Gait Speed and Grip Strength Reflect Cognitive Impairment and Are Modestly Related to Incident Cognitive Decline in Memory Clinic Patients With Subjective Cognitive Decline and Mild Cognitive Impairment: Findings From the 4C Study.
BACKGROUND
Prospective studies in the general population show that slow gait speed is associated with cognitive decline and clinical progression to dementia. However, longitudinal studies in memory clinic populations are mostly lacking. We aimed to study the association between gait speed and grip strength and cognitive functioning at baseline and cognitive decline over time in memory clinic patients with subjective cognitive decline and mild cognitive impairment.


METHODS
We included 309 patients (age 70 ± 9 years, 108 [35%] women, Mini-Mental State Examination 27 ± 3 points). Baseline gait speed was assessed over 15 feet, grip strength with a hydraulic hand dynamometer. Cognitive functioning was assessed annually with a comprehensive test battery during 3 years.


RESULTS
Age- and gender-adjusted linear mixed models showed that slower gait speed was related to worse baseline attention, memory, information processing speed, and verbal fluency. Longitudinally, gait speed was related to decline in information processing speed and executive functioning. Weaker grip strength was related to worse baseline information processing speed and executive functioning but there were no longitudinal associations. Cox proportional hazards models revealed no significant associations with clinical progression.


CONCLUSIONS
Our findings suggest that markers of physical performance are related to current cognitive status and modestly related to cognitive decline but are seemingly not useful as an early marker of incident clinical progression.
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.|Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
Astrid M
AM
Hooghiemstra
Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands.
Inez H G B
IHGB
Ramakers
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.
Nicole
N
Sistermans
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.
Yolande A L
YAL
Pijnenburg
Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands.
Pauline
P
Aalten
Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands.
Renske E G
REG
Hamel
Department of Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.
René J F
RJF
Melis
Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands.
Frans R J
FRJ
Verhey
Department of Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.
Marcel G M
MGM
Olde Rikkert
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.
Philip
P
Scheltens
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.|Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.
Wiesje M
WM
van der Flier
D000368:Aged; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D015331:Cohort Studies; D003704:Dementia / Q000503:physiopathology; D018450:Disease Progression; D056344:Executive Function / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D000072797:Walking Speed / Q000502:physiology*
Alzheimer’s disease; Cognitive functioning; Dementia; Frailty