Low Handgrip Strength and Depression as Predictors of Cognitive Decline in Older Mexican Americans
Background. Cognitive decline and dementia are associated with increased morbidity and mortality in the geriatric population, and these conditions pose a significant burden on caregivers and the healthcare system. We aimed to assess whether having depression, low handgrip strength, or both conditions is more predictive of the development of cognitive decline in older Mexican Americans. Methods. The sample consisted of a prospective cohort of 1070 noninstitutionalized Mexican American individuals aged ³65 from the Hispanic Established Populations for the Epidemiological Study of the Elderly who were followed over 10 years, all of whom had a baseline Mini-Mental State Examination (MMSE) score ³21. Measures included: handgrip strength, medical conditions, ADL disability, and sociodemographic factors from baseline interview, and MMSE scores from four waves of data collection. Participants were divided into four groups according to baseline handgrip strength and depressive symptoms: neither depression nor handgrip weakness, depression only, low handgrip strength only, and both depression and low handgrip strength. Results. After controlling for all covariates, general linear mixed models demonstrated that decreased handgrip strength and depression each had a statistically significant association with subsequent cognitive decline, with grip weakness being the stronger risk factor. Participants with both low handgrip and depression had significantly lower baseline MMSE (24.3 ± 2.8 points, p = 0.0024) and experienced the largest mean decrease in MMSE over time (-0.27 points per year, SE = 0.15, p = 0.0749). Conclusion. Decreased handgrip strength and depression were strongly predictive of cognitive decline over a 10-year period in Older Mexican Americans with normal or high baseline cognitive function. While not statistically significant, possessing both depression and grip weakness led to a greater decline in MMSE over time compared to either risk factor alone.