Associations of handgrip strength asymmetry with physical frailty, cognitive impairment, and cognitive frailty: A cross-sectional finding from the Longitudinal Ageing Study in India (LASI), Wave 1 (2017-18)

Objectives: As one ages, it becomes essential to anticipate and address the obstacles that impede the pursuit of healthy ageing. Thus, the present study aims to find out the associations between hand grip strength (HGS) asymmetry, physical frailty, cognitive impairment, and cognitive frailty. Methods: The study utilizes Longitudinal Ageing Study in India (LASI) Wave-1 (2017-18) data. A total of 54,889 participants aged 45 years and above were included in the study. Physical frailty was assessed using the Modified Fried Frailty Phenotype and Cognitive impairment with the Composite Cognitive Impairment Index (CII). HGS asymmetry was calculated using hand grip ratios. Basic descriptive statistics were employed, and binary logistic regression confirmed the association between HGS asymmetry and cognitive frailty. Results at p < 0.05 were significant before and after adjusting for potential confounders. Results: HGS asymmetry is strongly associated with physical frailty, cognitive impairment, and cognitive frailty. Participants with cognitive frailty had significantly higher odds of exhibiting greater HGS asymmetry, even after adjusting for confounders (AOR: 1.05, 95 % CI: 0.82-1.34, p < 0.01). Additionally, females exhibited a significantly higher prevalence of HGS asymmetry (59.9 %) (p < 0.01). Individuals living alone had the highest prevalence of cognitive frailty (5.5 %) (p < 0.01). Conclusion: HGS asymmetry could strongly predict physical frailty, cognitive impairment, and cognitive frailty. Exercise-based intervention programs aiming to decrease HGS asymmetry and examine their impact on preventing physical frailty, cognitive impairment, and cognitive frailty should be developed and incorporated into various health policies designed with 'healthy ageing' in consideration.