Abstract: Objective To investigate the gender difference in the association between grip strength and cognitive function. 
Methods Cross-sectional study was conducted using database of the National Health and Nutrition Examination Survey (NHANES) 2011-2014, to evaluate four cognitive domains: immediate memory, delayed memory,  speech fluency, and attention. Weighted linear regression, weighted Logistic regression and interaction analysis were applied. 
Results Regression analysis showed that in males, compared with the group with the lowest grip strength, the group with the highest grip strength had a lower overall cognitive function decline (OR=0.377, 95%CI: 0.182-0.781) and a lower risk of immediate memory decline (OR=0.409, 95%CI: 0.221-0.759). In femlaes, grip strength was significantly and negatively correlated with overall cognitive function decline (OR=0.405, 95%CI: 0.224-0.733), decreased speech fluency (OR=0.567, 95%CI: 0.356-0.902), and decreased attention (OR=0.357, 95%CI: 0.211-0.607). Meanwhile, there was a significant interaction between gender and grip strength in overall cognitive function verbal fluency and attention, but no significant interaction was detected in the two cognitive domains of immediate memory, and delayed recall. 
Conclusion There is significant gender difference in the association between grip strength and overall cognitive function and cognitive domains. The finding suggests that strengthening grip strength levels, especially in females, may be beneficial in preventing cognitive decline. 

Key words: cognitive dysfunction, hand strength, gender factor