Patterns and correlates of grip strength change with age in Afro-Caribbean men

Prevalence of Sarcopenia and Relationships Between Muscle and Bone in Indian Men and Women

Both ethnicity and age are important determinants of musculoskeletal health. We aimed to determine the prevalence of sarcopenia, assess the suitability of current diagnostic guidelines, and explore muscle-bone relationships in adults from India. A total of 1009 young (20-35 years) and 1755 older (> 40 years) men and women from existing studies were collated and pooled for the analysis. Dual-energy x-ray absorptiometry measured areal bone mineral density (aBMD) at the hip and spine, and fat and lean mass; hand dynamometer measured hand grip strength (HGS). Indian-specific cut-points for appendicular lean mass (ALM), ALM index (ALMI) and HGS were calculated from young Indian (-2SD mean) populations. Sarcopenia was defined using cut-points from The Foundations for the National Institutes of Health (FNIH), revised European Working Group on Sarcopenia in Older People (EWGSOP2), Asian Working Group for Sarcopenia (AWGS), and Indian-specific cut-points. Low lean mass cut-points were then compared for their predictive ability in identifying low HGS. The relationship between muscle variables (ALM, ALMI, HGS) and aBMD was explored, and sex differences were tested. Indian-specific cut-points (men-HGS:22.93 kg, ALM:15.41 kg, ALMI:6.03 kg/m²; women-HGS:10.76 kg, ALM:9.95 kg, ALMI:4.64 kg/m²) were lower than existing definitions. The Indian-specific definition had the lowest, while EWGSOP2 ALMI had the highest predictive ability in detecting low HGS (men:AUC = 0.686, women:AUC = 0.641). There were sex differences in associations between aBMD and all muscle variables, with greater positive associations in women than in men. The use of appropriate cut-points for diagnosing low lean mass and physical function is necessary in ethnic populations for accurate sarcopenia assessment. Muscle-bone relationships are more tightly coupled during ageing in Indian women than men.

Grip strength is lower in adults born with extremely low birth weight compared to term-born controls

BACKGROUND

Grip strength predicts long-term morbidity and mortality in adults. We compared grip strength in adults born with extremely low birth weight (ELBW; under 1 kg) and a normal birth weight control group (NBW) and describe change in grip strength over a 10-year period in a longitudinal cohort study of preterm birth.

METHODS

Grip strength, body composition, and device-measured physical activity were assessed in 95 mature adults (MA) born ELBW (age 31.6 (1.6) mean (SD) years, 59 females) and 88 born NBW (age 31.9 (1.4) years, 52 females). Regression models were used to examine the effect of perinatal factors, body composition, physical activity, and physical self-efficacy on grip strength.

RESULTS

Grip strength was lower in MA born ELBW compared to NBW (31.8 (10.0) vs. 39.8 (11.2) kg; p < 0.001). Birth weight group was associated with grip strength independent of sex, height, and lean mass index, but device-measured physical activity was not. The change in grip strength from mid-20s to MA was similar in ELBW and NBW participants.

DISCUSSION

Grip strength in MA born ELBW is low and is similar to a reference group 25-30 years older, suggesting higher risk for cardiovascular and all-cause mortality.

IMPACT

Adults born extremely preterm have reduced grip strength compared to control participants born at full term. Reduced grip strength is a predictor of frailty and increased cardiovascular disease risk. Change in grip strength from age in mid-20s to mid-30s is similar in those born preterm and full-term-born controls. Grip strength is related to lean mass and not to device-measured physical activity-and correlates of grip strength are similar in those born preterm and term-born controls. Grip strength is a simple measure that may provide information about the health of adults born preterm.

Hand grip strength and early mortality after hip fracture

This research describes the risk of death in elderly after hip fracture according to their strength, measured by hand grip. The result is that the weaker the patient, the greater the risk of death after hip fracture, highlighting the need to assess the force in those patients. For the coming years, most of hip fractures will occur in developing countries. It has been described that low muscular strength, measured by grip strength, increases the risk of mortality in those with hip fracture, in both high-and low- income countries. The objective of this study was to determine the mortality among patients with hip fracture and lower hand grip strength (HGS).

MATERIAL AND METHODS

We conducted a cohort and longitudinal study at Hip and Pelvic Surgery Department of a tertiary hospital, in Monterrey, Mexico. The study included patients aged over of 69, admitted for hip fracture surgery from February 1st 2013 to July 31st 2014. HGS measurement was performed by a trained physician at arrival to emergency department prior to surgery; clinimetric variables were asked, and a complete medical history was included.

RESULTS

A total of 670 patients were included in the study and grouped in different tertiles according to hand grip strength. During follow-up, there were 112 deaths (17.4%), 61 (27.5%) in tertile 1, 37 (17.1%) in tertile 2, and 14 (6.8%) in tertile 3, p < 0.001. The association remained significant after adjusting for confounding variables. Less than 5% of patients discharged from hospital were identified with osteoporosis.

CONCLUSION

Lower hand grip strength in patients with a hip fracture is associated with high mortality after hip fracture.

Long-term rates of change in musculoskeletal aging and body composition: findings from the Health, Aging and Body Composition Study

Musculoskeletal disorders are common among older people. Preventive strategies require understanding of age-related changes in strength, function and body composition, including how they interrelate. We have described, and examined associations between, 9-year changes in these parameters among 2917 Health, Aging and Body Composition Study participants (aged 70-79 years). Appendicular lean mass (ALM), whole body fat mass and total hip BMD were ascertained using DXA; muscle strength by grip dynamometry; and muscle function by gait speed. For each characteristic annualised percentage changes were calculated; measures of conditional change (independent of baseline) were derived and their interrelationships were examined using Pearson correlations; proportion of variance at 9-year follow-up explained by baseline level was estimated; and mean trajectories in relation to age were estimated using linear mixed models. Analyses were stratified by sex. Median [lower quartile, upper quartile] annual percentage declines were grip strength (1.5 [0.0, 2.9]), gait speed (2.0 [0.6, 3.7]), ALM (0.7 [0.1, 1.4]), fat mass (0.4 [- 1.1, 1.9]) and hip BMD (0.5 [0.0, 1.1]). Declines were linear for ALM and accelerated over time for other characteristics. Most conditional change measures were positively correlated, most strongly between ALM, fat mass and hip BMD (r > 0.28). Proportion of variation at follow-up explained by baseline was lower for grip strength and gait speed (39-52%) than other characteristics (69-86%). Strength and function declined more rapidly, and were less correlated between baseline and follow-up, than measures of body composition. Therefore, broader intervention strategies to prevent loss of strength and function in later life are required as those targeting body composition alone may be insufficient.

The association between muscle strength and sociodemographic and lifestyle factors in adults and the younger segment of the older population in a city in the south of Brazil

Adequate muscular strength is required to perform daily activitiesand is considered a marker of overall health. The aim of this study was to identify sociodemographic and lifestyle factors associated with handgrip strength (HGS) in adults and the younger segment of the older population. A cross-sectional,population-based study was conducted with 705 individuals aged between 25 and 65 years in the city of Florianópolis, capital of the State of Santa Catarina, Brazil.HGS was assessed usinga manual hand dynamometer. Interviews were conducted with the participants to collect sociodemographic and lifestyle data.Multiple linear regressionwas performed to identify the predictors of HGS. The findings revealed that women and individuals from older age groups showed lower HGS, while being active during leisure time was associated with higher HGS.Interventions aimed at maintaining HGS levels in individuals should pay special consideration toaging and individuals who are physically inactive or insufficiently active during leisure time.

Correlates of Level and Loss of Grip Strength in Later Life: Findings from the English Longitudinal Study of Ageing and the Hertfordshire Cohort Study

Characterisation of grip strength (GS) using isometric dynamometry is central to the definition of sarcopenia. Determinants of low GS include: older age, shorter stature, low physical activity, poor nutrition, socioeconomic disadvantage and multimorbidity. Less is known about risk factors for accelerated loss of GS. We investigated determinants of level and 8-year loss of GS in 3703 men and women (aged 52-82 years) in the English Longitudinal Study of Ageing (ELSA). Four hundred and forty-one men and women (aged 59-71 years) who participated in a 10-year follow-up of the Hertfordshire Cohort Study (HCS) were used for replication. Variables were harmonised between cohorts. Change in GS was characterised using mixed-effects models in ELSA and a residual change approach in HCS and analysed for men and women combined. Men in ELSA and HCS had higher average levels of GS at baseline, and accelerated rates of loss, compared with women. In ELSA, older age, shorter stature and multimorbidity were correlated with lower level, and accelerated rate of loss, of GS in both sexes (accelerated loss of 0.04 (95% CI 0.00-0.08) standard deviation scores per additional morbidity after multivariable adjustment). Socioeconomic disadvantage, low level of physical activity and poorer self-reported health were also correlated with low GS level, but not loss rate, after multivariable adjustment. Analysis in HCS yielded similar results. Our results identify multimorbidity as a modifiable determinant of loss of muscle strength in later life, and raise the possibility that developmental influences may impact on rate of involutional decline in muscle strength.

Normative Values of Hand Grip Strength for Elderly Singaporeans Aged 60 to 89 Years: A Cross-Sectional Study

OBJECTIVES

What are normative values for hand grip strength (HGS) for elderly Singaporeans? Which elderly characteristics influence the normative values of HGS for elderly Singaporeans?

DESIGN

Nationally representative, cross-sectional observational study.

SETTING

Singapore.

PARTICIPANTS

A total of 2664 community-dwelling elderly Singaporeans aged 60 to 89 years.

MEASUREMENTS

HGS was measured in a standing position with elbows extended twice for each hand; a Smedley spring-type dynamometer was used. Elderly characteristics known to affect HGS, including age, sex, hand dominance, height, weight, occupation, education, and ethnicity, were also assessed.

RESULTS

We present single-year age, sex-, and hand-specific graphs for normative values (5th, 20th, and 50th percentiles) of HGS. The influence of specific elderly characteristics on the normative values of HGS varies by sex, hand, and considered percentile. We present equations for considered percentiles of HGS that account for such influences.

CONCLUSIONS

This study uses a large, nationally representative sample to establish normative values for HGS for elderly Singaporeans aged 60 to 89 years. These results will facilitate the interpretation of HGS measurements conducted using Smedley spring-type dynamometers in clinical and research settings in Singapore, and potentially other Asian countries.

[Nonorganized and organized physical activity and health-related physical fitness in Burundian adults: cross-sectional study]

Introduction

l’activité physique régulière a un impact positif sur la santé. Cette étude a pour objet de comparer la condition physique liée à la santé des adultes qui s’exercent librement avec celle des adultes bénéficiant d’un encadrement professionnel. Elle tente aussi d’établir une relation entre le niveau d’activité physique et les paramètres de la condition liée à la santé.

Méthodes

nous avons évalué le niveau d’activité physique et les paramètres de la condition physique liée à la santé. Par le test t pour échantillons indépendants, nous avons comparé les moyennes et avons par le calcul du coefficient de corrélation r de Pearson analysé la relation entre le niveau d’activité physique et les paramètres de la condition physique.

Résultats

des écarts significatifs (p < 0,05) de niveau d’activité physique, de souplesse, de V˙O2max et de la FC de repos ont été enregistrés en faveur du groupe encadré. Le niveau d’activité physique est positivement corrélé (p < 0,05) au V˙O2max et à la force de préhension mais négativement corrélé à la FC de repos et au cholestérol LDL. La prévalence des facteurs de risque cardiovasculaire n’est pas élevée excepté pour le cholestérol HDL.

Conclusion

les résultats de cette étude montrent que l’activité physique libre est aussi efficace que l’activité physique encadrée dans le maintien des profils lipidique et physiologique favorables à la santé chez l’adulte burundais. Cependant, l’activité physique encadrée apporte des bénéfices supplémentaires pour le V˙O2max, la fréquence cardiaque de repos, la souplesse antérieure et la détente verticale

The association between blood pressure and grip strength in adolescents: does body mass index matter?

Increased body mass index (BMI) has been related to both low grip strength and high blood pressure (BP) in adolescents. Previous reports of high BP associated with decreased grip strength could be due to the inherent increase in BP in youths with high BMI. This cross-sectional study aimed to examine the association between grip strength and BP in adolescents independent of BMI. A total of 88 865 Chinese adolescents aged 13-17 years were included in this study. Sex-, age- and height-specific references were applied to calculate the BP z-score and define elevated BP. Grip strength was evaluated as handgrip (kg)/weight (kg) and converted into a sex- and age-specific z-score for analysis. Using fractional polynomial regression, we found that increased BMI was associated with enhanced BP and decreased grip strength; however, after stratification by or adjustment for BMI, strong grip strength was related to an increased BP. Logistic regression models revealed that a one s.d. increase in boys' grip strength z-score was associated with an 18% (95% confidence interval: 12, 25) to 37% (19, 59) higher risk of elevated BP when adjusted for BMI. These associations remained significant after further adjustment for cardiorespiratory fitness. A similar pattern was also observed in girls. These results indicated that strong grip strength was associated with increased adolescent BP after adjustment for BMI. Our findings raise questions about using muscle-strengthening training as an approach to improve the BP profile in adolescents.

A influência da composição corporal na força de homens idosos brasileiros

INTRODUÇÃO: A população de idosos representa 10% do total da população brasileira. A diminuição da musculatura esquelética é provavelmente a alteração mais significativa, sendo associada à idade e algumas enfermidades, e é determinante na perda da força muscular. OBJETIVO: Avaliar a relação entre composição corporal e a força de preensão palmar de homens idosos brasileiros. MÉTODO: Quarenta e seis homens com idade igual ou superior a 60 anos foram divididos em 4 grupos de acordo com a percentagem de gordura e valor de massa magra. Foram definidas as medianas para %G = 28,65 e massa magra = 54,35 kg. Para as avaliações utilizou-se teste de bioimpedância elétrica e dinamômetro de preensão palmar. RESULTADOS: Observam-se diferenças significativas entre os quatro grupos quanto à massa magra e percentil de massa gorda (p≥0,05), caracterizando as especificidades de cada grupo quanto às variáveis analisadas. CONCLUSÃO: Os resultados demonstram que os níveis de força de preensão palmar não dependem unicamente da massa magra, mas também %G, em que a correlação entre massa magra e percentual de gordura pode indicar uma melhor ou pior condição para realizar o esforço isométrico de preensão manual.

Handgrip strength, ageing and mortality in rural Africa

Background: muscle strength measured as handgrip strength declines with increasing age and predicts mortality. While handgrip strength is determined by lifestyle through nutrition and physical activity, it has almost exclusively been studied in western populations with a sedentary lifestyle. This study aims to investigate the relation between handgrip strength, ageing and mortality in a population characterised by a predominance of malnutrition and manual labour.

Design: a population-based longitudinal study.

Setting: a traditional African rural population in Ghana.

Subjects: nine hundred and twenty-three community-dwelling individuals aged 50 and older.

Methods: demographic characteristics were registered. At baseline, height, body mass index (BMI) and handgrip strength were measured and compared with those in a western reference population. Survival of the participants was documented during a period of up to 2 years.

Results: handgrip strength was dependent on age, sex, height and BMI. Compared with the western reference population, handgrip strength was lower due to a lower height and BMI but declined over age similarly. Risk of mortality was lower in participants having higher handgrip strength, with a hazard ratio of 0.94 per kg increase (P = 0.002). After adjustment for age, sex, tribe, socio-economic status, drinking water source, height and BMI, only handgrip strength remained predictive of mortality.

Conclusion: in a traditional rural African population characterised by malnutrition and manual labour, handgrip strength declines over age and independently predicts mortality similar to western populations. Handgrip strength can be used as a universal marker of ageing.

Handgrip strength and associated factors in hospitalized patients

BACKGROUND

Handgrip strength (HGS) is a marker of nutrition status. Many factors are associated with HGS. Age, height, body mass index, number of diagnoses, and number and type of drugs have been shown to modify the association between undernutrition and HGS. Nevertheless, other patient characteristics that could modify this association and its joint modifier effect have not been studied yet.

OBJECTIVE

To evaluate the association of inpatients' HGS and undernutrition considering the potential modifier effect of cognitive status, functional activity, disease severity, anthropometrics, and other patient characteristics on HGS.

METHODS

A cross-sectional study was conducted in a university hospital. Sex, age, abbreviated mental test score, functional activity score, Charlson index, number of drugs, Patient-Generated Subjective Global Assessment (PG-SGA) score, body weight, mid-arm muscle circumference, adductor pollicis muscle thickness, body height, wrist circumference, hand length, and palm width were included in a linear regression model to identify independent factors associated with HGS (dependent variable).

RESULTS

The study sample was composed of 688 inpatients (18-91 years old). All variables included in the model were associated with HGS (β, -0.16 to 0.38; P ≤ .049) and explained 68.5% of HGS. Age, functional activity decline, Charlson index, number of drugs, PG-SGA score, body weight, and wrist circumference had a negative association with HGS. All other studied variables were positively associated with HGS.

CONCLUSION

Nutrition status evaluated by PG-SGA was still associated with HGS after considering the joint effect of other patient characteristics, which reinforces the value of HGS as an indicator of undernutrition.