[Handgrip strength and flexibility and their association with anthropometric variables in the elderly]

Population-specific equations of age-related maximum handgrip force: a comprehensive review

Background

The measurement of handgrip force responses is important in many aspects, for example: to complement neurological assessments, to investigate the contribution of muscle mass in predicting functional outcomes, in setting realistic treatment goals, evaluating rehabilitation strategies. Normative data about handgrip force can assist the therapist in interpreting a patient's results compared with healthy individuals of the same age and gender and can serve as key decision criteria. In this context, establishing normative values of handgrip strength is crucial. Hence, the aim of the this study is to develop a tool that could be used both in rehabilitation and in the prevention of work-related musculoskeletal disorders. This tool takes the form of population-specific predictive equations, which express maximum handgrip force as a function of age.

Methodology

In order to collect data from studies measuring maximum handgrip force, three databases were searched. The search yielded 5,058 articles. Upon the removal of duplicates, the screening of abstracts and the full-text review of potentially relevant articles, 143 publications which focussed on experimental studies on various age groups were considered as fulfilling the eligibility criteria. A comprehensive literature review produced 1,276 mean values of maximum handgrip force.

Results

A meta-analysis resulted in gender- and world region-specific (general population, USA, Europe and Asia) equations expressing maximum force as a function of age. The equations showed quantitative differences and trends in maximum handgrip force among age, gender and national groups. They also showed that values of maximum handgrip force are about 40% higher for males than for females and that age-induced decrease in force differs between males and females, with a proved 35% difference between the ages of 35 and 75. The difference was lowest for the 60-64 year olds and highest for the 18-25 year-olds. The equations also showed that differences due to region are smaller than those due to age or gender.

Conclusions

The equations that were developed for this study can be beneficial in setting population-specific thresholds for rehabilitation programmes and workstation exposure. They can also contribute to the modification of commonly used methods for assessing musculoskeletal load and work-related risk of developing musculoskeletal disorders by scaling their limit values.

The Controversial Relationship between Body Mass Index and Handgrip Strength in the Elderly: An Overview

Body mass index (BMI) is one of the most commonly used anthropometric measurements. BMI is measured by dividing an individual's weight by their height. In the elderly, the aging process causes physiological changes to organ systems as well as body composition. The most noticeable changes occur in the musculoskeletal system-that is, of decreased muscle strength. Handgrip strength is one of the most commonly considered criteria to measure muscle strength. Various factors, including age, gender and anthropometric measurements such as BMI, are known to affect a person's muscle strength. In addition, weight and height affect the handgrip strength of an elderly person. However, whether BMI directly affects handgrip strength in the elderly is still debated. Several studies have stated that BMI has a relationship with handgrip strength in the elderly, while other studies have found no relationship between BMI and handgrip strength. BMI and handgrip strength is still controversial and requires further research.

Overweight in Older Adults: A Follow-Up of Fifteen Years of the SABE Survey

Despite extensive research on overweight and obesity, there are few studies that present longitudinal statistical analyses among non-institutionalized older adults, particularly in low- and middle-income countries. This study aimed to assess the prevalence and factors associated with excess weight in older adults from the same cohort over a period of fifteen years. A total of 264 subjects aged (≥60 years) from the SABE survey (Health, Wellbeing and Aging) in the years 2000, 2006, 2010, and 2015 in the city of São Paulo, Brazil, were evaluated. Overweight was assessed by a BMI of ≥28 kg/m². Multinomial logistic regression models adjusted for sociodemographic and health data were used to assess factors associated with excess weight. After normal weight, overweight was the most prevalent nutritional status in all evaluated periods: 34.02% in 2000 (95%CI: 28.29-40.26); 34.86% in 2006 (95%CI: 28.77-41.49%); 41.38% in 2010 (95%CI: 35.25-47.79); 33.75% in 2015 (95%CI: 28.02-40.01). Being male was negatively associated with being overweight in all years (OR: 0.34 in 2000; OR: 0.36 in 2006; OR: 0.27 in 2010; and OR: 0.43 in 2015). A greater number of chronic diseases and worse functionality were the main factors associated with overweight, regardless of gender, age, marital status, education, physical activity, and alcohol or tobacco consumption. Older adults with overweight and obesity, a greater number of chronic diseases, and difficulties in carrying out daily tasks required a greater commitment to healthcare. Health services must be prepared to accommodate this rapidly growing population in low- and middle-income countries.

Factors related to the physical capacity of upper and lower limbs in quilombola elderly people

This paper aimed to assess the factors related to the physical capacity of upper and lower limbs in quilombola older adults. This is a cross-sectional, analytic study performed with elderly residents in the quilombola community Caiana dos Crioulos, Alagoa Grande, Paraíba, Brazil. The researched dependent variables were the physical capacity of upper and lower limbs. It was performed the Spearman correlation and multiple and linear simple regression (95% CI; p<0.05). This work was performed per Resolution 466/2012 from National Health Council. Forty-three older adults were assessed. The bivariate analyses showed a positive correlation between handgrip strength (HGS) and physical activity (PA), between HGS and arm muscle circumference (AMC), and an inverse correlation between Short Physical Performance Battery (SPPB) and age. The multiple-model for HGS was significantly correlated with age, AMC, and years of study (R2=0.374; p<0.05). Regarding the SPPB, it showed a significant correlation with age (R2=0.2524; p=0.001). Therefore, the muscle mass reserve, years of study, and age were factors related to the physical capacity among quilombola older adults. The strict compliance of these aspects and the early intervention can preserve physical capacity and ensure the productive inclusion and economic autonomy so much sought in the communities' social agenda.

Avaliação multidimensional da fragilidade em idosos hospitalizados

Introdução: a Síndrome da Fragilidade (SF) pode representar um impacto significativo nos cuidados hospitalares aos idosos gerando desfechos com prognósticos funcionais variados.Objetivo: conhecer a multidimensionalidade envolvida no processo de hospitalização de idosos e a sua condição de fragilidade.Métodos: estudo transversal com abordagem descritiva que avaliou 150 idosos com 60 anos ou mais, internados em dois grandes hospitais na cidade de Curitiba, PR. Foram coletados dados relacionados à caracterização sociodemográfica; fatores cognitivos pelo Mini Exame do Estado Mental (MEEM); nível de fragilidade pela Edmonton Frail Scale (EFS); depressão pela Escala de Depressão Geriátrica (EDG-15); e força de preensão manual (FPM) verificada por dinamometria manual.Resultados: a média de idade foi de 70,0±7,9 anos e 92 (61,3%) eram homens. 30% dos idosos foram classificados como vulneráveis, 27,3% evoluindo como uma fragilidade leve, 22,7% moderada, 9,3% considerada uma forma grave e, apenas 10,7% normais. Fatores como diminuição de força de preensão palmar e depressão foram estatisticamente associados à condição de fragilidade, servindo como parâmetros analíticos dentro de uma multidimensionalidade avaliada.Conclusão: os colaboradores deste estudo apresentam-se mais vulneráveis, tanto físico como cognitivamente, levando a um cenário condizente a uma redução de suas habilidades motoras, pior expectativa de vida e consequente morte precoce.

Association between Handgrip Strength, Mobility, Leg Strength, Flexibility, and Postural Balance in Older Adults under Long-Term Care Facilities

INTRODUCTION

Low muscle strength is common and important in geriatric syndromes including frailty and sarcopenia. The epidemiology of grip strength of older people under long-term care facilities has been little explored.

PURPOSE

The aim of this study was to assess handgrip strength of older women and men covered by institutional care and to analyse the associations between HGS and mobility, leg strength, flexibility, and postural balance.

MATERIALS AND METHODS

This is a cross-sectional study carried out at care homes in southeastern Poland. After considering the inclusion criteria, 209 older people aged 65 to 85 were included in the study. Sociodemographic data were collected, and tests of muscular strength, mobility, flexibility, and postural balance were carried out by the use of the stabilometric platform CQ Stab 2P.

RESULTS

The average handgrip strength in the study group amounted to 19.8 kg, including 14.8 kg in women and 25.9 kg in men. Low grip strength was found in 67.83% women and 52.13% men in institutional care. A negative correlation between handgrip strength (HGS) and the Timed Up and Go (TUG) test was demonstrated, both with and without cognitive task and strength of lower limbs. Gait speed and dynamic balance were positively correlated with HGS. A negative correlation was found between the total length of the centre of pressure (COP) path, the length of the COP path in the lateral-medial direction, and the sway area delimited by the COP and HGS for the dominant hand. Speaking of women, gait speed was most strongly associated with HGS, while among men, it was upper limb flexibility.

CONCLUSION

Regardless of gender, HGS is associated with mobility, strength of the lower limbs, and dynamic balance. By means of simple tools, early diagnosis will facilitate the planning of appropriate interventions in order to prevent disability and mortality in long-term care facilities.

Physical Fitness and Body Composition in Women with Systemic Lupus Erythematosus

Background and objectives: Higher physical fitness is associated with a more favorable weight and body composition in the general population, although this association has not been studied in patients with systemic lupus erythematosus (SLE). The aim of the present study was to examine the association of different components of physical fitness with body composition in women with SLE with mild disease activity. Materials and Methods: This cross-sectional study included 77 women with SLE (43.2 ± 13.8 years old) and clinical stability during the previous 6 months. Body composition (including body mass index (BMI), fat mass index (FMI), waist circumference, waist-to-height ratio and waist-to-hip ratio) was assessed using a stadiometer, an anthropometric tape, and a bioimpedance device. Physical fitness included cardiorespiratory fitness (Siconolfi step test and 6 min walk test), muscular strength (handgrip strength test as upper body measure and 30 s chair stand as lower body measure), and flexibility (back-scratch test). Participants with a fitness level equal or above the median of the study sample were categorized as "fit" and those below the median were categorized as "unfit". Linear regression assessed the association of physical fitness with body composition parameters. Results: Cardiorespiratory fitness and upper body muscular strength were negatively associated with BMI, FMI, waist circumference, and waist-to-height ratio (all, p < 0.05). Lower body muscular strength and flexibility were negatively related to FMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio (all, p < 0.05). These relationships were still significant after controlling for age, disease duration, accrual damage, and SLE activity. Overall, fit patients presented significantly lower values in all body composition parameters compared to unfit patients (all, p < 0.05). Conclusions: The main findings of the present study suggest that physical fitness is inversely associated with body composition in women with SLE. Given the cross-sectional nature of this study, future clinical trials should study the causal pathways underlying these relationships.

Evaluation of dynapenia in the elderly in São Caetano do Sul, São Paulo, Brazil

Abstract Introduction: Aging is characterized by psychological, social, nutritional and biological changes, among which dynapenia stands out. Objective: To analyze the presence of dynapenia and associated factors in elderly people living in the city of São Caetano do Sul. Method: A cross-sectional study was carried out with 295 elderly individuals aged 60 years or older, who were users of public health units in the city of São Caetano do Sul. Dynapenia was assessed by handgrip strength, and its associations were investigated using multivariate logistic regression, according to sociodemographic variables, nutritional status, protein consumption, presence of diseases, and physical activity. Statistical analysis was performed using the IBM-SPSS (Statistical Package for Social Science) software. The adopted level of significance was p < 0.05. Results: Most of the participants were female (n = 251), with mean age of 70.6 years (± 7.0). The presence of dynapenia was observed in 24.07% (n = 71), among which 47 were women (18.73%) and 24 were men (54.55%). Observed associations concerned older age, male sex, lower circumference of the arm and calf, and lower triceps skinfold (p < 0.05). Conclusion: Approximately one-fourth of the elderly studied presented dynapenia, which represents a higher risk of morbidity and mortality. The inclusion of PPF alongside other anthropometric measures for assessing nutritional status is recommended. It is important for public policies to be directed towards health promotion and risk prevention in this age group.

Efeitos do Uso do Computador na Cognição, Estado Emocional, Qualidade de Vida e Habilidade Manual de Idosos

Resumo Este estudo buscou verificar os efeitos do uso do computador no desempenho cognitivo, estado emocional, qualidade de vida e habilidade motora manual de participantes de oficinas de informática. A amostra foi constituída por 114 idosos, divididos em grupo sem informática (GSI) com 58 idosos e grupo informática (GI) com 56 idosos. Os instrumentos utilizados foram: Exame Cognitivo de Addenbrooke Revisado (ACE-R), Escala de Depressão Geriátrica (GDS-15), Inventário de Ansiedade de Beck (BAI), qualidade de vida (WHOQOL-Bref), força de preensão manual (dinamômetro Saehan Corporation®) e motricidade fina (painel de habilidades manuais). Os resultados revelaram que o uso do computador contribuiu positivamente para a funcionalidade cognitiva do idoso, melhorando seu estado emocional, sua qualidade de vida e sua habilidade motora manual.

Functional, nutritional and social factors associated with mobility limitations in the elderly: a systematic review

 Objective. To systematically review the prevalence and in­cidence of mobility limitations in the elderly people and their associated factors. Materials and methods. Articles in the electronic literature were searched via PubMed, Scopus, Lilacs, SciELO, PAHO, MedCarib, Repidisca, Wholis, IBCES, PEDro, Medline and Bireme (2012-2016). The instrument STROBE was used to analyze the quality of the work and the PRISMA recommendation was used to structure the review. Results. Nine studies were included. The prevalence of mobility limitations ranged from 58.1 to 93.2% and the inci­dence ranged from 23 to 53.7%. Studies provided evidence of association of mobility limitations in the elderly popula­tion with high BMI, low 25-hydroxy vitamin D, sarcopenia, fragility, chronic pain, functional dependence, advanced age in women, low hip flexion, sedentary lifestyle, and social support difficulties. Conclusion. Mobility limitations in the elderly had high prevalence and incidence, and there was evidence of association with nutritional, functional and social factors.

[Anthropometric indicators as predictors in determining frailty in elderly people]

The scope of this article is to analyze anthropometric indicators as predictors in determining frailty in elderly people. This is a cross-sectional, family-based and analytical study. The survey was composed of 316 elderly subjects. The association between the anthropometric markers and frailty was tested using the Logistic Regression technique. However, the power of frailty diagnosis using anthropometric markers and the identification of the best cutoff points were evaluated using the parameters provided by the Receiver Operating Characteristic (ROC) curve. The anthropometric indicators of nutritional status: calf circumference, body mass index and corrected arm-muscle area are inversely associated with frailty. Thus, an increase in the values of these indicators is a protective factor against this syndrome. Analyzing body mass index and calf circumference simultaneously in order to perform a simpler screening for frail elderly people is recommended, as these indicators show good sensitivity and are easier to measure.

Physical performance and its association with anthropometric and body composition variables in the elderly

The aging process leads to biological changes that affect the physical performance and nutritional status of older adults. The objective this study is to determine the association between physical performance and anthropometric and body composition variables in the elderly. This is a cross-sectional study. Were assessed: sex, age, handgrip strength (HGS), flexibility/mobility, balance, body mass index, waist and calf circumference, triceps skinfold thickness, arm fat area and arm muscle circumference. Multiple logistic regression was used (p<0.05). Overall, 420 elderly were evaluated. Malnourished individuals were more likely to show poor HGS. Elderly aged 70-79 years, 80 years or older and those malnourished were more likely to show poor balance. Older women were less likely to show poor flexibility/mobility. We conclude that lowercalf circumferencewas associatedwithworse performance inHGSand balance.The ageincreased the chanceof the elderlypresentinstability.The flexibility/mobilitydoesn't seem tobe influenced bychanges in body composition. Therefore, these resultsmay beimportantguidingspecific actionsto ensurehealthy aging.

[Factors associated with loss of handgrip strength in long-lived elderly]

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.