Evaluation of factors influencing grip strength in elderly koreans

Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people

OBJECTIVES

This study aimed to examine the association of absolute and relative hand grip strength (HGS) with the risk of all-cause mortality among middle-aged and old-aged people in South Korea. Considering that both absolute HGS and relative HGS could be effective measures, an in-depth investigation is necessary to compare the effects of both measures on mortality.

METHODS

Data of 9,102 participants, derived from the Korean Longitudinal Study of Aging from 2006 to 2018, were examined. HGS was divided into two categories: absolute HGS and relative HGS (defined as HGS divided by body mass index). The risk of all-cause mortality was the dependent variable. Cox proportional hazard regression was used to analyze the association between HGS and all-cause mortality.

RESULTS

The average of absolute and relative HGS were 25.6 ± 8.7 kg and 1.1 ± 0.4 kg/BMI, respectively. The all-cause mortality rate decreased by 3.2% as absolute HGS increased by 1 kg (adjusted hazard ratio [HR] = 0.968, 95% CI = 0.958-0.978). An increase in relative HGS by 1 kg/BMI was associated with a 22% reduction in risk of all-cause mortality (adjusted HR = 0.780, 95% CI = 0.634-0.960). Individuals with more than two chronic diseases, there was a decrease in all-cause mortality as absolute HGS increased by 1 kg and relative HGS by 1 kg/BMI (absolute HGS; adjusted HR = 0.97, 95% CI = 0.959-0.982, relative HGS; adjusted HR = 0.483, 95% CI = 0.325-0.718).

CONCLUSIONS

Our study findings showed that both absolute and relative HGS were inversely associated with the risk of all-cause mortality; a higher absolute/relative HGS was associated with a lower risk of all-cause mortality. Moreover, these findings highlight the importance of improving HGS to alleviate the burden of adverse health problems.

Does an Association among Sarcopenia and Metabolic Risk Factors Exist in People Older Than 65 Years? A Systematic Review and Meta-Analysis of Observational Studies

Sarcopenia is defined as the generalized and progressive loss of skeletal muscle strength and mass that may be affected by metabolic factors, although this relationship has been poorly studied. The aim of this review and meta-analysis was to analyze the relationship among the different metabolic risk factors and sarcopenia in people older than 65 years. Following the PRISMA 2020 guide, we searched for articles that studied the relationship among sarcopenia and metabolic risk factors in adults over 65 years of age, published between 2012 and 2022 in four databases: PubMed, Web of Science, Cochrane Plus, and CINAHL. A total of 370 articles were identified in the initial search, of which 13 articles were selected for inclusion in this review. It was observed that metabolic risk factors such as Body Mass Index, systolic and diastolic blood pressure, glucose, cholesterol, or triglycerides had a significant association with sarcopenia. There is evidence of the association of different metabolic risk factors with sarcopenia in adults over 65 years of age, so it is necessary to carry out studies that investigate different strategies that reduce the appearance of sarcopenia, and with it, the incidence of metabolic diseases.

Influencing factors of weak grip strength and fall: a study based on the China Health and Retirement Longitudinal Study (CHARLS)

BACKGROUND

Fall is a major cause of mortality and cause a significant burden on the healthcare system and economic system. Weak grip strength signifies impaired function. Older people with weak grip strength are at a higher risk of death. China has the largest ageing population in the world today. This study aims to analyze the factors contributing to weak grip strength and fall among Chinese.

METHODS

This study analyzed data from the 2011 baseline and 2015 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). To identify the risk factors of fall and weak grip strength, we used a stepwise multivariable logistic regression model and a least absolute shrinkage and selection operator (LASSO) regression model.

RESULTS

In the LASSO regression model, all the risk factors were not shrunken. In the stepwise logistic regression model, adjusted for gender, age, grip strength, depression, and chronic disease, we found that female (aOR = 1.376, 95% CI = 1.243-1.523; P < 0.001), history of ischemic stroke (aOR = 1.786, 95% CI = 1.263-2.524; P = 0.001), depression (aOR = 1.559, 95% CI = 1.396-1.742; P < 0.001), weak grip strength (aOR = 1.285, 95% CI = 1.105-1.494; P = 0.001), older age (aOR = 1.227, 95% CI = 1.163-1.294; P < 0.001), rheumatoid arthritis (aOR = 1.410, 95% CI = 1.270-1.560; P < 0.001), history of kidney disease (aOR = 1.383, 95% CI = 1.136-1.682; P = 0.001) were factors associated with fall significantly. After further adjusting, we found the risk factors of weak grip strength included symptomatic knee osteoarthritis (aOR = 1.755, 95% CI 1.158-2.661; P = 0.008), living in rural area (aOR = 2.056, 95% CI 1.290-3.277; P = 0.002), depression (aOR = 1.523, 95% CI 1.116-2.078; P = 0.008), older age (aOR = 2.116, 95% CI 1.801-2.486; P < 0.001).

CONCLUSION

From the study, we found that older age and depression were risk factors of weak grip strength and fall. Weak grip strength was a risk factor of fall. Female, ischemic stroke, kidney disease, rheumatoid arthritis were risk factors of fall; living in rural area and symptomatic knee osteoarthritis were risk factors of weak grip strength.

The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study

Objectives

This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population.

Patients and methods

Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Turkey by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA.

Results

The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all).

Conclusion

In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.

Postoperative early and proactive grip strength training program for distal radius fractures promotes earlier recovery of grip strength: A retrospective study

The use of volar locking plates (VLPs) for distal radius fractures has remarkably improved clinical outcomes; however, there are some reports of delayed recovery of grip strength. Since January 2019, we have been conducting an early and proactive grip strength training program (EGTP). In this program, 20 minutes of grip strength training-using a gripper with a load of 0.7 kg-was initiated from 2 weeks after surgery; the load was then gradually increased. From 6 weeks postsurgery, daily home grip strength training was performed using a gripper with a load of 5 kg, provided to the patient.We investigated whether the introduction of the EGTP could lead to earlier recovery of grip strength. We also examined whether the EGTP caused postoperative correction loss at the fractured site, or contributed to the early improvement of wrist function.Thirty-nine patients who underwent surgery using VLPs for distal radius fractures were included in this study; 20 followed the EGTP (EGTP group) and 19 patients did not (NGTP group). For these patients, grip strength and range of motion of the wrist joint were evaluated both 3 and 6 months postoperatively. The Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) scores were also evaluated 6 months postoperatively. Additionally, corrective losses of radial inclination (RI), palmar tilt (PT), and ulnar variance (UV)-occurring from immediately postsurgery to 6 months after surgery-were evaluated.At both 3 and 6 months postoperatively, the grip strength of the EGTP group was significantly higher than that of the NGTP group. Regarding range of motion, only palmar flexion was significantly improved in the EGTP group at 3 months postoperatively. Conversely, no differences in corrective losses of RI, PT, and UV, or in qDASH scores, were observed between the two groups.The results of this study suggest that the EGTP can provide early recovery of grip strength and palmar flexion of the wrist without causing corrective loss at the fracture site.

Association between grip strength and anthropometric characteristics in the community-dwelling elderly population in Taiwan

BACKGROUND

Sarcopenia and muscle weakness in elderly are contributed burden of public health and impact on quality of life. Weak grip strength was key role in diagnosis of sarcopenia and reported increased mortality, function declined in elderly. This study evaluated the association between GS and each common anthropometric characteristic in community-dwelling elderly.

DESIGN AND METHOD

From 2017 to 2019, we conducted a community-based health survey among the elderly in Chiayi county, Taiwan. Participants were 65 years old or older, and total of 3,739 elderly subjects (1,600 males and 2,139 females) with a mean age of 76 years (range 65-85 years old) were recruited. General demographic data and lifestyle patterns were measured using a standard questionnaire. Anthropometric characteristics such as body height, body weight, body mass index (BMI), body waist and hip circumference, and body fat were measured by standard methods. GS was measured using a digital dynamometers (TKK5101) method.

RESULTS

The mean GS was 32.8 ± 7.1 kg for males and 21.6 ± 4.8 kg for females (p < 0.001). For both sexes, elderly subjects with the same body weight but smaller body waist circumference had greater GS. The subjects with the same body waist size but heavier weight had greater GS. Furthermore, after adjusting for age, lifestyles, disease status, and potential anthropometric variable, multivariate regression analyses indicated that BMI was positively associated with GS (for males, beta = 0.310 and for females beta = 0.143, both p < 0.001) and body waist was negatively associated with GS (for males, beta = -0.108, p < 0.001; for females, beta = -0.030, p = 0.061).

CONCLUSIONS

This study suggested that old adults with higher waist circumstance had weaker GS. Waist circumstance was negatively associated with GS, body weight was positively associated with GS in contrast. It may implies that central obesity was more important than overweight for GS in elderly.

Preoperative Vitamin D Deficiency is Associated with Postoperative Functional Recovery and Complications after Hip Fracture Surgery

Background

Low concentrations of vitamin D are considered one of the risk factors for hip fracture and are associated with worse outcomes. The purpose of this retrospective study was to compare vitamin D deficient group and vitamin D sufficient group and assess the association preoperative vitamin D deficiency and postoperative walking ability after hip fracture surgery.

Methods

Between January 2014 and January 2020, 1,029 elderly patients with hip fracture (243 in men and 785 in women) were measured preoperative serum 25-hydroxy-vitamin D3 levels. Among 1,029 elderly patients, 702 patients were classified as Vitamin D deficient group (<20 ng/mL). Outcome parameters for functional recovery were the length of the hospital stay and KOVAL score, and those for complications were delirium, pneumonia, and thromboembolism.

Results

The mean length of the hospital stay in the vitamin D deficient group was significantly longer than in the vitamin D sufficient group (27.7±17.8 vs. 2.9±11.8 days; odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02–1.05; P=0.001). The mean postoperative KOVAL score in the deficient group was significantly higher than in the sufficient group (4.0±2.1 vs. 3.1±1.9 days; OR, 1.21; 95% CI, 1.11–1.32; P=0.001). Vitamin D deficiency was significantly associated with a higher risk of delirium and pneumonia in deficiency group.

Conclusions

Preoperative vitamin D deficiency in hip fractures patients was associated with prolonged duration of hospital stay and decrease of postoperative ambulatory status, and may increase the risk of delirium and pneumonia. Therefore, it is necessary to evaluate the preoperative vitamin D level and recommend vitamin D supplementation in elderly patients with a high probability of hip fracture.

Impact of premature natural menopause on body composition and physical function in elderly women: A Korean frailty and aging cohort study

Induced premature menopause accelerates the rate of body composition changes (decrease in skeletal muscle mass and increase in fat mass) and deteriorating physical function. However, few studies have focused on the impact of premature natural menopause. This study aimed to investigate the impact of age at natural menopause (ANM) on body composition and physical function in elderly women.Using data from the Korean Frailty and Aging Cohort Study, 765 community-dwelling elderly women aged 70 to 85 years who experienced natural menopause were recruited in this study. Body composition was measured using dual-energy X-ray absorptiometry. Physical function was evaluated by grip strength, the timed up and go test (TUG), and the short physical performance battery (SPPB). Participants were categorized into 4 groups according to their ANM: <40 (premature natural menopause, PNM), 40 to 44 (early natural menopause, ENM), 45 to 54 (normal menopause, NM), and ≥55 (late menopause, LM) years.There were no significant differences in the body composition parameters, such as the appendicular skeletal muscle mass index (PNM: 5.90 ± 0.90 vs ENM: 5.91 ± 0.70 vs NM: 5.85 ± 0.73 vs LM: 5.90 ± 0.75, kg/m2, P = .75) and trunk fat mass index (PNM: 19.4 ± 3.9 vs ENM: 19.9 ± 4.4 vs NM: 19.9 ± 3.9 vs LM: 20.0 ± 3.8, %, P = .87) between the groups. In the physical function evaluation, there was no significant difference between the groups in grip strength (PNM: 19.8 ± 0.6 vs ENM: 20.3 ± 0.4 vs NM: 20.6 ± 0.2 vs LM: 20.6 ± 0.4, kg, P = .53). However, in the TUG (PNM: 11.8 ± 0.4 vs ENM: 10.3 ± 0.3 vs NM: 10.6 ± 0.1 vs LM: 10.2 ± 0.3, seconds, P < .01) and SPPB (PNM: 10.0 ± 0.2 vs ENM: 10.5 ± 0.2 vs NM: 10.6 ± 0.1 vs LM: 10.8 ± 0.2, points, P < .05), the PNM group showed significantly lower values than the other groups did. There was no difference in physical function between the groups except the PNM.Premature natural menopause did not affect the body composition in elderly women but was associated with physical function deterioration. Therefore, more attention should be paid to the prevention of the physical function deterioration caused by premature natural menopause in elderly women.

Handgrip strength: Should repeated measurements be performed in both hands?

AIM

We aimed to determine whether both hands should be tested for handgrip strength and whether it is necessary to perform repeated measurements in each hand.

METHODS

The data were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2018. The participants performed three trials of handgrip strength measurement for each hand alternately, with 60-s rest between the trials. From this pool of data, we included 23 901 participants aged ≥19 years who had completed surveys on the handgrip strength test, and obtained their medical history.

RESULTS

The dominant hand had a significantly stronger handgrip strength than the non-dominant hand (32.75 ± 0.10 vs. 30.95 ± 0.09 kg, P < 0.001); however, 26.4% of the subjects had stronger handgrip strength in the non-dominant hand. During the three repeated measurements, the handgrip strength gradually increased; however, the mean difference between the trials (0.579 and 0.104 kg) was below the noninferiority threshold. In older adults, however, the mean difference in the handgrip strength between the first and the second trial was higher than the noninferiority threshold.

CONCLUSIONS

While the handgrip strength gradually increased during three repeated measurements, the difference was clinically important only in older adults. Hence, we suggest that the handgrip strength should be measured in both hands and at least twice in older adults, whereas a single attempt provides a maximal value in younger adults. Geriatr Gerontol Int 2021; 21: 426-432.

Vitamin D Deficiency and Sarcopenia in Hip Fracture Patients

Background

Vitamin D plays a critical role in the proliferation and differentiation of skeletal muscle and bone metabolism. We compared the prevalence of vitamin D deficiency in elderly patients undergoing hip fracture surgery (HFS) with those undergoing elective primary total hip arthroplasty (THA). We also evaluated the association between vitamin D deficiency and sarcopenia.

Methods

This prospective study included 70 patients in the HFS group, and 100 patients in the elective THA group. The HFS group included 42 women, while the elective THA group included 74 women. The mean age in the HFS and elective THA groups was 79.8 and 75.4 years, respectively, and the mean preoperative Koval score was 2.1 and 2.3, respectively. Serum 25-hydroxy-vitamin D3 levels were measured by I125 radioimmunoassay. Bone mineral density and appendicular skeletal muscle mass (ASM) were measured using dual X-ray absorptiometry. Sarcopenia index was calculated by dividing ASM (kg) by the body mass index (kg/m²). Sarcopenia was diagnosed when the sarcopenia index was <0.789 in men and <0.512 in women.

Results

Serum vitamin D levels were lower, and the percentages of patients with vitamin D insufficiency and deficiency were higher in the HFS group than in the elective THA group. In the HFS group, the prevalence of sarcopenia was higher in men (57%, 16/28) than in women (29%, 12/42; P=0.025).

Conclusions

Vitamin D deficiency was more prevalent in patients undergoing HFS than in patients undergoing elective THA. Among patients undergoing HFS, vitamin D deficiency was more prevalent in sarcopenic than in non-sarcopenic patients.

Measurement and Interpretation of Handgrip Strength for Research on Sarcopenia and Osteoporosis

Handgrip strength (HGS) is associated with several chronic diseases, cognitive decline, length of hospital-stay, and mortality. More importantly, HGS is one of the diagnostic criteria of sarcopenia and gaining attention because of its relevance to bone mineral density (BMD) and osteoporotic fractures. As the measurement of HGS is widely used in clinical practice as well as in research, its accurate measurement and interpretation are becoming more crucial. This review describes how to use different types of dynamometers accurately, the impact of body and arm positions and anthropometric parameters on HGS, the current reference values of HGS for sarcopenia research, and the updates on the relationship between HGS and BMD and osteoporotic fractures.

What Does a Hand-Over Tell?-Individuality of ShortMotion Sequences

How much information with regard to identity and further individual participant characteristics are revealed by relatively short spatio-temporal motion trajectories of a person? We study this question by selecting a set of individual participant characteristics and analysing motion captured trajectories of an exemplary class of familiar movements, namely handover of an object to another person. The experiment is performed with different participants under different, predefined conditions. A selection of participant characteristics, such as the Big Five personality traits, gender, weight, or sportiness, are assessed and we analyse the impact of the three factor groups “participant identity”, “participant characteristics”, and “experimental conditions” on the observed hand trajectories. The participants’ movements are recorded via optical marker-based hand motion capture. One participant, the giver, hands over an object to the receiver. The resulting time courses of three-dimensional positions of markers are analysed. Multidimensional scaling is used to project trajectories to points in a dimension-reduced feature space. Supervised learning is also applied. We find that “participant identity” seems to have the highest correlation with the trajectories, with factor group “experimental conditions” ranking second. On the other hand, it is not possible to find a correlation between the “participant characteristics” and the hand trajectory features.

Assessment of nutritional status in older diabetic outpatients and related factors in Hanoi, Vietnam

Purpose: Nutritional status is an important element for the wellness among older diabetic outpatients. This study aimed to assess the nutritional status of the older diabetic outpatient by using the Mini-Nutrition Assessment Short Form (MNA-SF) tool, and describe the relationship among related factors in older diabetic outpatients in the National Geriatric Hospital, Hanoi, Vietnam.

Patients and methods: A cross-sectional study was conducted from June to September 2015 in the National Geriatric Hospital. A total of 158 diabetic patients aged ≥60 years at the Outpatient Department were included in this study. Patients were interviewed face-to-face to evaluate their nutritional status by using the MNA-SF. Socio-demographic, diabetic treatment information, frailty, exhaustion, cognitive function, hand grip strength and 4 m walk test were collected. Multivariate regression was used to determine factors associated with nutritional status.

Results: The mean age was 69.52 (SD=6.758) with 31% patients malnourished and at risk of malnutrition. A significant association was found between the nutritional status and exhaustion, cognitive impairment, and frailty. In multiple logistic regression, the study found that risk of malnutrition was associated with frailty (OR=8.45; 95%CI=1.91–37.39) and cognitive impairment (OR=2.21; 95%CI=1.01–4.84).

Conclusion: The results suggest that frailty was significantly associated with risk of malnutrition in older diabetic outpatients. Thus, early screening by nutritional assessment, and other interventions might improve the nutritional status of older outpatients with diabetes to prevent this complication and its effects.

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing

OBJECTIVE

To examine whether reduced handgrip strength, as a marker of muscle weakness, is linked with the risk of cardiovascular, cancer and all-cause mortality among older adults.

DESIGN

We used data from the 2006 to 2014 Korean longitudinal study of ageing study. Estimates of handgrip strength were collected using a handheld dynamometer. Cox proportional hazard models with time-varying covariates were used to estimate HRs and their 95% CIs for all-cause mortality. The cause-specific hazards regression analysis was also used to model cardiovascular and cancer mortality, by treating deaths from the cause of interest as events and other causes of death as censored.

PARTICIPANTS

5859 participants aged 50 years or older were followed up until death or until the date of censoring (31 December 2014).

PRIMARY OUTCOME MEASURES

The study outcomes of interest were all-cause, cardiovascular and cancer mortality.

RESULTS

Of the participants included in analyses, 515 individuals (8.8%) died, reflecting an overall crude mortality rate of 11.0 deaths per 1000 person-years. Participants in the lowest handgrip strength tertile showed an increased risk of all-cause and cardiovascular mortality evidenced by a multivariable adjusted HRs of 1.90 (95% CI 1.33 to 2.73) and 1.59 (95% Cl 1.08 to 2.34), respectively. However, there were no significant differences in the rates of cancer-related death, with HR of 1.29 (95% CI 0.92 to 1.81 [lowest vs highest tertile; p trend=0.21]).

CONCLUSION

These results demonstrate that lower handgrip strength is an independent predictor of mortality among a population-based sample of Korean elderly; highlighting the importance of interventions targeted at enhancing muscle strength for improvements in survival at older ages.

Sleep Quality and Attention May Correlate With Hand Grip Strength: FARM Study

OBJECTIVE

To determine the socio-demographic, psychologic, hematologic, or other relevant factors associated with hand grip strength in Korean farmers.

METHODS

A total of 528 healthy Korean farmers were enrolled. Hand grip strength was measured in both hands using a hydraulic dynamometer. Socio-demographic characteristics were assessed and anthropometric measurements were obtained. Psycho-cognitive measurements such as sleep quality (Pittsburgh Sleep Quality Index) and Go/No-Go test response time were conducted. In addition to physical measurements, serologic parameters including insulin-like growth factor 1 were measured. The factors associated with hand grip strength were analyzed using multiple linear regression analysis after adjusting for age, height, and weight.

RESULTS

The mean hand grip strength was associated with the Pittsburgh Sleep Quality Index total score (β=-0.12, p=0.01), the Go/No-Go test response time (β=-0.18, p=0.001), vitamin D (β=0.12, p=0.02), and insulin-like growth factor 1 levels (β=0.1, p=0.045). In female farmers, hand grip strength was only associated with the Pittsburgh Sleep Quality Index total score (β=-0.32, p<0.001).

CONCLUSION

The results of this study demonstrate that hand grip strength was associated with sleep quality and attention in Korean farmers.

Association between obesity with low muscle mass and dialysis mortality

BACKGROUND/AIM

To examine the association between body composition and dialysis mortality.

METHODS

Adult patients who underwent haemodialysis in Taoyuan General Hospital from 2012 to 2016 were enrolled. We reviewed their baseline characteristics and followed up their treatment over 5 years after dialysis. Patients with body mass index >25 kg/m² were defined as obese. High or low muscle mass were classified by skeletal muscle mass index (SMMI) based on consensus from Chinese population. All age-matched subjects were classified into four groups: (A) optimal; (B) obesity; (C) low muscle mass; and (D) obesity with low muscle mass. Adjusted hazard ratios for mortality and cumulative survival curves were evaluated by Cox proportional hazard model and Kaplan-Meier method. The discriminative power of SMMI was calculated according to the area under the curve and the receiver operating characteristic curve.

RESULTS

From a total of 176 age-matched patients, the incidence rates of mortality for different groups were 3.7, 7.8, 10.3 and 16.5 per 1000 person-months. After adjusting for continuous variables, SMMI was independently associated with mortality. The difference between groups A and D was more significant in women than in men after multivariate adjustment (adjusted hazard ratios: 7.465 vs 1.682) (P = 0.035 and 0.553). The discriminative power of SMMI to predict 5-year mortality was 0.700 for men and 0.750 for women, and the best cut-off values were 11.1 and 8.4 kg/m² CONCLUSIONS: Low muscle mass was associated with dialysis mortality. Obesity with low muscle mass was a predictor for dialysis mortality in women.

Examining how p16(INK4a) expression levels are linked to handgrip strength in the elderly

Although many studies have shown that p16^INK4a is more highly expressed in the human body during senescence, studies on its relevance to handgrip strength among old adults, are relatively sparse. We enrolled 205 community-dwelling old adults aged 65 years and older without specific medical conditions. Handgrip strength of the dominant hand was measured. Low handgrip strength was defined as the lowest quartile of handgrip strength among the participants. RNA was extracted from peripheral white blood cells. Use quantitative polymerase chain reaction to estimate the p16^INK4a mRNA expression level. The average handgrip strength was 25.22 ± 8.98 kg, and gender difference was observed. In the linear regression model, the p16^INK4a mRNA expression level was significantly negatively associated with handgrip strength in men but not in women. The β coefficient, representing the change of handgrip strength for each increment in the p16^INK4a mRNA expression level, was −0.208 (p = 0.024) among old men. The negative association remained after additional covariates adjustment. In the multiple logistic regression model among old men, the odds ratio (OR) of low handgrip strength was 1.246 (p = 0.032). In this study, we observed the p16^INK4a mRNA expression level was negative associated with handgrip strength among community-dwelling old men.

Chronic diseases, multimorbidity, and handgrip strength among older adults from Southern Brazil

ABSTRACT Objective: To investigate the association between various chronic diseases, multimorbidity, and handgrip strength in community dwelling older adults in Southern Brazil. Methods: A cross-sectional study carried out with 477 older adults (60 years and older) who resided in Antônio Carlos, Santa Catarina state. Subjects aged 60-79 years were selected by probability sampling (n=343) and all subjects aged 80 years or older (n=134) were evaluated. Chronic diseases were identified by self-report. A mechanical dynamometer verified handgrip strength (i.e., the outcome). Adjustments variables were age, literacy, living arrangement, smoking, body mass index, cognitive function, and comorbid chronic diseases. Sex-stratified analyses were conducted with simple and multiple linear regression. Results: A total of 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years) were assessed. In the adjustment analysis, cancer (β=-3.69; 95%CI=-6.97 to -0.41) and depression (β=-1.65; 95%CI=-3.20 to -0.10) were associated with lower handgrip strength in women. For men, diabetes (β=-5.30; 95%CI=-9.64 to -0.95), chronic lung disease (β=-4.74; 95%CI=-7.98 to -1.50), and coronary heart disease (β=-3.07; 95%CI=-5.98 to -0.16) were associated with lower handgrip strength values. There was an inverse trend between number of diseases and handgrip strength for men only. Conclusion: The results showed an independent association between chronic diseases and handgrip strength. As such, handgrip strength is a valid measure to use for prevention or intervention in chronic disease and multimorbidity.

Muscle strength: clinical and prognostic value of hand-grip dynamometry

PURPOSE OF REVIEW

Grip strength measured by dynamometry is well established as an indicator of muscle status, particularly among older adults. This review was undertaken to provide a synopsis of recent literature addressing the clinical and prognostic value of hand-grip dynamometry.

RECENT FINDINGS

Numerous large-scale normative grip strength projects have been published lately. Other recent studies have reinforced the concurrent relationship of grip strength with measures of nutritional status or muscle mass and measures of function and health status. Studies published in the past few years have confirmed the value of grip strength as a predictor of mortality, hospital length of stay, and physical functioning.

SUMMARY

As a whole, the recent literature supports the use of hand-grip dynamometry as a fundamental element of the physical examination of patients, particularly if they are older adults.

The influence of dominant limb involvement on DASH and QuickDASH

PURPOSE

The purpose of this study is to determine whether involvement of the dominant limb affects Disabilities of the Arm Shoulder and Hand (DASH) scores.

METHODS

A convenience sample of 948 patients from 12 prospective studies that recorded hand dominance, affected side, diagnosis, and a DASH or QuickDASH score was used to assess the influence of involvement of the dominant limb on DASH scores. Diagnosis was categorized as traumatic and nontraumatic. Region was categorized as hand and wrist, elbow, and arm and shoulder.

RESULTS

In bivariate analysis, involvement of the dominant limb, diagnosis, region, and sex had significant influence on DASH/QuickDASH score. In multivariable analysis, dominant hand condition, traumatic diagnosis, arm and shoulder involvement, and female sex were associated with significantly higher DASH scores (more disability), but accounted for only 10 % of the variability in scores.

CONCLUSION

Upper extremity disability as measured by the DASH is slightly, but significantly greater when the dominant limb is involved.

LEVEL OF EVIDENCE

Prognostic level II.

Relationship between Low Muscle Mass and Metabolic Syndrome in Elderly People with Normal Body Mass Index

BACKGROUND

Metabolically obese normal weight (Wt) occurs in people who have high prevalence of cardiovascular disease even with normal body mass index (BMI). In this study, we determined the relationship between low muscle mass and metabolic syndrome which is known to be associated with cardiovascular disease in aged people with normal BMI.

METHODS

This study used the data of Korea National Health and Nutrition Examination Survey. Aged people (≥ 65 years) with normal BMI (18.5 to 22.9 kg/m(2)) were enrolled. Low muscle mass class I was defined as appendicular skeletal muscle divided by Wt 1 to 2 standard deviation below the mean of gender specific young healthy adult and class II was defined as below 2 standard deviations.

RESULTS

The prevalence of low muscle mass class I and II were 18.8% and 5.2% in men and 11.2% and 2.2% in women, respectively. In men and women, low muscle mass and metabolic syndrome was associated with each other after adjusting for age. After further adjusting for BMI, smoking status, alcohol consumption, and exercise frequency, the relationship was maintained in aged men. Moreover in aged men, the risk of metabolic syndrome was increased according to the grade increase in low muscle mass class.

CONCLUSIONS

In the aged with normal BMI, low muscle mass was a risk factor of metabolic syndrome. Furthermore, in normal BMI men, when the degree of low muscle mass was enhanced, the risk of metabolic syndrome was increased.

Treadmill walking effects on grip strength in young men with Down syndrome

This study was aimed at investigating the relation between grip strength and anthropometric factors and the impact of an aerobic exercise on grip strength in young men with Down syndrome (DS). This study was a pre-post design. Twelve males with DS were assigned to an exercise group, who walked using an incremental protocol on a treadmill for 20 min at aerobic levels. Eight additional persons with DS were assigned to an attentional control group, who watched a video. Measure of grip strength was tested pre- and post-interventions. The results showed positively significant relationship among grip strength and age (r=.74, p<.01), weight (r=.52, p=.02), body mass index (r=.61, p=.01) and waist circumference (r=.54, p=.02). In addition, Grip strength was slightly improved after exercise (p=.03) but decreased after control condition. The results showed that anthropometric factors, such as age, weight, body mass index and waist circumference, were positively correlated with grip strength in young men with DS. Further, improvement in grip strength can be found even after a single exercise session. This finding emphasizes the importance of maintaining an active lifestyle in persons with DS for performing activities of daily living.