Hand Grip Strength Predicts Cognitive Decline in Subjective Cognitive Decline: 2-Year Follow-up Results

Hand grip strength (HGS) has been proposed as a potential clinical marker for cognitive decline. However, its association with domain-specific cognitive changes and underlying amyloid pathology remains unclear.

This longitudinal study included 107 older adults with subjective cognitive decline (SCD) who completed a 24-month follow-up. Participants were categorized based on the presence of HGS weakness using Asian Working Group of Sarcopenia criteria. Logistic regression analyses were performed to examine the association between baseline HGS and cognitive decline across multiple domains, adjusting for relevant covariates. Repeated measures analysis of variance evaluated longitudinal changes in neuropsychological performance.

Participants with HGS weakness had significantly higher amyloid positron emission tomography (PET) positivity (47.1% vs. 18.9%, P = 0.012). HGS weakness was associated with poorer baseline performance and greater decline in visuospatial and executive function over 24 months. Baseline HGS weakness predicted decline in visuospatial function (odds ratio [OR], 3.517; 95% confidence interval [CI], 1.072-11.535) and verbal memory (OR, 3.503; 95% CI, 1.046-11.729), but these associations lost significance after adjusting for amyloid positivity.

HGS weakness is associated with cognitive decline, particularly in visuospatial and executive domains, and may serve as an early indicator of amyloid-related neurodegeneration in older adults with SCD. HGS assessment could be a practical clinical tool for identifying individuals at risk, especially when amyloid PET is not available.