A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory.

BACKGROUND: Measures of handgrip strength have not only emerged as a clinically viable screening tool for determining risk for morbidity, functional disability, and early mortality, but also for helping to identify cognitive deficits. However, the phenomena that links low handgrip strength with cognitive decline remains unclear. The role of the muscular and neural systems, and their adaptations to muscle strengthening activities over the life course, may provide important information for how age-related changes to muscle mass, strength, and neural capacity influence cognition. Moreover, disentangling how handgrip strength and cognitive function are associated may help to inform healthcare providers working with aging adults and guide targeted interventions aiming to preserve muscle and cognitive functioning. OBJECTIVE: To 1) highlight and summarize evidence examining the associations of handgrip strength and cognitive functioning, and 2) provide directions for future research in this area. METHODS: Articles from the PubMed database were searched from November 2018-May 2019. The search term algorithm, inclusion and exclusion criteria were pre-specified by investigators. RESULTS: Several cross-sectional and longitudinal studies have revealed that measures of handgrip strength were associated with cognitive declines regardless of age demographics and the presence of comorbidities. CONCLUSION: Handgrip strength can be used in clinical and epidemiological settings for helping to determine the onset and progression of cognitive impairment. Future research should continue to examine how handgrip strength and cognitive function are linked.

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults.

Over a third of adults in the United States have prediabetes, and many of those with prediabetes will progress to type 2 diabetes within 3-5 years. Health insurance status may factor into a proper diagnosis of prediabetes and diabetes. This study sought to determine the associations between health insurance and undiagnosed prediabetes and diabetes in a national sample of American adults. Publicly available data from 13,029 adults aged 18-64 years from the 2005-2016 waves of the National Health and Nutrition Examination Survey were analyzed. Health insurance type (Medicaid, Private, Other, None) was self-reported. Prediabetes and diabetes status were assessed with measures of self-report, glycohemoglobin, fasting plasma glucose, and two-hour glucose. Covariate-adjusted logistic models were used for the analyses. Overall, 5976 (45.8%) participants had undiagnosed prediabetes, while 897 (6.8%) had undiagnosed diabetes. Having health insurance was associated with decreased odds ratios for undiagnosed prediabetes: 0.87 (95% confidence interval (CI: 0.79, 0.95)) for private insurance, 0.84 (CI: 0.73, 0.95) for other insurance, and 0.78 (CI: 0.67, 0.90) for Medicaid. Moreover, having private health insurance was associated with 0.82 (CI: 0.67, 0.99) decreased odds for undiagnosed diabetes. Health insurance coverage and screening opportunities for uninsured individuals may reduce prediabetes and diabetes misclassifications.

Clinical Outcomes of Different Tempos of Music During Exercise in Cardiac Rehabilitation Patients.

This study examined the effects of stimulating and sedative music on ratings of perceived exertion (RPE), heart rate (HR), blood pressure (BP), and feeling status during exercise in cardiac rehabilitation (CR) patients. Twenty-two male and female older adults age 64 ± 8.0 y currently enrolled in phase III CR completed the study. Repeated measures crossover designs guided data collection. The manipulated independent variable was music condition (sedative, stimulating, and non-music control). The dependent variables were RPE, BP, HR, and feeling status with each represented by four repeated measures ANOVAs over time via SAS 9.3. Data analysis indicated significant differences for all exercise related variables besides BP. While standardizing the exercise, we observed that sedative music is the best choice to manipulate for decreases in RPE (p=.0019), increases in feeling status (p=.0192), and decreases in HR (p<.0001). While standardizing the exercise, sedative music is the best choice to observe decreases in RPE, increases in feeling status, and decreases HR. Stimulating music would only be the correct choice to observe increases in HR, and does not have as much of a beneficial effect on RPE and feeling status as sedative music. There were no significant effects of either type of music on BP.