Enhancing predictive validity of motoric cognitive risk syndrome for incident dementia and all-cause mortality with handgrip strength: insights from a prospective cohort study

This study aimed to assess whether integrating handgrip strength (HGS) into the concept of motoric cognitive risk (MCR) would enhance its predictive validity for incident dementia and all-cause mortality. A cohort of 5, 899 adults from the Health and Retirement Study underwent assessments of gait sp...

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Bibliographic Details
Published in:	Frontiers in aging neuroscience Vol. 16; p. 1421656
Main Authors:	Bai, Weimin, Ma, Ruizhu, Yang, Yanhui, Xu, Juan, Qin, Lijie
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 21-06-2024
Subjects:	all-cause mortality Cox regression handgrip strength integrated discrimination improvement motoric cognitive risk syndrome net reclassification indices Neuroscience integrated discrimination improvement motoric cognitive risk syndrome net reclassification indices Cox regression handgrip strength all-cause mortality
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Summary:	This study aimed to assess whether integrating handgrip strength (HGS) into the concept of motoric cognitive risk (MCR) would enhance its predictive validity for incident dementia and all-cause mortality. A cohort of 5, 899 adults from the Health and Retirement Study underwent assessments of gait speed, subjective cognitive complaints, and HGS were involved. Over a 10-year follow-up, biennial cognitive tests and mortality data were collected. Cox proportional hazard analyses assessed the predictive power of MCR alone and MCR plus HGS for incident dementia and all-cause mortality. Patients with MCR and impaired HGS (MCR-HGS) showed the highest adjusted hazard ratios (AHR) for dementia (2.33; 95% CI, 1.49-3.65) and mortality (1.52; 95% CI, 1.07-2.17). Even patients with MCR and normal HGS (MCR-non-HGS) experienced a 1.77-fold increased risk of incident dementia; however, this association was not significant when adjusted for socioeconomic status, lifestyle factors, and medical conditions. Nevertheless, all MCR groups demonstrated increased risks of all-cause mortality. The inclusion of HGS in the MCR models significantly improved predictive discrimination for both incident dementia and all-cause mortality, as indicated by improvements in the C-statistic, integrated discrimination improvement (IDI) and net reclassification indices (NRI). Our study underscores the incremental predictive value of adding HGS to the MCR concept for estimating risks of adverse health outcomes among older adults. A modified MCR, incorporating HGS, could serve as an effective screening tool during national health examinations for identifying individuals at risk of dementia and mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Takao Yamasaki, Minkodo Minohara Hospital, Japan These authors have contributed equally to this work Reviewed by: Hui Chang, Guizhou Medical University, China Haixu Liang, Xiamen University, China
ISSN:	1663-4365 1663-4365
DOI:	10.3389/fnagi.2024.1421656