Public Health.

Background: Hand-grip strength (HGS) is known to be a surrogate marker of not only fitness and frailty, but of cognitive and cardiometabolic health. It is cheap, readily deployed and can be a valuable tool in resource-limited settings. Little however is known about the determinants and correlates of HGS in sub-Saharan Africa, where stroke and vascular cognitive disorders are projected to exponentially increase. We examined the determinants of HGS among older adults in a rural community in Ibadan, South West Nigeria.

Method: Vascular heAlth, fraiLty and cognition in Ageing Nigerians (VALIANT) Study is an ongoing longitudinal community-based cohort study aimed at exploring the association between cardiovascular health, cognition and frailty in Nigeria. One thousand (1000) participants have so far been recruited (via a multistage, stratified cluster random sampling method) and have been taken through a battery of cardiovascular, cognitive and frailty assessment tools. Data on HGS, obtained using a digital hand dynamometer, was available for 480 men and women aged ≥50years. A multivariable adjusted linear regression analysis was used to assess the determinants of HGS. All associations were reported as coefficients with 95% confidence intervals (CI) RESULT: The mean age was 64.5 (11.8) with 35% males. The mean HGS was higher among males (22.86 10.1) than in females (16.26 6.1) (p<0.001) and decreased with increasing age and in the left hand. Using the Rockwood frailty scale, 66 (13.8%) of the study participants were vulnerable to frail while 80% had cognitive impairment (MoCA <26). In the multivariable linear regression analysis, the independent determinants of hand grip strength with corresponding beta coefficients (95%CI) were attainment of tertiary/postgraduate education 5.19 (1.70; 8.68), being a widow/widower -2.75 (-5.47; -0.03), lower MoCA score<19 -2.50 (-4.42; -0.59) and higher IDEA-IADL score 0.23 (0.02, 0.44) CONCLUSION: Amongst older adults in rural Nigeria, attainment of tertiary/postgraduate education was independently associated with higher HGS; while being a widow/widower and presence of low cognitive reserve were independently associated with lower HGS. This study has identified unique determinants of HGS among West Africans.