Longitudinal bidirectional dynamic association between handgrip strength and cognitive function in Chinese older...

This study examined the bidirectional dynamic relationship between handgrip strength and cognitive function and the influence of gender and age differences among Chinese adults aged 60 and above.

Data were derived from the 2013-2015 waves of the China Health and Retirement Longitudinal Study (CHARLS), including 4533 older adults. Cross-lagged panel models were used to analyze the temporal relationship between handgrip strength and cognitive function. Covariates covered sociodemographic characteristics, lifestyle factors, and health indicators. Data analysis was performed using SAS 9.4 and R 4.4.1.

During the 2-year follow-up, both handgrip strength and cognitive function showed declining trends in older adults. Cross-lagged analysis revealed that baseline handgrip strength positively predicted follow-up cognitive function (P < 0.001), indicating that individuals with greater baseline grip strength maintained better cognitive performance. Conversely, baseline cognitive function also positively predicted follow-up handgrip strength (P < 0.001).These bidirectional associations exhibited gender differences: the predictive effect of handgrip strength on cognition was stronger in males (P < 0.001), whereas the effect of cognition on handgrip strength was more pronounced in females (P < 0.001). Age-stratified analysis demonstrated that the association between handgrip strength and cognition was strongest in the 70-79 age group (P < 0.001). However, this relationship weakened in adults aged 80 and above, potentially due to compensatory mechanisms or external environmental support.

A bidirectional muscle-cognition association exists in older adults, supporting the incorporation of handgrip strength testing into cognitive screening. Gender- and age-specific interventions should prioritize rural populations with low education and high-risk individuals aged 70-79 years. These findings provide a scientific basis for preventing cognitive decline in aging populations.