Grip Strength Is Associated With Cognitive Performance in Schizophrenia and the General Population: A UK Biobank Study of 476559 Participants

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Abstract

Background

Handgrip strength may provide an easily-administered marker of cognitive functional status. However, further population-scale research examining relationships between grip strength and cognitive performance across multiple domains is needed. Additionally, relationships between grip strength and cognitive functioning in people with schizophrenia, who frequently experience cognitive deficits, has yet to be explored.

Methods

Baseline data from the UK Biobank (2007–2010) was analyzed; including 475397 individuals from the general population, and 1162 individuals with schizophrenia. Linear mixed models and generalized linear mixed models were used to assess the relationship between grip strength and 5 cognitive domains (visual memory, reaction time, reasoning, prospective memory, and number memory), controlling for age, gender, bodyweight, education, and geographical region.

Results

In the general population, maximal grip strength was positively and significantly related to visual memory (coefficient [coeff] = −0.1601, standard error [SE] = 0.003), reaction time (coeff = −0.0346, SE = 0.0004), reasoning (coeff = 0.2304, SE = 0.0079), number memory (coeff = 0.1616, SE = 0.0092), and prospective memory (coeff = 0.3486, SE = 0.0092: all P < .001). In the schizophrenia sample, grip strength was strongly related to visual memory (coeff = −0.155, SE = 0.042, P < .001) and reaction time (coeff = −0.049, SE = 0.009, P < .001), while prospective memory approached statistical significance (coeff = 0.233, SE = 0.132, P = .078), and no statistically significant association was found with number memory and reasoning ( P > .1).

Conclusions

Grip strength is significantly associated with cognitive functioning in the general population and individuals with schizophrenia, particularly for working memory and processing speed. Future research should establish directionality, examine if grip strength also predicts functional and physical health outcomes in schizophrenia, and determine whether interventions which improve muscular strength impact on cognitive and real-world functioning.

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Most cited references 37

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Waist circumference and not body mass index explains obesity-related health risk.

Ian Janssen, Peter Katzmarzyk, Robert Ross (2004)

The addition of waist circumference (WC) to body mass index (BMI; in kg/m(2)) predicts a greater variance in health risk than does BMI alone; however, whether the reverse is true is not known. We evaluated whether BMI adds to the predictive power of WC in assessing obesity-related comorbidity. Subjects were 14 924 adult participants in the third National Health and Nutrition Examination Survey, grouped into categories of BMI and WC in accordance with the National Institutes of Health cutoffs. Odds ratios for hypertension, dyslipidemia, and the metabolic syndrome were compared for overweight and class I obese BMI categories and the normal-weight category before and after adjustment for WC. BMI and WC were also included in the same regression model as continuous variables for prediction of the metabolic disorders. With few exceptions, overweight and obese subjects were more likely to have hypertension, dyslipidemia, and the metabolic syndrome than were normal-weight subjects. After adjustment for WC category (normal or high), the odds of comorbidity, although attenuated, remained higher in overweight and obese subjects than in normal-weight subjects. However, after adjustment for WC as a continuous variable, the likelihood of hypertension, dyslipidemia, and the metabolic syndrome was similar in all groups. When WC and BMI were used as continuous variables in the same regression model, WC alone was a significant predictor of comorbidity. WC, and not BMI, explains obesity-related health risk. Thus, for a given WC value, overweight and obese persons and normal-weight persons have comparable health risks. However, when WC is dichotomized as normal or high, BMI remains a significant predictor of health risk.

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Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

J. Mintz, M. Green, D Braff … (2000)

There has been a surge of interest in the functional consequences of neurocognitive deficits in schizophrenia. The published literature in this area has doubled in the last few years. In this paper, we will attempt to confirm the conclusions from a previous review that certain neurocognitive domains (secondary verbal memory, immediate memory, executive functioning as measured by card sorting, and vigilance) are associated with functional outcome. In addition to surveying the number of replicated findings and tallying box scores of results, we will approach the review of the studies in a more thorough and empirical manner by applying a meta-analysis. Lastly, we will discuss what we see as a key limitation of this literature, specifically, the relatively narrow selection of predictor measures. This limitation has constrained identification of mediating variables that may explain the mechanisms for these relationships.

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Resistance training and executive functions: a 12-month randomized controlled trial.

Teresa Liu-Ambrose, Lindsay S. Nagamatsu, Peter Graf … (2010)

Cognitive decline among seniors is a pressing health care issue. Specific exercise training may combat cognitive decline. We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women. In this single-blinded randomized trial, 155 community-dwelling women aged 65 to 75 years living in Vancouver were randomly allocated to once-weekly (n = 54) or twice-weekly (n = 52) resistance training or twice-weekly balance and tone training (control group) (n = 49). The primary outcome measure was performance on the Stroop test, an executive cognitive test of selective attention and conflict resolution. Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests (parts A and B) and working memory as assessed by verbal digit span forward and backward tests. Gait speed, muscular function, and whole-brain volume were also secondary outcome measures. Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group (P < or = .03). Task performance improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups, respectively; it deteriorated by 0.5% in the balance and tone group. Enhanced selective attention and conflict resolution was significantly associated with increased gait speed. Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study (P < or = .03). Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women. clinicaltrials.gov Identifier: NCT00426881.

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Author and article information

Journal

Journal ID (nlm-ta): Schizophr Bull

Journal ID (iso-abbrev): Schizophr Bull

Journal ID (publisher-id): schbul

Title: Schizophrenia Bulletin

Publisher: Oxford University Press (US )

ISSN (Print): 0586-7614

ISSN (Electronic): 1745-1701

Publication date (Print): June 2018

Publication date (Electronic): 19 April 2018

Publication date PMC-release: 19 April 2018

Volume: 44

Issue: 4

Pages: 728-736

Affiliations

[1 ]NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia

[2 ]Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

[3 ]Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK

[4 ]Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

[5 ]KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium

[6 ]UPC KU Leuven, Kortenberg, Belgium

[7 ]Department of Zoology, Edward Grey Institute, University of Oxford, Oxford, UK

[8 ]Merton College, University of Oxford, Oxford, UK

[9 ]The Prince of Wales Hospitals, Randwick, Australia

[10 ]School of Psychiatry, University of New South Wales, Sydney, Australia

[11 ]Black Dog Institute, Randwick, Australia

[12 ]Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden

[13 ]Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia

[14 ]Department of Psychiatry, University of Melbourne, The Melbourne Clinic, Melbourne, Australia

[15 ]Greater Manchester Mental Health Foundation Trust, Manchester, UK

Author notes

To whom correspondence should be addressed; NICM Health Research Institute, School of Science and Health, University of Western Sydney, Campbelltown, Sydney, NSW 2560, Australia; tel: +61-0-451-231-815, fax: +61 2 4620 3291, e-mail: j.firth@ 123456westernsydney.edu.au

Article

Publisher ID: sby034

DOI: 10.1093/schbul/sby034

PMC ID: 6007683

PubMed ID: 29684174

SO-VID: b1d83b5d-d09e-4d08-aaa2-78f1442d81d1

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Page count

Pages: 9

Funding

Funded by: Blackmores Institute Fellowship

Award ID: P117413F07

Funded by: National Health and Medical Research Council 10.13039/501100000925

Award ID: APP1125000

Funded by: National Institute for Health Research 10.13039/501100000272

Award ID: APP1125000

Funded by: King’s College Hospital NHS Foundation Trust 10.13039/100010872

Funded by: Kings College London 10.13039/501100000764

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Grip Strength Is Associated With Cognitive Performance in Schizophrenia and the General Population: A UK Biobank Study of 476559 Participants

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Abstract

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Karger: Neurology and Neuroscience

Most cited references 37

Waist circumference and not body mass index explains obesity-related health risk.

Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

Resistance training and executive functions: a 12-month randomized controlled trial.

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