{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:54:59Z","timestamp":1777395299302,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:p>Background: Handgrip strength (HGS) and serum folate and homocysteine (Hcy) levels were associated with cognitive function. However, little was known whether there were interactions between HGS and serum folate and Hcy levels on cognitive function. Objective: To examine the interactions between HGS and serum folate and Hcy levels on cognitive function. Methods: This study analyzed the baseline data of the Tianjin Elderly Nutrition and Cognition Cohort study. All participants aged \u226560 years were potential eligible. HGS was measured using a grip strength dynamometer. Serum folate and Hcy levels were assayed using standard laboratory protocol. A Mini-Mental State Examination was used to assess cognitive function. Linear regressions were employed to examine the interactions between HGS and serum folate and Hcy levels on cognitive function. Results: 4,484 participants were included in this study. There were interactions between HGS and serum folate and Hcy levels on cognitive function. Furthermore, subjects with strong HGS and sufficient folate level had the best cognitive function (\u03b2=\u200a2.018), sequentially followed by those with strong HGS and insufficient folate level (\u03b2=\u200a1.698) and with poor HGS and sufficient folate level (\u03b2=\u200a0.873). Similarly, cognitive function was ranked in the descending order of subjects with strong HGS and normal Hcy level (\u03b2=\u200a1.971), strong HGS and high Hcy level (\u03b2=\u200a1.467), and poor HGS and normal Hcy level (\u03b2=\u200a0.657). Conclusion: There were interactions between HGS and serum folate and Hcy levels on cognitive function. However, the temporal associations cannot be examined in a cross-sectional study. Further cohort study should be conducted to confirm these associations in the future.<\/jats:p>","DOI":"10.3233\/jad-201537","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T13:02:53Z","timestamp":1615294973000},"page":"1503-1513","source":"Crossref","is-referenced-by-count":3,"title":["Interactions Between Handgrip Strength and Serum Folate and Homocysteine Levels on Cognitive Function in the Elderly Chinese Population"],"prefix":"10.1177","volume":"80","author":[{"given":"Yongjie","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuoyu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changqing","family":"Sun","sequence":"additional","affiliation":[{"name":"Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengdi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingzhu","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xumei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangshun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guowei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-201537_ref1","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1188\/07.ONF.981-994","article-title":"Chemotherapy-related change in cognitive function: A conceptual model","volume":"34","author":"Hess","year":"2007","journal-title":"Oncol Nurs Forum"},{"key":"10.3233\/JAD-201537_ref2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12966-018-0697-x","article-title":"Physical activity to improve cognition in older adults: Can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis","volume":"15","author":"Gheysen","year":"2018","journal-title":"Int J Behav Nutr Phys Act"},{"key":"10.3233\/JAD-201537_ref3","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1007\/s10072-018-3473-4","article-title":"The effects and potential mechanisms of folic acid on cognitive function: A comprehensive review","volume":"39","author":"Enderami","year":"2018","journal-title":"Neurol Sci"},{"key":"10.3233\/JAD-201537_ref4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/inthealth\/ihz114","article-title":"Trends in the prevalence of cognitive impairment in Chinese older adults: Based on the Chinese Longitudinal Healthy Longevity Survey cohorts from 1998 to 2014","volume":"12","author":"Kuang","year":"2020","journal-title":"Int Health"},{"key":"10.3233\/JAD-201537_ref5","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1600-0447.2008.01326.x","article-title":"Rate of progression of mild cognitive impairment to dementia\u2013meta-analysis of 41 robust inception cohort studies","volume":"119","author":"Mitchell","year":"2009","journal-title":"Acta Psychiatr Scand"},{"key":"10.3233\/JAD-201537_ref6","unstructured":"Alzheimer\u2019s Disease International (2019) World Alzheimer Report 2019. Attitudes to dementia. Alzheimer\u2019s Disease International, London."},{"key":"10.3233\/JAD-201537_ref7","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1007\/s12603-019-1230-x","article-title":"Nutritional status and cognitive impairment among the very old in a community sample from Southern Brazil","volume":"23","author":"Senger","year":"2019","journal-title":"J Nutr Health Aging"},{"key":"10.3233\/JAD-201537_ref8","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000360280","article-title":"Decreased motor function is associated with poorer cognitive function in elderly with type 2 diabetes","volume":"4","author":"Guerrero-Berroa","year":"2014","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"10.3233\/JAD-201537_ref9","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.rehab.2013.02.005","article-title":"Dimensions of physical frailty and cognitive function in older adults with amnestic mild cognitive impairment","volume":"56","author":"McGough","year":"2013","journal-title":"Ann Phys Rehabil Med"},{"key":"10.3233\/JAD-201537_ref10","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jamda.2019.08.032","article-title":"The longitudinal associations of handgrip strength and cognitive function in aging Americans","volume":"21","author":"McGrath","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"10.3233\/JAD-201537_ref11","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.arr.2017.01.004","article-title":"Handgrip strength as a means of monitoring progression of cognitive decline - A scoping review","volume":"35","author":"Fritz","year":"2017","journal-title":"Ageing Res Rev"},{"key":"10.3233\/JAD-201537_ref12","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1093\/geronb\/gbz072","article-title":"A coordinated multi-study analysis of the longitudinal association between handgrip strength and cognitive function in older adults","volume":"76","author":"Zammit","year":"2021","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"10.3233\/JAD-201537_ref13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ggi.12508","article-title":"Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis","volume":"16","author":"Rijk","year":"2016","journal-title":"Geriatr Gerontol Int"},{"key":"10.3233\/JAD-201537_ref14","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.3233\/JAD-190042","article-title":"Handgrip strength is associated with poorer cognitive functioning in aging Americans","volume":"70","author":"McGrath","year":"2019","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-201537_ref15","doi-asserted-by":"crossref","first-page":"622","DOI":"10.2174\/1567205016666190725144629","article-title":"Effects of folic acid and vitamin B12, alone and in combination on cognitive function and inflammatory factors in the elderly with mild cognitive impairment: A single-blind experimental design","volume":"16","author":"Ma","year":"2019","journal-title":"Curr Alzheimer Res"},{"key":"10.3233\/JAD-201537_ref16","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3390\/nu9070725","article-title":"Plasma homocysteine and serum folate and vitamin B12 levels in mild cognitive impairment and Alzheimer\u2019s disease: A case-control study","volume":"9","author":"Ma","year":"2017","journal-title":"Nutrients"},{"key":"10.3233\/JAD-201537_ref17","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1503\/cmaj.1031586","article-title":"Homocysteine and cognitive function in elderly people","volume":"171","author":"Garcia","year":"2004","journal-title":"CMAJ"},{"key":"10.3233\/JAD-201537_ref18","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1146\/annurev-nutr-071715-050947","article-title":"Homocysteine, B vitamins, and cognitive impairment","volume":"36","author":"Smith","year":"2016","journal-title":"Annu Rev Nutr"},{"key":"10.3233\/JAD-201537_ref19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s12937-016-0208-3","article-title":"Serum folate predicts muscle strength: A pilot cross-sectional study of the association between serum vitamin levels and muscle strength and gait measures in patients >\u200a65 years old with diabetes mellitus in a primary care setting","volume":"15","author":"Wee","year":"2016","journal-title":"Nutr J"},{"key":"10.3233\/JAD-201537_ref20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3177\/jnsv.65.1","article-title":"Relationship between homocysteine, folate, vitamin B12 and physical performance in the institutionalized elderly","volume":"65","author":"Ao","year":"2019","journal-title":"J Nutr Sci Vitaminol (Tokyo)"},{"key":"10.3233\/JAD-201537_ref21","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/gerona\/glu011","article-title":"Grip strength cutpoints for the identification of clinically relevant weakness","volume":"69","author":"Alley","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"10.3233\/JAD-201537_ref22","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1146\/annurev.med.60.041807.123308","article-title":"The treatment of hyperhomocysteinemia","volume":"60","author":"Maron","year":"2009","journal-title":"Annu Rev Med"},{"key":"10.3233\/JAD-201537_ref23","first-page":"951","article-title":"Gender differences in cognition among older adults in China","volume":"47","author":"Lei","year":"2012","journal-title":"J Hum Resour"},{"key":"10.3233\/JAD-201537_ref24","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1467-789X.2011.00944.x","article-title":"Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993\u20132009","volume":"13","author":"Xi","year":"2012","journal-title":"Obes Rev"},{"key":"10.3233\/JAD-201537_ref25","doi-asserted-by":"crossref","first-page":"578742","DOI":"10.3389\/fnagi.2020.578742","article-title":"Age- and sex-specific prevalence and modifiable risk factors of mild cognitive impairment among older adults in China: A population-based observational study","volume":"12","author":"Fu","year":"2020","journal-title":"Front Aging Neurosci"},{"key":"10.3233\/JAD-201537_ref26","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12877-019-1199-7","article-title":"Role of gait speed and grip strength in predicting 10-year cognitive decline among community-dwelling older people","volume":"19","author":"Chou","year":"2019","journal-title":"BMC Geriatr"},{"key":"10.3233\/JAD-201537_ref27","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s12877-018-0918-9","article-title":"Association among handgrip strength, body mass index and decline in cognitive function among the elderly women","volume":"18","author":"Jeong","year":"2018","journal-title":"BMC Geriatr"},{"key":"10.3233\/JAD-201537_ref28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4082\/kjfm.17.0074","article-title":"The relationship between handgrip strength and cognitive function in elderly Koreans over 8 years: A prospective population-based study using Korean Longitudinal Study of Ageing","volume":"40","author":"Kim","year":"2019","journal-title":"Korean J Fam Med"},{"key":"10.3233\/JAD-201537_ref29","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1037\/0882-7974.16.4.588","article-title":"The \u201ccommon cause hypothesis\u201d of cognitive aging: Evidence for not only a common factor but also specific associations of age with vision and grip strength in a cross-sectional analysis","volume":"16","author":"Christensen","year":"2001","journal-title":"Psychol Aging"},{"key":"10.3233\/JAD-201537_ref30","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1037\/0882-7974.12.1.12","article-title":"Emergence of a powerful connection between sensory and cognitive functions across the adult life span: A new window to the study of cognitive aging?","volume":"12","author":"Baltes","year":"1997","journal-title":"Psychol Aging"},{"key":"10.3233\/JAD-201537_ref31","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1159\/000111582","article-title":"Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults","volume":"29","author":"Rosano","year":"2007","journal-title":"Neuroepidemiology"},{"key":"10.3233\/JAD-201537_ref32","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.clineuro.2008.05.013","article-title":"Cerebellar neurocognition: Insights into the bottom of the brain","volume":"110","author":"Baillieux","year":"2008","journal-title":"Clin Neurol Neurosurg"},{"key":"10.3233\/JAD-201537_ref33","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.mad.2008.11.006","article-title":"Aging: An important factor for the pathogenesis of neurodegenerative diseases","volume":"130","author":"Farooqui","year":"2009","journal-title":"Mech Ageing Dev"},{"key":"10.3233\/JAD-201537_ref34","doi-asserted-by":"crossref","first-page":"7569","DOI":"10.1523\/JNEUROSCI.1553-10.2010","article-title":"A general factor of brain white matter integrity predicts information processing speed in healthy older people","volume":"30","author":"Penke","year":"2010","journal-title":"J Neurosci"},{"key":"10.3233\/JAD-201537_ref35","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/gerona\/glp149","article-title":"The relationship between cognitive function and physical performance in older women: Results from the women\u2019s health initiative memory study","volume":"65","author":"Atkinson","year":"2010","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"10.3233\/JAD-201537_ref36","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1532-5415.2009.02671.x","article-title":"Physical frailty is associated with incident mild cognitive impairment in community-based older persons","volume":"58","author":"Boyle","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"10.3233\/JAD-201537_ref37","first-page":"216","article-title":"The methylation, neurotransmitter, and antioxidant connections between folate and depression","volume":"13","author":"Miller","year":"2008","journal-title":"Altern Med Rev"},{"key":"10.3233\/JAD-201537_ref38","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1038\/ejcn.2013.97","article-title":"Homocysteine and the methylenetetrahydrofolate reductase 677C\u2013>T polymorphism in relation to muscle mass and strength, physical performance and postural sway","volume":"67","author":"Swart","year":"2013","journal-title":"Eur J Clin Nutr"},{"key":"10.3233\/JAD-201537_ref39","doi-asserted-by":"crossref","first-page":"377S","DOI":"10.1093\/jn\/130.2.377S","article-title":"Homocysteine thiolactone: Metabolic origin and protein homocysteinylation in humans","volume":"130","author":"Jakubowski","year":"2000","journal-title":"J Nutr"},{"key":"10.3233\/JAD-201537_ref40","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S0014-5793(00)01278-3","article-title":"Homocysteine accelerates endothelial cell senescence","volume":"470","author":"Xu","year":"2000","journal-title":"FEBS Lett"},{"key":"10.3233\/JAD-201537_ref41","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/ggi.12093","article-title":"Rate of cognitive decline in relation to sex after 60 years-of-age: A systematic review","volume":"14","author":"Ferreira","year":"2014","journal-title":"Geriatr Gerontol Int"},{"key":"10.3233\/JAD-201537_ref42","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1007\/s12603-018-1041-5","article-title":"Depression and handgrip strength among U.S. adults aged 60 years and older from NHANES 2011-2014","volume":"22","author":"Brooks","year":"2018","journal-title":"J Nutr Health Aging"}],"container-title":["Journal of Alzheimer's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JAD-201537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:05:24Z","timestamp":1777370724000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JAD-201537"}},"subtitle":[],"editor":[{"given":"Anne","family":"Ording","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,20]]},"references-count":42,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3233\/jad-201537","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,20]]}}}