Enhancing Predictive Validity of Motoric Cognitive Risk Syndrome for Incident Dementia and All-cause Mortality with Handgrip Strength: Insights from a Prospective Cohort Study

TitleEnhancing Predictive Validity of Motoric Cognitive Risk Syndrome for Incident Dementia and All-cause Mortality with Handgrip Strength: Insights from a Prospective Cohort Study
Publication TypeJournal Article
Year of Publication2024
AuthorsQin, L, Weimin, B, Ma, R, Yang, Y, Xu, J
JournalFrontiers in Aging Neuroscience
Volume16
Keywordsall-cause mortality, Cox regression, Handgrip strength, Integrated discrimination improvement, Motoric Cognitive Risk Syndrome, Net Reclassification Indices
Abstract

Background: 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.
Methods: 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.
Results: 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).
Conclusion: 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.

DOI10.3389/fnagi.2024.1421656
Citation Key14018