Handgrip strength, physical activity and incident mild cognitive impairment and dementia.

• Moderate to vigorous levels of physical activity were independently associated with a lower incidence of mild cognitive impairment. • Handgrip strength was associated a lower hazard for incident mild cognitive impairment and dementia. • Handgrip strength partly mediated the association between moderate to vigorous levels of physical activity and mild cognitive impairment. We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia. We used prospective data from 14 European countries participating in the Survey of Health, Ageing, and Retirement in Europe. 19,686 participants free of dementia and mild cognitive impairment (64.9 ± 8.7 years) were followed up for a mean of 10.2 years. Moderate to vigorous physical activity was self-reported, and handgrip strength was assessed with a dynamometer. Mild cognitive impairment was defined as 1.5 standard deviations below the mean of the standardized global cognition score, while dementia was determined by physician diagnosis. Gender, age, country, education, presence of chronic diseases, depressive symptoms, limitations in activities of daily living, body mass index, and baseline cognitive levels were used as covariates. Cox proportional hazards as well as mediation models were used. Moderate to vigorous physical activity for at least 1 day per week was independently associated with lower incident mild cognitive impairment (HR: 0.85; 95%CI: 0.74–0.98). A 10 % increase in handgrip strength was associated a 6 % lower hazard for incident mild cognitive impairment (0.94; 0.92–0.97) and 5 % lower hazard for incident dementia (0.95; 0.93–0.98). Handgrip strength partly mediated the association of moderate to vigorous physical activity with mild cognitive impairment (Coefficient: 0.03; 95%CI: 0.01–0.05; 17.9 %). Physical activity is independently associated with a lower incidence of mild cognitive impairment. [ABSTRACT FROM AUTHOR]