Archives of Gerontology and Geriatrics · Jun 16, 2025

Pinch strength as an independent correlate of cognitive impairment beyond grip strength in older adults

By Ren J, Chen X, Jiang W et al.

OBJECTIVES: To compare pinch strength parameters against grip strength metrics for identifying cognitive impairment in community-dwelling older adults. DESIGN: Cross-sectional analysis of baseline data from a prospective cohort study. SETTING AND PARTICIPANTS: 954 community-dwelling older adults from three communities. METHODS: Pinch and grip strength were measured using portable dynamometers. Derived metrics included peak strength, coefficient of variation (CV), fatigue index, and pinch/grip ratio. Functional assessments were also collected. Cognitive impairment was defined by a Mini-Cog score ≤ 2. Multivariable logistic regression models, adjusted for age, sex, and education, assessed associations between standardized strength metrics and cognitive impairment, reporting adjusted odds ratios (ORs) and 95 % confidence intervals (CIs). Model performance was compared using Area Under the Receiver Operating Characteristic Curve (AUC), Decision Curve Analysis (DCA), and calibration. RESULTS: Cognitive impairment prevalence was 32.7 % (312/954). Lower peak pinch strength strongly correlated with cognitive impairment (OR 0.50, 95 % CI 0.40-0.61), remaining robust after adjusting for grip strength (OR 0.48, 95 % CI 0.38-0.60). Peak grip strength association attenuated when pinch was included. Higher grip strength CV also correlated with cognitive impairment (OR 1.2-1.3, p < 0.05). A simple model with peak pinch strength (AUC 0.689) performed comparably to a full model (AUC 0.699, p = 0.121) and significantly better than a peak grip strength model (AUC 0.633, p < 0.001). DCA indicated clinical utility for pinch-strength-based models. CONCLUSIONS: Peak pinch strength demonstrated a stronger association with cognitive impairment than peak grip strength. This finding warrants further research into the mechanisms linking fine motor strength and cognition.

doi.org/10.1016/j.archger.2025.105938PubMed 40554813Biomarkers