Interactions Between Handgrip Strength and Serum Folate and Homocysteine Levels on Cognitive Function in the Elderly Chinese Population

Article type: Research Article

Authors: Chen, Yongjie^{a; f; 1} | Du, Yue^{b; f; 1} | Sun, Zhuoyu^{a; f; 1} | Liu, Qian^{c; f} | Sun, Changqing^d | Lin, Hongyan^{c; f} | Jin, Mengdi^{c; f} | Fu, Jingzhu^{c; f} | Ma, Fei^{a; f} | Li, Wen^{c; f} | Liu, Huan^{c; f} | Zhang, Xumei^{c; f} | Wang, Guangshun^{e; *} | Huang, Guowei^{c; f; *}

Affiliations: [a] Department of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China | [b] Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China | [c] Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China | [d] Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China | [e] Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China | [f] Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China

Correspondence: [*] Correspondence to: Guowei Huang, Professor, PhD, Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Heping District, Tianjin 300070, China. Tel.: +86 22 83336603; Fax: +86 22 83336603; E-mail: huangguowei@tmu.edu.cn and Guangshun Wang, Professor, MD, Department of Tumor, Baodi Clinical College of Tianjin Medical University, No 8 Guangchuan Road, Baodi District, Tianjin 301800, China. E-mail: wgs@bddhospital.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Handgrip strength (HGS) and serum folate and homocysteine (Hcy) levels were associated with cognitive function. However, little was known whether there were interactions between HGS and serum folate and Hcy levels on cognitive function. Objective:To examine the interactions between HGS and serum folate and Hcy levels on cognitive function. Methods:This study analyzed the baseline data of the Tianjin Elderly Nutrition and Cognition Cohort study. All participants aged ≥60 years were potential eligible. HGS was measured using a grip strength dynamometer. Serum folate and Hcy levels were assayed using standard laboratory protocol. A Mini-Mental State Examination was used to assess cognitive function. Linear regressions were employed to examine the interactions between HGS and serum folate and Hcy levels on cognitive function. Results:4,484 participants were included in this study. There were interactions between HGS and serum folate and Hcy levels on cognitive function. Furthermore, subjects with strong HGS and sufficient folate level had the best cognitive function (β= 2.018), sequentially followed by those with strong HGS and insufficient folate level (β= 1.698) and with poor HGS and sufficient folate level (β= 0.873). Similarly, cognitive function was ranked in the descending order of subjects with strong HGS and normal Hcy level (β= 1.971), strong HGS and high Hcy level (β= 1.467), and poor HGS and normal Hcy level (β= 0.657). Conclusion:There were interactions between HGS and serum folate and Hcy levels on cognitive function. However, the temporal associations cannot be examined in a cross-sectional study. Further cohort study should be conducted to confirm these associations in the future.

Keywords: Alzheimer’s disease, cognitive function, handgrip strength, serum folate, serum homocysteine

DOI: 10.3233/JAD-201537

Journal: Journal of Alzheimer's Disease, vol. 80, no. 4, pp. 1503-1513, 2021