Abstract
AIM: Handgrip strength (HGS) is a simple, noninvasive measure that may help with the early detection and risk assessment of cognitive decline in middle-aged and older adults. This study aimed to explore the relationship between both absolute and relative measures of HGS and cognitive impairment in a nationally representative sample of Mexican adults aged 55 and older. METHODS: This secondary cross-sectional study included 1870 participants (58.4% women; mean age = 68.1 ± 8.7 years) from the Mexican Cognitive Aging Study (Mex-Cog). Data from individuals aged ≥ 55 years included socioeconomic, lifestyle, anthropometric, and biomarker information. HGS was assessed using a dynamometer in absolute values (kg) and relative indices (HGS/height, HGS/height², HGS/weight, and HGS/BMI). Quartiles (Q) were created, with Q4 representing the highest performance. Cognitive impairment was defined as an MMSE score of < 24 points. Associations were examined using sex-stratified binary logistic regression adjusted for age, education level, and population density. RESULTS: Women in the lowest quartile of absolute handgrip strength had significantly higher odds of cognitive impairment than those in the highest quartile (odds ratio [OR] = 2.24, 95% CI 1.04-4.80, p = 0.039). In men, significant associations were found for the second quartile of HGS normalised by height and height². Overall, absolute HGS and HGS/height² showed the strongest and most consistent significant association with cognitive impairment. CONCLUSIONS: Lower absolute and relative HGS values were strongly associated with a higher likelihood of cognitive impairment in Mexican adults. Due to its low cost, accessibility, and reproducibility, HGS may represent a practical biomarker for the early detection and tracking of cognitive decline, particularly in low-resource settings.