Associações entre desempenho cognitivo, força de preensão manual e alterações vasculares em indivíduos idosos

Abstract

Global cardiovascular and brain health is important for the elderly to lead independent lives. Both aging and hypertension are associated with reduced cognitive performance. Aging leads to a reduction in the physiological reserve in different systems, corroborating with a sharp decline in physical and cognitive performance. The objectives of this study were to evaluate the association between maximum handgrip strength (HGS) and cognitive performance in the elderly. Secondly, to evaluate aging as a factor for specific changes in cognitive performance, handgrip strength, vascular function and its correlations. Elderly (n = 90), aged> 60 years, underwent cognitive performance assessment by means of the mini mental state exam (MMSE), the Wechsler Adult Intelligence Scale 3rd Edition subtests and the Trail Making Tests A / B tests (TMT-A / B) FMP was measured using a standardized protocol with a validated dynamometer. The participants were divided into groups of low (BFP) and high handgrip strength (AFP), according to the median of the FMP, different for women and men. In a second step, they were subdivided according to the age group: 60-69 years (elderly-young), 70-79 years (elderly) and ≥80 years (very elderly). The individuals were submitted to cognitive tests, handgrip strength (FPM) and central hemodynamics measurements by applanation tonometry (Sphygmocor) and pulse wave velocity (VOP; Complior-SP). There were no differences in years of schooling, anthropometric values and prevalence of hypertension and diabetes. Although the MMSE was similar between the groups, the verbal fluency subtest was lower, and the TMT-B was higher in the BFP group. The immediate change in systolic blood pressure before and after handgrip was inversely correlated with the understanding subtest and positively correlated with TMT-B. The mean age of the age groups was 65 ± 4, 74 ± 3 years and 83 ± 3 years, respectively. Systolic pressure was similar, but diastolic pressure was lower in the very elderly group (76 ± 9 vs 75 ± 8 vs 68 ± 8 mmHg, P = 0.002). The pressure-normalized OPV was higher in the elderly and very elderly groups (8.8 ± 1.9 vs 10.5 ± 2 vs 11.1 ± 4.9 m / s, P = 0.002). In central hemodynamics, only the increment pressure (AP; 22 ± 10 vs 23 ± 11 vs 35 ± 33 mmHg, P = 0.032) was higher in the very elderly group. This very elderly group had a lower comprehension score and higher Trail Making Tests A and B scores. In multiple linear regression, age was independently associated with the comprehension test (β = -0.27, P = 0.006), FPM (β = -0.27, P = 0.003), OPV-normalized (β = 0.24, P = 0.008) and AP (β = 0.23, P = 0.008). Elderly people with BFP had specific cognitive deficits, related to the immediate change in systolic blood pressure. Handgrip strength measurements can be useful in screening for low cognitive performance. The markers of vascular aging in the older population seem to be carefully identified. Normalized PWV and AP seem to be more reliable indicators and more specific tests may indicate earlier cognitive decline.