, respectively. Patients with AD dementia were divided with respect to the severity of cognitive impairment into mild and moderate-to-severe patients. Moderate-to-severe patients with AD presented lower handgrip strength than MCI and controls. No differences were observed in muscle mass. In MCI and AD dementia, handgrip strength was associated with overall cognitive functioning, attentional and memory performance. The routine implementation of handgrip strength assessment in the clinical work-up of patients with MCI and AD could potentially represent a simple method to monitor functional and cognitive decline along the disease course.

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References

Albert M, DeKosky S, Dickson D, Dubois B, Feldman H, Fox N . The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011; 7(3):270-9. PMC: 3312027. DOI: 10.1016/j.jalz.2011.03.008. View

Lawton M, Brody E . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-86. View

Su H, Sun X, Li F, Guo Q . Association between handgrip strength and cognition in a Chinese population with Alzheimer's disease and mild cognitive impairment. BMC Geriatr. 2021; 21(1):459. PMC: 8356394. DOI: 10.1186/s12877-021-02383-8. View

Dubois B, Hampel H, Feldman H, Scheltens P, Aisen P, Andrieu S . Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria. Alzheimers Dement. 2016; 12(3):292-323. PMC: 6417794. DOI: 10.1016/j.jalz.2016.02.002. View

Rosenberg A, Ngandu T, Rusanen M, Antikainen R, Backman L, Havulinna S . Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial. Alzheimers Dement. 2017; 14(3):263-270. DOI: 10.1016/j.jalz.2017.09.006. View

Praetorius Bjork M, Johansson B, Hassing L . I forgot when I lost my grip-strong associations between cognition and grip strength in level of performance and change across time in relation to impending death. Neurobiol Aging. 2016; 38:68-72. PMC: 5125016. DOI: 10.1016/j.neurobiolaging.2015.11.010. View

Thomas V, Vandenberg E, Potter J . Non-neurological factors are implicated in impairments in gait and mobility among patients in a clinical dementia referral population. Int J Geriatr Psychiatry. 2002; 17(2):128-33. DOI: 10.1002/gps.547. View

Taekema D, Ling C, Kurrle S, Cameron I, Meskers C, Blauw G . Temporal relationship between handgrip strength and cognitive performance in oldest old people. Age Ageing. 2012; 41(4):506-12. DOI: 10.1093/ageing/afs013. View

Hebert L, Bienias J, McCann J, Scherr P, Wilson R, Evans D . Upper and lower extremity motor performance and functional impairment in Alzheimer's disease. Am J Alzheimers Dis Other Demen. 2010; 25(5):425-31. PMC: 3033748. DOI: 10.1177/1533317510367636. View

10.

Bai A, Xu W, Sun J, Liu J, Deng X, Wu L . Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old. BMC Geriatr. 2021; 21(1):292. PMC: 8101237. DOI: 10.1186/s12877-021-02190-1. View

11.

Cassilhas R, Viana V, Grassmann V, Santos R, Santos R, Tufik S . The impact of resistance exercise on the cognitive function of the elderly. Med Sci Sports Exerc. 2007; 39(8):1401-7. DOI: 10.1249/mss.0b013e318060111f. View

12.

Wulff K, Gatti S, Wettstein J, Foster R . Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease. Nat Rev Neurosci. 2010; 11(8):589-99. DOI: 10.1038/nrn2868. View

13.

Jack Jr C, Bennett D, Blennow K, Carrillo M, Dunn B, Budd Haeberlein S . NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018; 14(4):535-562. PMC: 5958625. DOI: 10.1016/j.jalz.2018.02.018. View

14.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

15.

Fritz N, McCarthy C, Adamo D . Handgrip strength as a means of monitoring progression of cognitive decline - A scoping review. Ageing Res Rev. 2017; 35:112-123. DOI: 10.1016/j.arr.2017.01.004. View

16.

Ogawa Y, Kaneko Y, Sato T, Shimizu S, Kanetaka H, Hanyu H . Sarcopenia and Muscle Functions at Various Stages of Alzheimer Disease. Front Neurol. 2018; 9:710. PMC: 6121095. DOI: 10.3389/fneur.2018.00710. View

17.

Shaughnessy K, Hackney K, Clark B, Kraemer W, Terbizan D, Bailey R . A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory. J Alzheimers Dis. 2020; 73(4):1265-1278. PMC: 7063546. DOI: 10.3233/JAD-190856. View

18.

Suo C, Fiatarone Singh M, Gates N, Wen W, Sachdev P, Brodaty H . Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise. Mol Psychiatry. 2016; 21(11):1633-1642. PMC: 5078857. DOI: 10.1038/mp.2016.19. View

19.

Raudino F . Non-cognitive symptoms and related conditions in the Alzheimer's disease: a literature review. Neurol Sci. 2013; 34(8):1275-82. DOI: 10.1007/s10072-013-1424-7. View

20.

Mitchell W, Williams J, Atherton P, Larvin M, Lund J, Narici M . Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front Physiol. 2012; 3:260. PMC: 3429036. DOI: 10.3389/fphys.2012.00260. View