ECSS Paris 2023: CP-MH15
INTRODUCTION: The association between muscle strength, as measured by handgrip strength (HGS), and dementia has been well-established. However, the role of HGS asymmetry in dementia risk remains understudied. This study investigated the independent and joint associations of HGS asymmetry and weakness with incident dementia in the Survey of Health, Ageing and Retirement in Europe (SHARE) study with a follow-up of 18 years. METHODS: This cohort study analyzed participants aged ≥ 50 years from SHARE (2004-2022) across 28 countries. Dementia was ascertained using the following question: “Doctor has said you had: Alzheimer’s disease, dementia, or senility”. HGS was measured in kg using a dynamometer. HGS asymmetry was defined as a >10% difference between hands (HGS ratio < 0.9 or > 1.1). Weakness was defined as maximum HGS < 27 kg in men or <16 kg in women per EWGSOP criteria. We created four combinations of HGS asymmetry and weakness to permit a joint analysis: ‘both asymmetry and weakness’, ‘weakness only’, ‘asymmetry only’, and ‘neither asymmetry nor weakness’. Time-varying Cox regression models were employed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders including age, sex, education (less than upper secondary, upper secondary and vocational, and tertiary education), marital status (married, partnered, separated, divorced, widowed, and never married), residence (rural/urban), geographical region (Eastern, Northern, Southern, Western Europe, and Israel), body mass index (underweight, normal weight, overweight, and obesity classes I-III), smoking status (never, previous, and current), weekly alcohol consumption (yes/no), physical activity (very low, moderately low, moderately high, and high), number of medications, and maximum HGS or HGS asymmetry. RESULTS: The study included 99,077 participants (54.9% women, mean age 66.6 years). Prevalence of HGS asymmetry and weakness were 49.4% and 6.8%. Over a mean follow-up of 7.6 years, there were 4,513 cases of dementia. The incidence of dementia was 6.0 per 1000 person-years (95% CI: 5.85, 6.20). Participants without HGS asymmetry had lower dementia risk [HR: 0.88 (95% CI: 0.79, 0.97)], after adjusting for all confounders including maximum HGS. The HR (95% CI) for dementia in the normal group was 0.50 (0.44, 0.56) compared to the weakness group, after adjusting for all confounders includings HGS asymmetry. In the joint analyses, compared with the ‘both asymmetry and weakness’ group, the HRs (95% CIs) for dementia were 0.81 (0.68, 0.98), 0.49 (0.42, 0.56), and 0.44 (0.38, 0.51) in the ‘weakness only’, ‘asymmetry only’, and ‘neither asymmetry nor weakness’ groups. CONCLUSION: HGS asymmetry and weakness were independently associated with dementia risk, with their co-occurrence conferring the highest risk. These findings suggest that clinical assessments targeting both muscle symmetry and muscle strength may contribute to the detection of dementia and inform effective intervention strategies.
Read CV Xiangyu ZhaiECSS Paris 2023: CP-MH15
INTRODUCTION: Balance impairments are among the most disabling symptoms in multiple sclerosis (MS). In healthy individuals, increased cortical theta and decreased alpha power during balance are thought to reflect error monitoring and attentional engagement, yet these neurophysiological mechanisms remain poorly understood in MS. This pilot study examined how postural demands modulate brain activity in MS patients versus healthy controls. METHODS: Six individuals with MS (mean: 52 ± 10.2 years; 4 women, Expanded Disability Status Scale (EDSS) between 4.0 and 6.5; mean: 5 ± 1) and six age- and sex-matched healthy controls (mean: 51 ± 10.4 years) performed three balance tasks for 3 x 20 seconds each: quiet stance with eyes open (stance-EO) and eyes closed (stance-EC), narrow stance with eyes open (narrow-EO), and a seated resting-state condition (resting-EO and resting-EC). Balance performance was recorded using a force plate to quantify center of pressure (COP) for path length, amplitude, root mean square (RMS), and average speed in anteroposterior (AP) and mediolateral (ML) direction. Brain activity was measured using 32-channel electroencephalography (EEG) and theta, alpha, beta, and gamma power were analyzed across frontal, fronto-central, centro-parietal, and occipital regions. Resting-state EEG was compared using Mann-Whitney U tests. EEG data during stance were baseline-corrected by subtracting the corresponding resting-state condition; both stance EEG and COP data were analyzed using linear mixed-effects models (LMMs). RESULTS: COP showed greater postural sway in MS patients (group main effects for RMS ML, amplitude ML, RMS total, amplitude AP; all p < .05). All COP variables exhibited significant Group x stance-EC interactions (p < .001 - .044). Group x narrow-EO interactions emerged for amplitude AP (p < .001), RMS AP (p < .001), and RMS total (p = .025). Resting-state EEG showed no robust group differences, except for elevated occipital theta power in MS patients during resting-EO (p = .015, r = .76). No main effects of group and condition were found during stance. No Group x narrow-EO interactions, but Group x stance-EC interactions emerged for frontal theta (p = .012) and beta (p = .011), fronto-central beta (p = .014), centro-parietal alpha (p = .023) and beta (p < .001), and occipital theta (p = .025) and alpha (p = .017). All beta-coefficients were negative (semi-partial R2 = .24 - .43), indicating larger power decreases in MS patients when visual input was removed. CONCLUSION: This pilot study provides preliminary evidence that balance-related differences between MS patients and healthy controls emerge specifically when visual input is removed, suggesting increased visual dependence in MS. Widespread Group x eyes-closed interactions across theta, alpha, and beta bands indicate that this visual dependence involves multiple cortical processes, including error monitoring, attentional allocation, and motor control. These findings warrant confirmation in larger samples.
Read CV Leonard BraunsmannECSS Paris 2023: CP-MH15
INTRODUCTION: Cognitive impairment is highly prevalent among patients receiving hemodialysis (HD) (1) and is associated with significant adverse effects on multiple health outcomes, quality‑of‑life domains, and increased mortality (2). Recent evidence suggests a relationship between functional capacity and cognitive function, primarily derived from studies conducted in older adult populations (3). Therefore, the aim of this cross‑sectional study was to examine the association between cognitive function and functional capacity in a sample of HD patients. METHODS: Thirty‑two patients undergoing hemodialysis (HD) (mean age: 60.3 ± 13.9 years) were recruited and provided informed consent to participate in this study. Cognitive function was assessed using the Mini‑Mental State Examination (MMSE) and the Trail Making Test (TMT) parts A and B. Functional capacity was evaluated using a battery of tests commonly applied in HD populations, including the Timed Up and Go (TUG) test, two sit‑to‑stand tests, isometric handgrip strength assessment, the six‑minute walk test (6MWT), and a cardiopulmonary exercise test performed on a cycle ergometer during HD to assess maximal oxygen uptake (VO2max). Pearson’s correlation coefficient was used to examine the relationships among the studied variables. RESULTS: Significant correlations were observed between performance on the TMT‑A and TMT‑B and performance scores across several functional capacity tests (p < 0.050). In contrast, MMSE scores were not significantly associated with any functional capacity measure (p > 0.050). The strongest correlation was identified between Timed Up and Go (TUG) performance and TMT‑B scores (r = 0.790, p < 0.001). Additionally, significant associations were found between both TMT‑A and TMT‑B performance and VO2max as well as handgrip strength (p < 0.050). CONCLUSION: The results of the present study demonstrated that reduced levels of functional capacity are associated with poorer cognitive performance in patients undergoing HD, confirming evidence from non‑HD populations. These findings highlight the need for the development of effective exercise interventions aimed at mitigating both functional and cognitive decline in HD patients. REFERENCES 1. Zhang et al. Plos One, 2024, 3;19(6):e0304762 2. Angermann et al. J Alzheimers Dis, 2018, 66(4):1529-37 3. Stavrinou et al. Life, 2022, 13;12(7):1042
Read CV Christoforos GiannakiECSS Paris 2023: CP-MH15