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Whether grip strength and manual dexterity dissociate in their cerebellar and cognitive correlates is unknown. We computed Pearson partial correlations (age, sex, and race covaried) between grip strength, Nine-Hole Peg Test (9HPT) dexterity, cerebellar Crus I\/II GMV, and Montreal Cognitive Assessment (MoCA) subscores in 304 healthy adults aged 20\u201379 from the University of South Carolina Aging Brain Cohort. GMV was derived from T1-weighted MRI using CAT12 with the AAL3 atlas. After false discovery rate (FDR) correction, dominant 9HPT time correlated with MoCA total score (\n                    <jats:italic>r<\/jats:italic>\n                    =-.240) and memory index (\n                    <jats:italic>r<\/jats:italic>\n                    =-.220; both pFDR&lt;0.001). Grip strength was unrelated to any MoCA measure but correlated bilaterally with Crus II GMV (\n                    <jats:italic>r<\/jats:italic>\n                    =.156\u2013.224, all pFDR\u22640.041). Bootstrapped mediation indicated that dexterity statistically accounted for 28.8% of the age\u2013cognition association and Crus II volume for 34.4\u201341.4% of the age\u2013grip association. Dichotomizing at the MoCA cut-off of 26, each additional second of peg time carried 17.6% higher odds of scoring below cut-off (odds ratio\u2009=\u20091.176, 95% CI [1.062,1.302]) while grip strength carried none. Grip strength, but not dexterity, was independently associated with Crus II GMV, whereas dexterity, but not grip, was associated with cognition. Grip strength and dexterity are therefore not interchangeable indices of motor function. Because the design is cross-sectional, mediation estimates describe shared variance rather than causal pathways, and the pronounced MoCA ceiling likely attenuated the cognitive associations.\n                  <\/jats:p>","DOI":"10.1007\/s00429-026-03213-6","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:07:35Z","timestamp":1792652855000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying dexterity and grip strength associations between age, cognitive function (MoCA), and cerebellar gray matter volume in healthy adults across the adult lifespan"],"prefix":"10.1007","volume":"231","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6147-798X","authenticated-orcid":false,"given":"Pranesh","family":"Rajesh Kannan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Pallapothu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh","family":"Kudaravalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriya","family":"Pallapothu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Newman-Norlund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"3213_CR1","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1002\/alz.13016","volume":"19","author":"Alzheimer\u2019s Association","year":"2023","unstructured":"Alzheimer\u2019s Association (2023) 2023 Alzheimer\u2019s disease facts and figures. 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This manuscript does not include any individually identifiable participant data, images, or case details; all figures present de-identified group-level neuroimaging renderings and aggregate statistical results.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AI and large language model tools were used in editing this paper\u2019s syntax and grammar for clarity and readability, in locating source literature, and in the creation and debugging of the analysis scripts. Their role is described in full in the Materials and Methods. The authors reviewed and verified all resulting content and take full responsibility for it.","order":5,"name":"Ethics","label":"AI tool disclosure","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"156"}}