The Association Between Handgrip Strength, Physical, and Cognitive Function Among Hospitalized Older Adults in Tanzania

Background In older adults admitted to hospitals in high-income countries, handgrip strength (HGS) has been used as an indicator of muscle strength and as a tool for identifying probable sarcopenia. In these settings, weakness in HGS has been associated with poor cognitive performance and greater physical dependency. The evidence suggests that HGS has potential as a predictor of adverse outcomes. However, the relationships among muscle strength, cognition, and physical dependency remain underexplored. This study examined the relationships between HGS and physical and cognitive function among hospitalized older adults in Tanzania. Methods An observational multicentrecross-sectional study was conducted between March and August 2022 among 308 hospitalized older adults aged 60 years and older from medical wards across four hospitals in Kilimanjaro. The primary outcome was the level of muscle strength and physical and cognitive function. Muscle strength was measured with a handheld dynamometer. Physical function was evaluated via the Barthel Index for Activities of Daily Living (ADL), and cognitive function was assessed via the Identifying Dementia in Elderly Africans cognitive screen (IDEA-Cog). Logistic regression modelling was used to determine the odds of poor physical or cognitive performance across different levels of muscle strength. Results After adjusting for confounders, lower HGS was associated with poorer cognitive function (β = 0.454, OR = 1.575, p < .001) and greater physical dependency (β = 0.304, OR = 1.355, p < .001). The regression analysis indicated that an increase in grip strength led to improvements in cognitive performance and reductions in physical dependency. Conclusion and Implications A lowerHGS was associated with poorer cognitive performance and greater physical dependency in this population of older adults admitted to the hospital in a low- to middle-income setting. Future research should explore its potential as a prognostic tool for identifying older adults at greatest risk of adverse outcomes and for guiding targeted interventions.