Hand grip strength and cognitive function among elderly cancer survivors

Lin Yang, Ai Koyanagi, Lee Smith, Liang Hu, Graham A. Colditz, Adetunji T. Toriola, Guillermo Felipe López Sánchez, Davy Vancampfort, Mark Hamer, Brendon Stubbs, Thomas Waldhör

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39 Scopus citations


Background We evaluated the associations of handgrip strength and cognitive function in cancer survivors 60 years old using data from the National Health and Nutrition Examination Survey (NHANES). Methods Data in two waves of NHANES (2011–2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value achieved using either hand. Two cognitive function tests were conducted among adults 60 years and older. The Animal Fluency Test (AFT) examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) assesses processing speed, sustained attention, and working memory. Survey analysis procedures were used to account for the complex sampling design of the NHANES. Multiple linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depressive symptoms and leisure time physical activity). Results Among 383 cancer survivors (58.5% women, mean age = 70.9 years, mean BMI = 29.3 kg/ m2), prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). In women, each increase in kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed an inverted U-shape association where cognitive function peaked at handgrip strength of 40–42 kg. Conclusions Handgrip strength, a modifiable factor, appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to address their causal relationship.

Original languageEnglish
Article numbere0197909
JournalPloS one
Issue number6
StatePublished - Jun 2018


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