Association of baseline hand grip strength and annual change in hand grip strength with mortality among older people (original) (raw)
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Grip strength and its determinants among older people in different healthcare settings
Age and Ageing, 2014
Background: low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of grip strength of older people in rehabilitation or long-term care has been little explored. Objective: to describe grip strength of older people in rehabilitation and nursing home settings. Design: cross-sectional epidemiological study. Setting: three healthcare settings in one town. Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents. Methods: grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, Mini-Mental State Examination (MMSE), nutritional status and number of falls in the last year were recorded. Results: grip strength differed substantially between healthcare settings for both men and women (P < 0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in grip strength between settings remained significant. The Barthel score was the characteristic most strongly associated with grip strength. Conclusions: older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings.
Normative Grip Strength Values in Males and Females, ages 50 to 89 years old
Internet Journal of Allied Health Sciences and Practice, 2018
Purpose. To develop normative reference values for grip strength of males and females between the ages of 50 and 89 years old that can be used by health care professionals in clinical settings. Methods. This study assessed data from a sample of males and females between the ages of 50 and 89 years old who participated in the Health and Retirement Study (HRS) sponsored by the National Institute on Aging. The Health and Retirement Study collected data from 6,266 participants in a physical measures sub-study. Grip strength was assessed in a standing position with the shoulder adducted and elbow flexed to 90 degrees. One practice trial was allowed and then the participant performed 2 maximal effort trials using each hand. Right and left hand mean scores were calculated. The HRS data were reported in kilograms. Results. Subjects were stratified by sex and age. Each stratum was defined using 5-year intervals, male or female, and by right or left hand. Mean grip strength, standard deviatio...
BMC Geriatrics, 2016
Background: Reduced muscular strength in the old age is strongly related to activity impairment and mortality. However, studies evaluating the gender-specific association between muscularity and mortality among older adults are lacking. Thus, the objective of the present study was to examine gender differences in the association between muscular strength and mortality in a prospective population-based cohort study. Methods: Data used in this study derived from the Cooperative Health Research in the Region of Augsburg (KORA)-Age Study. The present analysis includes 1,066 individuals (mean age 76 ± 11 SD years) followed up over 3 years. Handgrip strength was measured using the Jamar Dynamometer. A Cox proportional hazard model was used to determine adjusted hazard ratios of mortality with 95% confidence intervals (95% CI) for handgrip strength. Potential confounders (i.e. age, nutritional status, number of prescribed drugs, diseases and level of physical activity) were pre-selected according to evidence-based information. Results: During the follow-up period, 56 men (11%) and 39 women (7%) died. Age-adjusted mortality rates per 1,000 person years (95% CI) were 77 (59-106), 24 (13-41) and 14 (7-30) for men and 57 (39-81), 14 (7-27) and 1 (0-19) for women for the first, second and third sex-specific tertile of muscular strength, respectively. Low handgrip strength was significantly associated with all-cause mortality among older men and women from the general population after controlling for significant confounders. Hazard ratios (95% CI) comparing the first and second tertile to the third tertle were 3.33 (1.53-7.22) and 1.42 (0.61-3.28), respectively. Respective hazard ratios (95% CI) for mortality were higher in women than in men ((5.23 (0.67-40.91) and 2.17 (0.27-17.68) versus 2.36 (0.97-5.75) and 0. 97 (0.36-2.57)). Conclusions: Grip strength is inversely associated with mortality risk in older adults, and this association is independent of age, nutritional status, number of prescribed drugs, number of chronic diseases and level of physical activity. The association between muscular strength and all-cause mortality tended to be stronger in women. It seems to be particularly important for the weakest to enhance their levels of muscular strength in order to reduce the risk of dying early.
Grip Strength: An Indispensable Biomarker For Older Adults
Clinical Interventions in Aging
Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
Hand Grip Strength in Elderly Patients with Chronic Illnesses: A Case Control Study
Journal of Health Science, 2015
Background: Weak Handgrip Strength (HGS) is associated with poor functional performance capacity and frailty especially among older adults. This study compared HGS among elderly individuals with chronic illnesses and healthy controls. Methods: 176 (88 patients and 88 healthy controls) participants were purposively recruited for this case-control study. World Health Organization’s definition of old adult (i.e. 65 years and older) was adopted for the inclusion criteria. A handheld dynamometer was used to assess HGS. Anthropometric parameters were measured following standard procedures. Clinical bio-data of the patients were gleaned from case notes. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p<0.05. Results: The participants’ ages ranged between 65 and 84 years. The patient group had significant higher anthropometric measures (p<0.05). The controls had higher Dominant HGS (DHGS) (22.8 ± 7.12 vs. 26.5 ± 4.76 Kgf; p=0.001) and Non-Domina...
Factors associated with loss of handgrip strength in long-lived elderly
Revista da Escola de Enfermagem da USP, 2014
Objective To investigate the prevalence of reduced grip strength and associated factors in long-lived elderly, who are users of primary health care. Method Cross-sectional quantitative study, data were collected during the period of January to December of 2013, by applying tests and questionnaires. The convenience sampling was comprised of 157 seniors. Results The findings indicate that the reduction in grip strength presents a moderate prevalence (25.5%), predominantly among females (19.1%), in the age group of 80-89 years (18.5%) and in those with lower educational levels (15.9%). The association between reduced grip strength and the variables of age and body mass index showed a statistical significance. Conclusion Investigations about the handgrip strength are essential for identifying clinical conditions of Brazilian long-lived elderly, and contribute to the development of plans towards the management of frailty.
Factors associated with grip strength decline in older adults
Age and Ageing, 2014
few studies have examined associations of multi-faceted demographic, health and lifestyle factors with long-term change in grip strength performance across the adult lifespan. The aim of this study was to examine the associations of risk factors in specific parts of the adult lifespan (e.g. in early midlife, in late midlife and in old adulthood) separately for women and men. data came from the longitudinal Swedish Adoption/Twin Study of Aging (SATSA). Grip strength performance was followed in 849 participants who were 50-88 years of age at baseline. The follow-up period with seven waves of data of grip strength was 22 years, and the risk factors were measured up to 20 years before the assessment of grip strength. Latent growth modelling was used for the longitudinal analyses. a gender difference in the type of factors associated with grip strength performance and development across the adult lifespan was found. Significant factors for the age slopes for women were stress, smoking and dementia. For men, marital status, mean arterial pressure, physical activity at work and having a chronic disorder were of importance. These factors varied in their associations with grip strength across the adult lifespan. factors measured earlier in adulthood were associated with grip strength decline in late midlife and old adulthood. Gender-specific patterns of risk factors suggest that it may be worthwhile to conduct research on grip and muscle strength (and biological vitality) separately for men and women.
Hand-grip strength predicts incident disability in non-disabled older men
Age and Ageing, 1999
Objectives: to verify if hand-grip performance in older men is a predictor of disability. Design: population-based prospective study. Setting: a sample from the Italian rural cohorts of the FINE study (Finland, Italy, Netherlands Elderly), representative of the general population of elderly men surveyed in 1991 and 1995. Participants: 140 men aged 71-91 years who reported no disability in performing activities of daily living (ADLs), instrumental activity of daily living (IADLs) and mobility activities at baseline examination and provided information on their functional status at follow-up 4 years later. Measurements: disability was defined as needing help in performing ADLs, IADLs and mobility. Hand-grip strength was evaluated at baseline by a mechanical dynamometer. Results: after adjusting for potential confounding variables, a lower concentration of high-density lipoprotein cholesterol was the only factor predicting disability in men aged 76 years or younger and only reduced hand-grip strength predicted incident disability in men 77 years or older. Conclusion: poor hand strength as measured by hand-grip is a predictor of disability in older people. The handgrip test is an easy and inexpensive screening tool to identify elderly people at risk of disability.
Clinical Medicine Insights: Cardiology, 2018
Objective: (1) To examine the associations between 3 measures of grip strength: static grip strength, change in grip strength, and the combination of grip strength and its change, with all-cause and cardiovascular mortality, and (2) to determine which measure is the most powerful predictor of all-cause and cardiovascular mortality among the European older population. Method: Data come from the first 4 waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). A Cox proportional hazard model and a competing risk regression model were used to assess the associations. To determine the best predictor, Akaike information criterion was applied. Results: Grip strength and the combination of grip strength and its change were associated with all-cause and cardiovascular mortality. Change in grip strength was correlated with only all-cause mortality. Among the 3 measures, the static measure of grip strength was the best predictor of cardiovascular mortality whereas the combined m...
Age and Ageing, 2019
Background: higher grip strength is associated with better health outcomes. The optimal way to report grip strength (i.e. absolute vs. relative) for prediction, however, remains to be established. Methods: in participants (aged 37-73 at baseline) from the UK Biobank, we examined the associations of grip strength, expressed in absolute terms (kilograms) and relative to anthropometric variables, with mortality and disease incidence, after exclusion of the first 2 years of follow-up, and compared risk predictions scores of handgrip strength when differentially expressed. Results: of the 356 721 participants included in the analysis 6,234 died (1.7%) and 4,523 developed CVD (1.3%) over a mean follow-up of 5.0 years (ranging from 3.3 to 7.8) for mortality and 4.1 years (ranging from 2.4 to 7.0) for disease incidence data. As expected, baseline higher grip strength was associated with lower risk of all-cause and cause specific mortality and incidence. These associations did not meaningfully differ when grip-strength was expressed in absolute terms, vs. relative to height, weight, fat-free mass, BMI, fat-free mass index and fat-free mass, or as z-scores. Similarly the different ways of expressing grip strength had little effect on the ability of grip strength to improve risk prediction, based on C-index change, of an office-based risk score. Conclusions: the ability of grip strength to predict mortality is not altered by changing how it is expressed.