Handgrip strength as an indicator of decreased cognitive function in the elderly





Hand grip strength, Cognitive function, Congitive impairment, Alzheimer’s disease, Dementia, Geriatrics


In the elderly, the aging process occurs which is associated with a decrease in several functions in the body, including cognitive function and musculoskeletal function. According to the Centers for Disease Control (CDC), 1 in 9 elderly’s has decreased cognitive function. This decline in cognitive function is a form of cognitive dysfunction and is a precursor to the symptoms of Alzheimer's disease and other dementias. According to one study, the prevalence of people who were not detected for dementia because they had never undergone a cognitive examination was 61.7%. One of the possible causes is the absence of cognitive examinations in primary health facilities due to the unavailability of fast and easy instruments. Low hand grip strength has been associated with decreased cognitive function, and can be an effective indicator for early detection of cognitive impairment. In addition, hand grip strength can also be a predictor of decreased cognitive function in the elderly. The exact mechanism between decreased motor power and cognitive function is still unclear. Probably caused by the same cause like the presence of neuropathology in brain such as Lewy bodies, amyloid plaques, neurofibrillary tangles, infarction and atrophy.

Author Biography

Edy Parwanto, Department of Biology, Universitas Trisakti, Indonesia

Faculty of Medicine, Department of Biology


Republic of Indonesia. Law of the Republic of Indonesia Number 13 of 1998 concerning Elderly Welfare, 1998. Available at: https://id.wikisource.org/wiki/UndangUndang_Republik_Indonesia_Nomor_13_Tahun_1998. Accessed on 27 October 2022.

Badan Pusat Statistik. Senior Population Statistics, 2021. Available at: https://www.bps.go.id/publication/2021/12/21/c3fd9f27372f6ddcf7462006/statistikpenduduklanjutus021.html. Accessed on 27 October 2022.

Murman DL. The Impact of Age on Cognition. Semin Hear. 2015;36(3):111-21.

Seidler RD, Bernard JA, Burutolu TB, Fling BW, Gordon MT, Gwin JT, et al. Motor control and aging: links to age-related brain structural, functional, and biochemical effects. Neurosci Biobehav Rev. 2010;34(5):721-33.

Robbins TW. Cognition: the ultimate brain function. Neuropsychopharmacology. 2011;36(1):1-2.

Wreksoatmodjo BR. The Effect of Physical Activity on the Cognitive Function of Elderly in West Jakarta. Mir World Kedokt. 2016;43:7-12.

Luthfiana A, Harliansyah H. Memory Index Examination, MMSE (Mini Mental State Examination) and MoCA-Ina (Indonesian Version of Montreal Cognitive Assessment) on Yarsi University Employees. Yars Med J. 2019;27:62-8.

CDC. ubjective Cognitive Decline - A Public Health Issue, 2022. Available at: https://www.cdc.gov/aging/agingdata/docs/subjective-cognitive-decline-508.pdf. Accessed on 27 October 2022.

Teng E, Tassniyom K, Lu PH. Reduced quality-of-life ratings in mild cognitive impairment: analyses of subject and informant responses. Am J Geriatr Psychiatry. 2012;20(12):1016-25.

Johansson MM, Marcusson J, Wressle E. Cognitive impairment and its consequences in everyday life: experiences of people with mild cognitive impairment or mild dementia and their relatives. Int Psychogeriatr. 2015;27(6):949-58.

Lang L, Clifford A, Wei L, Zhang D, Leung D, Augustine G, et al. Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis. BMJ Open. 2017;7(2):e011146.

Rodriguez I, Smailagic N, Roqué-Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, et al. Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 2021;7(7):CD010783.

Fritz NE, McCarthy CJ, Adamo DE. Handgrip strength as a means of monitoring progression of cognitive decline - A scoping review. Ageing Res Rev. 2017;35:112-23.

Buchman AS, Bennett DA. Loss of motor function in preclinical Alzheimer's disease. Expert Rev Neurother. 2011;11(5):665-76.

Buracchio T, Dodge HH, Howieson D, Wasserman D, Kaye J. The trajectory of gait speed preceding mild cognitive impairment. Arch Neurol. 2010;67(8):980-6.

Amaral CA, Amaral TLM, Monteiro GTR, Vasconcellos MTL, Portela MC. Hand grip strength: Reference values for adults and elderly people of Rio Branco, Acre, Brazil. PLoS One. 2019;14(1):e0211452.

Alencar MA, Dias JM, Figueiredo LC, Dias RC. Handgrip strength in elderly with dementia: study of reliability. Rev Bras Fisioter. 2012;16(6):510-4.

Bodilsen AC, Juul-Larsen HG, Petersen J, Beyer N, Andersen O, Bandholm T. Feasibility and inter-rater reliability of physical performance measures in acutely admitted older medical patients. PLoS One. 2015;10(2):e0118248.

Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 10th ed. Philadelphia: Lippincot Williams and Wilkins; 2017: 4520.

Bishop NA, Lu T, Yankner BA. Neural mechanisms of ageing and cognitive decline. Nature. 2010;464(7288):529-35.

Kuznetsov IA, Kuznetsov AV. How the formation of amyloid plaques and neurofibrillary tangles may be related: a mathematical modelling study. Proc Math Phys Eng Sci. 2018;474(2210):20170777.

Kocahan S, Doğan Z. Mechanisms of Alzheimer's Disease Pathogenesis and Prevention: The Brain, Neural Pathology, N-methyl-D-aspartate Receptors, Tau Protein and Other Risk Factors. Clin Psychopharmacol Neurosci. 2017;15(1):1-8.

Raz L, Knoefel J, Bhaskar K. The neuropathology and cerebrovascular mechanisms of dementia. J Cereb Blood Flow Metab. 2016;36(1):172-86.

Venkat P, Chopp M, Chen J. Models and mechanisms of vascular dementia. Exp Neurol. 2015;272:97-108.

Horoupian DS, Wasserstein PH. Alzheimer's disease pathology in motor cortex in dementia with Lewy bodies clinically mimicking corticobasal degeneration. Acta Neuropathol. 1999;98(3):317-22.

Lewis C, Walterfang M, Velakoulis D, Vogel AP. A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration. Dement Geriatr Cogn Disord. 2018;46(5-6):285-97.

McGrath R, Robinson-Lane SG, Cook S, Clark BC, Herrmann S, O'Connor ML, et al. Handgrip Strength Is Associated with Poorer Cognitive Functioning in Aging Americans. J Alzheimers Dis. 2019;70(4):1187-96.

Jang JY, Kim J. Association between handgrip strength and cognitive impairment in elderly Koreans: a population-based cross-sectional study. J Phys Ther Sci. 2015;27(12):3911-5.

Vancampfort D, Stubbs B, Firth J, Smith L, Swinnen N, Koyanagi A. Associations between handgrip strength and mild cognitive impairment in middle-aged and older adults in six low- and middle-income countries. Int J Geriatr Psychiatry. 2019;34(4):609-16.

Mohan D, Stephan BC, Allotey P. Gender Difference in the Association between Handgrip Strength and Cognitive Performance of Older Adults in Rural Malaysia. Age Ageing. 2019;48(4):9-12.

Kim KH, Park SK, Lee DR, Lee J. The Relationship between Handgrip Strength and Cognitive Function in Elderly Koreans over 8 Years: A Prospective Population-Based Study Using Korean Longitudinal Study of Ageing. Korean J Fam Med. 2019;40(1):9-15.

Auyeung TW, Lee JS, Kwok T, Woo J. Physical frailty predicts future cognitive decline - a four-year prospective study in 2737 cognitively normal older adults. J Nutr Health Aging. 2011;15(8):690-4.

Kim GR, Sun J, Han M, Nam CM, Park S. Evaluation of the directional relationship between handgrip strength and cognitive function: the Korean Longitudinal Study of Ageing. Age Ageing. 2019;48(3):426-32.

Adamo DE, Anderson T, Koochaki M, Fritz NE. Declines in grip strength may indicate early changes in cognition in healthy middle-aged adults. PLoS One. 2020;15(4):e0232021.

Taekema DG, Ling CH, Kurrle SE, Cameron ID, Meskers CG, Blauw GJ, et al. Temporal relationship between handgrip strength and cognitive performance in oldest old people. Age Ageing. 2012;41(4):506-12.

Schneider JA, Li JL, Li Y, Wilson RS, Kordower JH, Bennett DA. Substantia nigra tangles are related to gait impairment in older persons. Ann Neurol. 2006;59(1):166-73.

Moretti R, Torre P, Antonello RM, Esposito F, Bellini G. Gait and equilibrium in subcortical vascular dementia. Curr Gerontol Geriatr Res. 2011;2011:263507.

Haider KS, Haider A, Doros G, Traish A. Long-Term Testosterone Therapy Improves Urinary and Sexual Function, and Quality of Life in Men with Hypogonadism: Results from a Propensity Matched Subgroup of a Controlled Registry Study. J Urol. 2018;199(1):257-65.

Parwanto MLE. The negative correlation between testosterone levels and age in healthy Indonesian men residing in the special capital province of Jakarta, Indonesia. Int J Res Med Sci. 2017;5:3431-7.

Guyansyah A, Parwanto MLE. Sex hormone binding proteins: sex hormone binding globulin (SHBG) and sex steroid action. J Biomed Health. 2019;2(1):45-50.

Parwanto E. Effect of Lipid-Protein Assumptions and Sex Hormone Binding Globulin (SHBG) Polymorphism on SHBG Levels in Indonesian and Caucasian Men. Dissertation of the Faculty of Medicine, University of Indonesia. UK: Services for Science and Education Ltd; 2004: 1-254.

Campo MD, Pijnenburg YAL, Chen-Plotkin A, Irwin DJ, Grossman M, Twaalfhoven HAM, et al. Sex Hormone-Binding Globulin (SHBG) in Cerebrospinal Fluid Does Not Discriminate between the Main FTLD Pathological Subtypes but Correlates with Cognitive Decline in FTLD Tauopathies. Biomolecules. 2021;11(10):1484.

Parwanto MLE, Suweino S, Tjahjadi D, Senjaya H, Edy HJ, Pakpahan A. The effect of sex hormonebinding globulin (SHBG) protein polymorphism on the levels of SHBG, testosterone, and insulin in healthy Indonesian men. Int J Med Sci Public Health. 2016;5:799-806.

Parwanto MLE, Indrawati Y, Setiawan H. Isoflavone supplementation reduced serum sex hormone-binding globulin concentration in postmenopausal women. Universa Medicina. 2012;31(1):52-62.

Chiu HT, Shih MT, Chen WL. Examining the association between grip strength and testosterone. Aging Male. 2020;23(5):915-22.

Parwanto MLE, Senjaya H. Dietary intake of mother in childbearing age with BMI<18.5 kg/m2 and has heterozygous variant D327N SHBG genotype (w/v). Int J Community Med Public Health. 2017;4(2):409-17.




How to Cite

Alyssa, N. I., & Parwanto, E. (2022). Handgrip strength as an indicator of decreased cognitive function in the elderly. International Journal of Research in Medical Sciences, 10(12), 2978–2983. https://doi.org/10.18203/2320-6012.ijrms20223109



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