Walking Speed and Hand Grip Predict Dementia, Stroke Risk

Allison Shelley

February 23, 2012

February 23, 2012 — Testing walking speed and hand grip strength can help clinicians predict subsequent risk for dementia and stroke, a new study shows.

"Very simple tests, which can be performed by any practitioner in any office based-setting, may help determine patients' risks of developing dementia or stroke years before these diseases ensue," lead investigator Erica Camargo, MD, from Boston Medical Center in Massachusetts, told Medscape Medical News.

Dr. Erica Camargo

The results are being released in advance of the American Academy of Neurology's 64th Annual Meeting, where they will be presented in April in New Orleans, Louisiana.

"While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren't sure until now how it impacted people of middle age," Dr. Camargo explained.

Using data from the Framingham Offspring Study, the researchers looked at 2410 people with an average age of 62. They conducted brain magnetic imaging and tested walking speed, hand grip strength, and cognitive function.

Framingham Data

Over follow-up of about 11 years, 34 people developed dementia and 79 had a stroke. People with a slower walking speed in middle age had a 50% increase in risk of developing dementia compared with people with faster walking speed (hazard ratio, 1.50; 95% confidence interval, 1.07 - 2.11; P = .020).

The researchers also found that slower walking speed was associated with lower total cerebral brain volume (-.17; P = .007) and was linked to poorer performance on memory, language, and decision-making tests.

Stronger hand grip strength was associated with a 42% lower risk for stroke or transient ischemic attack compared with those with weaker hand grip. This was not the case, however, for people in the study under the age of 65.

Hand strength was also linked to larger total cerebral brain volume as well as better performance on cognitive tests that asked people to identify similarities among objects.

"Further research is needed to understand why this is happening," Dr. Camargo said, "and whether preclinical disease could cause slow walking and decreased strength."

She pointed out her team was impressed to see the tests could predict dementia and stroke risk — even in middle-aged patients. "If these screening tests could be performed routinely, such as in annual physical exams, the information could in conjunction with consideration of other risk factors help general practitioners decide which patients should be referred to a neurologist for early evaluation and possible early clinical intervention."

This study was funded by the National Heart, Lung, and Blood Institute's Framingham Heart Study, the National Institute of Neurological Disorders and Stroke, and the National Institute on Aging.

The American Academy of Neurology 64th Annual Meeting. Abstract #2402. First results released February 15, 2012.

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