Serum dehydroepiandrosterone sulfate and osteoarthritis in older people: the Pro.V.A. study

Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigatedwhether reduced physical performance and lowhandgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older communitydwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participantswithout CI at the baseline were included (mean age 72.2 years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4mgait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in theMMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time.Multinomial logistic regression revealed that slowgait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the followup. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI.