Obesity and Low Handgrip Strength as Contrasting Predictors of Cognitive Impairment in Indonesian Older Adults
Lala Sri Fadila, Ernis AsantiABSTRACT
Background
Obesity and low handgrip strength represent two contrasting physical and nutritional conditions in older adults, each with distinct implications for cognitive health. Prior studies have reported inconsistent associations between obesity and cognitive impairment, whereas low handgrip strength has shown a more consistent detrimental effect. Limited evidence is available from Indonesia, a country experiencing rapid demographic aging.
Objectives
To examine the associations of obesity and low handgrip strength with cognitive impairment among older Indonesians using the Indonesia Longitudinal Aging Survey (ILAS) data.
Methods
A cross‐sectional analysis was conducted using data from 1495 ILAS participants aged ≥ 60 years. Cognitive impairment was assessed using the Six‐Item Screener (SIS). Obesity was defined using Body Mass Index (BMI) categories for Asian populations and central obesity using waist circumference cutoffs. Low handgrip strength was identified according to the AWGS 2019 cutoff points. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs).
Results
The prevalence of cognitive impairment was 35.7%. After adjusting for sociodemographic and health‐related covariates, obesity by BMI was inversely associated with cognitive impairment (OR = 0.56, 95% CI: 0.41–0.75), as was central obesity (OR = 0.64, 95% CI: 0.49–0.84). In contrast, low handgrip strength was associated with increased odds of impairment (OR = 1.89, 95% CI: 1.48–2.41).
Conclusions
Obesity and low handgrip strength emerged as contrasting predictors of cognitive impairment in Indonesian older adults, highlighting the “obesity paradox”. Further studies are needed to clarify mechanisms and guide tailored nutritional strategies for healthy aging.