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Song Q, Shu X, Zhao Y, Ge N, Yue J. Association of handgrip strength asymmetry and weakness with depression among middle-aged and older population in China: A cohort study. J Affect Disord 2024; 363:401-408. [PMID: 39029688 DOI: 10.1016/j.jad.2024.07.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/30/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Handgrip strength (HGS) weakness and asymmetry were recently reported to be associated with age-related health conditions. However, little is known about their combined effects on depression. We aimed to explore the joint association of HGS asymmetry and weakness with depressive symptoms in Chinese middle and older aged population. METHODS 8700 participants aged ≥45 years were enrolled from China Health and Retirement Longitudinal Study (2015-2018). HGS weakness was determined as maximal HGS < 28 kg in males and <18 kg in females. HGS asymmetry was measured by HGS ratio and was defined using two different rules. Specifically, HGS ratio < 0.90 or >1.10 (10 % rule) and <0.80 or >1.20 (20 % rule) were considered as asymmetry. Participants were classified into four groups: normal and symmetric HGS, asymmetry only, weakness only, and both weakness and asymmetry. Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression Scale, with scores ≥12 defined as depression. The logistic regression and multiple linear regression models were conducted to estimate the associations between HGS status and depressive symptoms. RESULTS The three-year incidence of depression was 19.2 %. After adjusting for covariates, compared to normal and symmetric HGS, participants with both HGS asymmetry and weakness showed the greatest risk of incident depression (10 % rule: OR 1.55, 95 % CI 1.19-2.02; 20 % rule: OR 1.71, 95 % CI 1.16-2.50). The coexistence of asymmetry and weakness was related to a significant increase in depression score (10 % rule: β 0.96, 95 % CI 0.38-1.54; 20 % rule: β 0.94, 95 % CI 0.08-1.81). The complete case analysis supported the results, and the associations were not modified by age, sex, and hand dominance. LIMITATIONS Depressive assessment was based on self-reported screening instrument. CONCLUSIONS The presence of both HGS asymmetry and weakness was associated with a higher risk of depression. Examining HGS asymmetry along with weakness may aid in identifying individuals at risk of depression to enable early interventions.
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Affiliation(s)
- Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ning Ge
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Güner M, Ceylan S, Okyar Baş A, Koca M, Öztürk Y, Doğu BB, Hali L MG, Cankurtaran M, Balci C. A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness. Clin Nutr 2024; 43:2381-2387. [PMID: 39270611 DOI: 10.1016/j.clnu.2024.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/24/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVES Handgrip strength (HGS) is accepted as a predictor of overall health status and a biomarker of aging, besides negative health outcomes and mortality. While differences in HGS between the dominant and non-dominant hands are expected, substantial discrepancies may signal impaired muscle function. This study aims to investigate whether handgrip asymmetry can serve as a reliable indicator of frailty in a diverse population of older adults. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 512 patients aged 65 years and older who were admitted to the geriatric medicine outpatient clinic of a university hospital were enrolled in the study. METHODS The Clinical Frailty Scale (CFS) was used to assess the overall level of frailty of the study population. The highest recorded HGS values from the non-dominant and dominant hand were used to calculate the HGS ratio. Those with a HGS ratio of dominant and non-dominant hand <0.90 or >1.10 were defined as HGS asymmetry. RESULTS Of the whole study group, 61.1% was female and the mean age was 73.2 ± 6.1 years. The ratio of the participants living with frailty was 57.6% (n = 219). The number of patients with HGS asymmetry was 264 (51.6%), and 48.4% (n = 248) of the study population had symmetric HGS. The normal and symmetric HGS was found in 40.2% of the non-frail group, whereas it was 23.7% in patients living with frailty. Furthermore, the ratio of low and asymmetric HGS was 16.3% in the non-frail group, and 35.0% in the patients living with frailty (p < 0.001). The presence of asymmetric and low HGS increased the risk of frailty three times independently of other confounding factors (OR:3.08; 95% CI:1.48-6.43; p = 0.003). CONCLUSIONS AND IMPLICATIONS Identifying HGS asymmetry along with low HGS as potential indicators of frailty may provide clinicians with a clear and quantifiable criterion for assessing older patients.
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Affiliation(s)
- Merve Güner
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey.
| | - Serdar Ceylan
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
| | - Arzu Okyar Baş
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
| | - Meltem Koca
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey; Etlik City Hospital, Division of Geriatric Medicine, Ankara Turkey
| | - Yelda Öztürk
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey; Eskişehir City Hospital, Division of Geriatrics, Eskişehir, Turkey
| | - Burcu Balam Doğu
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
| | - Meltem Gülhan Hali L
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
| | - Mustafa Cankurtaran
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
| | - Cafer Balci
- Hacettepe University Faculty of Medicine, Division of Geriatric Medicine, Ankara Turkey
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Pu J, Wang B, Wang Y. Validity of handgrip strength for assessing cognition and psychotic symptoms in hospitalized patients with stable schizophrenia. PLoS One 2024; 19:e0308133. [PMID: 39325780 PMCID: PMC11426447 DOI: 10.1371/journal.pone.0308133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 07/17/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES A correlation between low handgrip strength (HGS), HGS asymmetry, and low cognitive performance has been demonstrated. However, it remains unclear whether low HGS is associated with psychotic symptoms and whether HGS asymmetry is associated with cognitive and psychotic symptoms in hospitalized patients with schizophrenia. This study aimed to investigate the validity of HGS as a measure for assessing cognition and psychotic symptoms in hospitalized patients with stable schizophrenia. METHODS A total of 235 inpatients with stable schizophrenia were recruited between August 1, 2023, and August 31, 2023. The highest HGS values from three tests on the dominant hand were used to determine low HGS (male < 28 kg, female < 18 kg), and HGS asymmetry was identified when the non-dominant HGS/dominant HGS ratio was outside 0.9-1.1. Cognition and psychotic symptoms were assessed using the Chinese Montreal Cognitive Assessment (MoCA-C) and Positive and Negative Syndrome Scale (PANSS). Generalized linear model analyses examined the relationship between HGS and scale scores. RESULTS Covariate-adjusted generalized linear models confirmed a strong association between low HGS alone and the MoCA-C score (OR = 0.819, 95% CI = 0.710‒0.945, p = 0.006) and PANSS score (OR = 1.113, 95% CI = 1.036‒1.239, p = 0.006). Similarly, the combination of low and asymmetric HGS was strongly associated with both MoCA-C (OR = 0.748, 95% CI = 0.653‒0.857, p<0.001) and PANSS scores (OR = 1.118, 95% CI = 1.032‒1.211, p = 0.006). CONCLUSIONS The results suggest that hospitalized patients with schizophrenia and low HGS, with or without asymmetry, are likely to have lower MoCA-C scores and higher PANSS scores. Screening stable schizophrenia patients with low HGS, with or without asymmetry, could be a valuable and straightforward approach to identifying those with lower cognition and severe psychotic symptoms.
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Affiliation(s)
- Jianlin Pu
- Department of Psychiatry, Zigong Mental Health Center, The Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Binyou Wang
- Department of Psychiatry, Zigong Mental Health Center, The Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Yilin Wang
- Department of Psychiatry, Zigong Mental Health Center, The Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
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Zhang Y, Zhu R, Ge L, Zhang X, Tian D, Pan F, Wang M, Cai G. Association of handgrip strength asymmetry and weakness with cognitive function: a nationally representative cohort study. Maturitas 2024; 187:108057. [PMID: 38908060 DOI: 10.1016/j.maturitas.2024.108057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/14/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To describe the association of handgrip strength asymmetry and weakness with cognitive function among Chinese middle-aged and older adults. STUDY DESIGN We used data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study. Handgrip strength was measured at baseline. Handgrip strength asymmetry was defined on the basis of the ratio of handgrip strength of the non-dominant hand to that of the dominant hand (i.e. non-dominant/dominant): a ratio of <0.9 defined as dominant handgrip strength asymmetry and >1.1 as non-dominant handgrip strength asymmetry. Weakness was defined as a handgrip strength of <28 kg for males or <18 kg for females. MAIN OUTCOME MEASURES Cognitive function with its two core dimensions (episodic memory and mental status) at each wave was assessed and standardized. RESULTS 9333 participants (48.3 % female, age 58.2 ± 9.0 years) were included. Non-dominant but not dominant handgrip strength asymmetry was significantly associated with poorer cognitive function at baseline (β = -0.121, -0.092, and -0.132 for mental status, episodic memory, and global cognition, respectively). In longitudinal analyses over 2 years, dominant handgrip strength asymmetry significantly slowed cognitive decline (β = -0.078 and -0.069 for mental status and global cognition, respectively), and non-dominant handgrip strength asymmetry accelerated cognitive decline (β = 0.053 and 0.043 for episodic memory and global cognition, respectively). Weakness was associated with poorer cognitive function at baseline and cognitive decline over 2, 4, and 7 years (all P < 0.05). CONCLUSIONS In middle-aged and older adults, non-dominant handgrip strength asymmetry and weakness were associated with poorer cognitive function and predicted accelerated cognitive decline. Dominant handgrip strength asymmetry may be beneficial for maintaining cognitive function.
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Affiliation(s)
- Youyou Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Rui Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liru Ge
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Xiaoyue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Dalong Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Mengmeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China.
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
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You Y, Wu X, Zhang Z, Xie F, Lin Y, Lv D, Zhao Z. Association of handgrip strength with health care utilisation among older adults: A longitudinal study in China. J Glob Health 2024; 14:04160. [PMID: 39210658 PMCID: PMC11362712 DOI: 10.7189/jogh.14.04160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Background Evidence on the association between handgrip strength (HGS) and health care utilisation among Chinese older adults is scarce. In this study, we aimed to investigate the association of HGS with health care utilisation and to identify whether these associations varied by gender. Methods The analytic sample of this prospective cohort study included 6007 Chinese older adults (≥60 years) from 2011 to 2018 waves of the China Health and Retirement Longitudinal Study. A handgrip dynamometer was used to measure HGS. We measured health care utilisation by outpatient visits, inpatient visits, and unmet hospitalisation needs. We used covariates-adjusted general estimating equations for the analyses. Results Longitudinal results showed that participants with weakness increased the likelihood of outpatient visits (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.01-1.27), inpatient visits (OR = 1.51; 95% CI = 1.32-1.73), and unmet hospitalisation needs (OR = 1.44; 95% CI = 1.19-1.79) than their counterparts. Participants with weakness increased the number of outpatient visits (incidence rate ratio (IRR) = 1.29; 95% CI = 1.11-1.51) and the number of inpatient visits (IRR = 1.39; 95% CI = 1.10-1.61). Participants with HGS asymmetry increased the likelihood of unmet hospitalisation needs (OR = 1.19; 95% CI = 1.03-1.43) than their counterparts. The results of the impact of every one-kilogramme (kg) increase in HGS on health care utilisation indicated consistent results. The associations were similarly observed irrespective of gender. Conclusions Chinese older adults with weakness or HGS asymmetry used more health care. Interventions for improving muscle strength and correcting strength asymmetry are highly recommended, with the potential to considerably save households and health care systems.
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Wei L, Wang B, Wang Y. Low handgrip strength with asymmetry is associated with elevated all-cause mortality risk in older Chinese adults with abdominal obesity. PLoS One 2024; 19:e0306982. [PMID: 39137193 PMCID: PMC11321545 DOI: 10.1371/journal.pone.0306982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/26/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Low handgrip strength (HGS) and abdominal obesity (AO) have been reported to be linked to an increased all-cause mortality risk in older adults. However, the combined impact of AO with low HGS and/or HGS asymmetry on mortality risk remains unclear. Therefore, this study aimed to investigate the synergistic effects of AO and abnormal HGS on mortality risk among Chinese older adults. METHODS Baseline data of the China Health and Retirement Longitudinal Study in 2011, along with mortality outcomes obtained in 2018 were used for the analysis. Low HGS was identified as HGS <18 kg in women or <28 kg in men, while HGS asymmetry is defined as an HGS of either hand > 10% stronger than the other. AO was characterized by a waist circumference ≥90 cm in men and ≥85 cm in women. Logistic regression analysis was used to evaluate the relationship between AO, abnormal HGS and mortality risk. RESULTS A total of 5186 subjects aged 60 years or older were enrolled, 50.6% of whom were male. The proportions of participants with only AO, only low HGS, only HGS asymmetry, low HGS with asymmetry, both AO and low HGS, both AO and asymmetric HGS, and AO with both low HGS and asymmetry were 20.0%, 6.1%, 16.6%, 8.3%, 3.2%, 13.4%, and 3.9%, respectively. Over the course of a 7-year follow-up interval, 970 of these individuals died, with 13.4%, 12.4%, 13.6%, 15.5%, 4.1%, 10.1% and 6.9% of deaths in the above groups, respectively. The adjusted logistic regression analysis model confirmed that only low HGS (OR = 1.897, 95%CI: 1.386-2.596, p<0.001), low HGS with asymmetry (OR = 1.680, 95%CI: 1.265-2.231, p<0.001), and AO combined with both low HGS and asymmetry (OR = 2.029, 95%CI: 1.381-2.981, p<0.001) were associated with a higher risk of mortality. CONCLUSIONS Low HGS, with or without asymmetry, is associated with increased mortality risk in older Chinese adults without AO, and the combination of low HGS and HGS asymmetry further elevates mortality risk in those with AO.
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Affiliation(s)
- Ling Wei
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Binyou Wang
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Yilin Wang
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
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Zhou S, Si H, Wu L, Liu Y, Peng L, Li M, Shen B. Association between handgrip strength weakness and asymmetry with incident hip fracture among older Chinese adults. Arch Gerontol Geriatr 2024; 122:105385. [PMID: 38417298 DOI: 10.1016/j.archger.2024.105385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/11/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND To evaluate the association between handgrip strength (HGS) weakness and asymmetry with incident hip fracture among older Chinese adults. METHODS Data was obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). HGS weakness was defined as maximal HGS 〈 28 kg in men and < 18 kg in women. HGS asymmetry was defined as the HGS ratio < 0.9 or 〉 1.1. Participants were categorized into normal HGS, weakness only, asymmetry only, and both weakness and asymmetry. Given the sex differences in HGS, the association between HGS weakness and asymmetry was analyzed by sex using the multivariable logistic regression models. RESULTS A total of 4789 participants aged ≥ 60 years old without hip fracture at baseline were included in the final analysis. Over the four-year follow-up, there were 152 (3.17 %) participants having incident hip fractures, of which 69 (2.90 %) were men and 83 (3.45 %) were women. Compared to the normal group, men with both weakness and asymmetry had a significantly higher risk of incident hip fracture in the fully adjusted model (adjusted odds ratio (OR): 2.31, 95 % confidence interval (CI):1.17-4.52). There was no significant association between HGS asymmetry and weakness with hip fracture in women. CONCLUSIONS Our findings indicated that among the Chinese population, men with both HGS weakness and asymmetry were associated with increased odds of hip fracture, while no significant association was observed in women.
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Affiliation(s)
- Shengliang Zhou
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haibo Si
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Limin Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuan Liu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Linbo Peng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Mingyang Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bin Shen
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China.
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Wang Y, Li Z, Li M, Chen X. The relationship between asymmetrical grip strength criteria and fall incidence among middle-aged and older Chinese adults. Eur Geriatr Med 2024:10.1007/s41999-024-01011-z. [PMID: 38907785 DOI: 10.1007/s41999-024-01011-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE Current handgrip strength (HGS) protocols employ a variety of criteria, affecting the assessment of asymmetric HGS. The impact of these different criteria on fall prediction is understudied. This study was devised to compare the relative performance of average and maximum HGS asymmetry criteria as tools to predict fall incidence among middle-aged or older adults in China. METHODS 9627 Chinese adults 50 + years of age who were participants in the China Health and Retirement Longitudinal Study (2013-2015 waves) were evaluated. The measurement of HGS was achieved based on either the maximum recorded value (HGSmax) or the average (HGSave), and these values were employed for the calculation of HGS asymmetry. Fall incidence over a 2-year period was evaluated based on self-reported data. Logistic regression analyses were utilized to determine the predictive performance of HGSmax asymmetry or HGSave asymmetry when gaging 2-year fall risk. RESULTS Significant differences in overall rates of HGS asymmetry and the rates of subdivisions thereof were observed when comparing the HGSmax and HGSave criteria, with moderate consistency (kappa = 0.599, p < 0.001). Over the 2-year follow-up period, 1743 fall incidents were recorded. Adjusted logistic regression models indicated that only HGSmax asymmetry > 30.0% was significantly related to fall risk (p = 0.034, odds ratio = 1.36, 95% confidence interval: 1.02-1.81). CONCLUSION These findings highlight the importance of HGS criteria in detecting HGS asymmetry, and suggest that HGSmax is a more robust criterion for predicting fall risk among Chinese adults 50 + years of age.
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Affiliation(s)
- Yilin Wang
- Department of Geriatric Medicine, The Zigong Affiliated Hospital of Southwest Medical University, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Zhouyu Li
- Department of Geriatric Medicine, The Zigong Affiliated Hospital of Southwest Medical University, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Mei Li
- Department of Geriatric Medicine, The Zigong Affiliated Hospital of Southwest Medical University, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Xiaoyan Chen
- Department of Geriatric Medicine, The Zigong Affiliated Hospital of Southwest Medical University, Zigong Mental Health Center, Zigong, Sichuan, China.
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Zevallos A, Pajuelo-Vásquez R, Camacho-Caballero K, Corcuera-Ciudad R, Goicochea-Romero P, Gutiérrez-Baca W, Chambergo-Michilot D, Parodi JF, Runzer-Colmenares FM. Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults. Ann Geriatr Med Res 2024; 28:184-191. [PMID: 38486469 PMCID: PMC11217652 DOI: 10.4235/agmr.23.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/02/2024] [Accepted: 03/12/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. METHODS We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. RESULTS From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. CONCLUSION Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.
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Affiliation(s)
- Alba Zevallos
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Renzo Pajuelo-Vásquez
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Kiara Camacho-Caballero
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Rodrigo Corcuera-Ciudad
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Paola Goicochea-Romero
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Wendy Gutiérrez-Baca
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Diego Chambergo-Michilot
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - José F. Parodi
- Centro de Investigación del Envejecimiento (CIEN), Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | - Fernando M. Runzer-Colmenares
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
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Weng M, Pu J, Wang B, Wang Y. Risk factors associated with weak and asymmetric handgrip strength in older Chinese adults. Am J Hum Biol 2024; 36:e24007. [PMID: 37867368 DOI: 10.1002/ajhb.24007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVES This study sought to investigate the potential risk factors associated with weak and asymmetric handgrip strength (HGS) in older Chinese adults. METHODS A total of 2702 participants aged ≥65 years from the two waves of data (2011 and 2013) from the China Health and Retirement Longitudinal Study were analyzed. The highest recorded HGS values (Method A) or the average HGS values (Method B) for the dominant hand were used to compute the HGS asymmetry (nondominant HGS/dominant HGS out of 0.9-1.1) and HGS weakness (male <28 kg, female <18 kg). Risk factors associated with the weak and asymmetric HGS were identified by logistic regression analysis. RESULTS Risk factors associated with weak and asymmetric HGS of varying severity differed between the two methods. Both methods identified age and illiteracy as risk factors for weak HGS with 10%-20% asymmetry. Method A also identified speech impediment, stroke, and sleep duration as additional risk factors. Similarly, both methods identified age, illiteracy, primary school education and below, diabetes, and stroke as risk factors for weak HGS and asymmetry over 30.1%. Method B additionally identified a history of falls as a risk factor. However, apart from age, the risk factors for weak HGS with 20.1%-30% asymmetry differed between the two methods-Method A identified kidney disease, while Method B identified illiteracy and asthma. CONCLUSIONS The results revealed that risk factors associated with the abnormal HGS in older adults varied based on the methods used to define these conditions.
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Affiliation(s)
- Minghui Weng
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
| | - Jianlin Pu
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
| | - Binyou Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
| | - Yilin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
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Song Q, Shu X, Li Y, Zhao Y, Yue J. Association of handgrip strength asymmetry and weakness with functional disability among middle-aged and older adults in China. J Glob Health 2024; 14:04047. [PMID: 38549505 PMCID: PMC10979250 DOI: 10.7189/jogh.14.04047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2024] Open
Abstract
Background Little is known about the association of handgrip strength (HGS) asymmetry with functional disability in China. We aimed to examine the individual and combined association of HGS asymmetry and weakness with functional disability among middle-aged and older Chinese adults. Methods We included participants aged ≥45 years from two waves of the China Health and Retirement Longitudinal Study (2011 and 2015). HGS weakness was defined as the maximal HGS<28 kg for men and <18 kg for women. HGS asymmetry was measured by dividing the maximal nondominant HGS (kg) by the maximal dominant HGS (kg), with the value <0.90 or >1.10 considered as asymmetry. Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL) and was defined as encountering difficulty in completing one or more ADL/IADL tasks. The logistic regression models were used to explore the association between HGS measures and functional disability. Results 11 950 (mean age 59.2 ± 9.6 years, 47.9% males) and 7540 (mean age 57.5 ± 8.6 years, 50.1% males) participants were included in the cross-sectional and prospective study, respectively. HGS asymmetry and weakness, individually or simultaneously, were associated with an increased prevalence of functional disability. During the four-year follow-up, 1822 (24.2%) participants had incident functional disability. The separate exposure to HGS asymmetry (odds ratio (OR) = 1.18; 95% confidence interval (CI) = 1.05-1.32) or weakness (OR = 1.59; 95% CI = 1.30-1.95) was independently associated with functional disability. For combined associations, those with both weakness and asymmetry showed the greatest risk of new-onset functional disability (OR = 1.91; 95% CI = 1.45-2.52). Conclusions HGS asymmetry and weakness were associated with a higher risk of functional disability. Assessing HGS asymmetry together with weakness may help to better identify those at risk of functional disability to enable early interventions.
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Wang Y, Wang J, Wang B, Fu J, Chen X. The accuracy of different calculation methods when identifying handgrip strength asymmetry among middle-aged and older Chinese adults. PLoS One 2024; 19:e0299469. [PMID: 38547095 PMCID: PMC10977670 DOI: 10.1371/journal.pone.0299469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/09/2024] [Indexed: 04/02/2024] Open
Abstract
At present, there is no uniform standard mean of identifying handgrip strength (HGS) asymmetry based on maximum or average HGS values. Therefore, this study aimed to explore the accuracy of different calculation methods in the evaluation of HGS asymmetry. Using the maximum reading of two trials from both hands (Method A) as the reference standard, the accuracy of the HGS asymmetry identified by the average value of two trials of both hands (Method B) was determined by using various indicators, including specificity, sensitivity, the area under the receiver operating characteristic curve (AUC), positive, and negative predictive values. Overall, 12,163 individuals were included in this study, of whom 47.61% (5791/12,163) were male. The percentages of individuals with HGS asymmetry differed as a function of age and sex when using these two different methods. When employing Method A, 38.52%, 41.57%, and 44.57% of males 45 ≤ age<60, 60 ≤ age<80, and ≥ 80 years of age exhibited HGS asymmetry as compared to 40.78%, 39%, and 39.63% of females. Using Method B, the corresponding proportions were 41.69%, 42.5%, and 40% in males and 42.01%, 41.18%, and 40.55% in females, respectively. When compared to Method A, Method B was found to be effective in identifying HGS asymmetry, with AUC values ranging from 0.844 to 0.877. However, there was only moderate agreement between the two methods in assessing HGS asymmetry. Specifically, the Kappa values for the two Methods were 0.692, 0.694, and 0.766 in males aged 45 to 60, 60 to 80, and 80 years and above, respectively. For females, the Kappa values were 0.674, 0.661, and 0.751, respectively. These results demonstrated that the maximal or average HGS values from two trials using both hands has a significant impact on the consequent identification of HGS asymmetry.
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Affiliation(s)
- Yilin Wang
- Department of Geriatric Medicine, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Jing Wang
- School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, China
- Deyang People’s Hospital, Deyang, Sichuan Province, China
| | - Binyou Wang
- Department of Geriatric Medicine, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Jing Fu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xiaoyan Chen
- Department of Geriatric Medicine, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
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Chen X, Xie L, Xia X, Luo X, Chen J, Zhang J, Li Q, Zhang X, Jiang J, Yang M. Effects of measurement protocols and repetitions on handgrip strength weakness and asymmetry in patients with cancer. J Cachexia Sarcopenia Muscle 2024; 15:220-230. [PMID: 38014503 PMCID: PMC10834335 DOI: 10.1002/jcsm.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/29/2023] [Accepted: 10/03/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The use of handgrip strength (HGS) in clinical cancer research is surging. The association between HGS and outcomes in patients with cancer varied across studies, which might be due to the different measurement protocols for HGS. We aimed to answer three questions: (1) Did the use of various protocols for HGS, along with different numbers of repetitions, lead to significant differences in maximum HGS values? (2) If yes, were these differences clinically significant? (3) Did the differences in HGS protocols and repetitions affect the identification of HGS weakness or HGS asymmetry? METHODS We continuously recruited adult patients with solid tumours. Two protocols were used to measure HGS: Method A, following the American Society of Hand Therapists guidelines, and Method B, following the National Health and Nutrition Examination Survey guidelines. To analyse HGS, we used the maximal value obtained from either two or three repetitions of the dominant hand or four or six repetitions of both hands. RESULTS We included 497 patients (326 men and 171 women, median age: 58 years). The maximal HGS values, measured with Method B, were significantly higher than those measured by Method A in both men and women, despite repetitions (all P < 0.05). The maximum HGS values were significantly different across the repetition groups, regardless of measurement protocols and sex (all P < 0.01). The protocol-induced differences in maximal HGS values might be clinically meaningful in over 60% of men and 40% of women despite repetitions. The repetition-induced difference was only clinically significant in 4.3-17.8% of men and 4.1-14.6% of women. To identify HGS weakness, using Method A (six repetitions) as the 'gold' standard, the other protocols demonstrated an overall accuracy of 0.923-0.997 in men and 0.965-1 in women. To identify HGS asymmetry, using Method A (six repetitions) as the 'gold' standard, Method B (six repetitions) demonstrated a diagnostic accuracy of 0.972 in men and 0.971 in women. Method A (four repetitions) showed a diagnostic accuracy of 0.837 in men and 0.825 in women, while Method B (four repetitions) showed a diagnostic accuracy of 0.825 in men and 0.807 in women. CONCLUSIONS Both measurement protocols and repetitions significantly affect the maximal HGS values. The identification of HGS weakness is not significantly affected by either protocols or repetitions, while the identification of HGS asymmetry may be affected by different repetitions but not protocols.
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Affiliation(s)
- Xiaoyan Chen
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Lingling Xie
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaozhen Luo
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Jing Chen
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - QinLan Li
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Xuemei Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaojiao Jiang
- Rehabilitation Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Peng L, Xiang Q, Zhou Y, Yin R. Associations of Handgrip Strength Weakness and Asymmetry with Lower Cognitive Function: Results from the National Health and Nutrition Examination Survey (2011-2014). J Alzheimers Dis 2024; 99:393-402. [PMID: 38669541 DOI: 10.3233/jad-231375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background The joint associations of handgrip strength (HGS) weakness and asymmetry with cognitive decline remain understudied in older adults. Objective To investigate the associations between HGS weakness, asymmetry, and lower cognitive function in a nationally representative sample of older Americans. Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2011-2014. Weakness was defined as HGS <26 kg for men and <16 kg for women. Asymmetry was determined by calculating the ratio of dominant to non-dominant HGS. Participants with an HGS ratio <0.90 or >1.10 were classified as having any HGS asymmetry. Those with an HGS ratio >1.10 exhibited dominant HGS asymmetry, while those with an HGS ratio <0.90 displayed nondominant HGS asymmetry, respectively. Lower cognitive functioning was defined as global cognitive composite scores more than 1 standard deviation below the mean. Covariate-adjusted logistic regression models were used to analyze the associations between HGS asymmetry/weakness and lower cognitive functioning. Results Compared to individuals with non-weak and symmetric HGS, those with any HGS asymmetry alone and weakness alone had 1.017 (95% confidence interval [CI]: 0.707-1.463) and 1.391 (95% CI: 0.542-3.571) greater odds for cognitive decline, while co-occurrence of both HGS asymmetry and weakness was associated with 3.724 (95% CI: 1.711-8.107) greater odds for lower cognitive function after controlling for confounders. Cnclusions Individuals exhibiting both diminished and asymmetrical HGS demonstrated an elevated susceptibility to cognitive impairment, thereby implying that the inclusion of HGS asymmetry assessment in conjunction with weakness evaluation may enhance the accuracy of prognosticating cognitive decline.
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Affiliation(s)
- Lang Peng
- Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Qingwei Xiang
- Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Yong Zhou
- Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
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Peng TC, Chiou JM, Chen YC, Chen JH. Handgrip strength asymmetry and cognitive impairment risk: Insights from a seven-year prospective cohort study. J Nutr Health Aging 2024; 28:100004. [PMID: 38267160 DOI: 10.1016/j.jnha.2023.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES This study aimed to explore the links of handgrip strength and asymmetry with cognitive impairment. DESIGN This was a seven-year prospective cohort study. SETTING AND PARTICIPANTS We used data from wave 3 (2015-2017) to wave 5 (2019-2022) from the ongoing Taiwan Initiative of Geriatric Epidemiological Research (TIGER), with wave 3 as the baseline (n = 446). The study included community-dwelling participants aged 65 years or older. MEASUREMENTS Handgrip strength was measured, and abnormalities were determined based on handgrip strength weakness and asymmetry. Handgrip strength asymmetry was categorized into three groups at baseline based on the handgrip strength ratio (left handgrip strength/right handgrip strength). Cognitive tests evaluating global and specific cognitive domains were conducted at baseline and two biennial follow-ups. Generalized linear mixed models were utilized to assess the associations of abnormal handgrip strength with global cognition and multiple cognitive domain progression over time. RESULTS This study included 392 dementia-free participants, with an average age of 75.8 years and 179 (45.7%) males. Mild handgrip strength asymmetry was present in 88 participants (22.4%), while 53 (13.5%) exhibited moderate asymmetry. In men, the coexistence of low handgrip strength and handgrip strength asymmetry was linked to cognitive impairment over time. These associations were observed in global cognition (β^ = -1.76, 95% CI: -2.79 to -0.74), memory (immediate free recall: β^ = -0.67, 95% CI: -1.17 to -0.17), executive function (Trail Making Test-A: β^ = -0.54, 95% CI: -0.94 to -0.13), and attention (Digit span-forward: β^ = -1.00, 95% CI: -1.46 to -0.54). CONCLUSIONS This study found that individuals with reduced handgrip strength and handgrip strength asymmetry had an increased risk of cognitive impairment across various domains. Moreover, this association appears to be more pronounced among men than women. Incorporating these simple assessments into regular clinical practice improves the allocation of limited screening resources and timely clinical interventions in older adults.
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Affiliation(s)
- Tao-Chun Peng
- Division of Family Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistics and Data Science, College of Science, National Taiwan University, Taipei, Taiwan; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, No.1 Jen Ai Road Section 1, Taipei 100233, Taiwan.
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Wang Y, Huang Y, Chen X. The relationship between low handgrip strength with or without asymmetry and fall risk among middle-aged and older males in China: evidence from the China Health and Retirement Longitudinal Study. Postgrad Med J 2023; 99:1246-1252. [PMID: 37740568 DOI: 10.1093/postmj/qgad085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/26/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE This study sought to explore the potential correlation between low handgrip strength (HGS) with or without asymmetry and fall risk in middle-aged and older Chinese adults. METHODS Baseline characteristic data from participants 45+ years of age and data regarding fall events collected from two rounds (2011-2013) of the China Health and Retirement Longitudinal Study were utilized for the present analyses. HGS and HGS asymmetry was defined according to the updated American Society of Hand Therapist. Fall events were identified through self- or proxy-reported details. Logistic regression analyses were employed to gauge the potential relationship between abnormal HGS and fall risk. RESULTS In total, 10 563 participants were enrolled in this analysis, of whom 47.49% (5016/10 563) were male. The proportions of low HGS alone, HGS asymmetry alone, and low HGS with asymmetry were 22.23%, 18.34%, and 22.75%, respectively, in males, but just 3.64%, 35.12%, and 6.62% in females. A total of 693 and 1019 fall events were recorded for male (13.82%) and female (18.37%) participants over the 2-year follow-up period, respectively. Significant differences in fall event incidence among different HGS groups were only observed among males. An adjusted logistic regression analysis model confirmed that low HGS with dominant asymmetry was closely related to fall risk among middle-aged and older males [P = 0.014, odds ratio = 1.332, 95% confidence interval: 1.059-1.676). CONCLUSION These results demonstrated that low HGS with dominant asymmetry is a risk factor linked to increased fall risk among middle-aged and older Chinese males. What is already known on this topic Low HGS or HGS asymmetry is been reported to be linked to an increased risk of falls in middle-aged and older adults; however, little is known about the association between fall risk and low HGS and/or HGS asymmetry. Main messages The prevalence of low HGS alone and low HGS asymmetry in men was significantly higher than in women, while HGS alone asymmetry was more common in women than men. The risk factor for the increased risk of falls in Chinese middle-aged and older men is low and asymmetric HGS, rather than low or asymmetric HGS alone. Low HGS with dominant asymmetry rather than nondominant asymmetry is associated with future fall risk among middle-aged and older Chinese males. Current research questions What is the mechanism for the significant difference in the proportion of abnormal HGS components between the sexes? If female subjects with low HGS and asymmetric HGS were added, would an association be observed between low HGS and asymmetric HGS falls? Is there an association between the severity of asymmetric HGS with weakness and falls?
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Affiliation(s)
- Yilin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center , Zigong, Sichuan Province 643020, China
| | - Yalian Huang
- Sichuan Research Center of Applied Psychology, Chengdu Medical College, Chengdu, Sichuan Province 610500, China
| | - Xiaoyan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center , Zigong, Sichuan Province 643020, China
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Fraser BJ, Blizzard L, Tomkinson GR, McGrath R, Dwyer T, Venn AJ, Magnussen CG. Tracking handgrip strength asymmetry from childhood to mid-life. Acta Paediatr 2023; 112:2408-2417. [PMID: 37531128 PMCID: PMC10952407 DOI: 10.1111/apa.16930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023]
Abstract
AIM Determine if asymmetric handgrip strength exists in childhood and adulthood and quantify the degree of tracking of handgrip strength asymmetry over time. METHODS Participants from the Childhood Determinants of Adult Health Study had their right and left handgrip strength measured using handgrip dynamometry in childhood (1985: 9-15 y), young adulthood (2004-06: 26-36 y) and/or mid-adulthood (2014-19: 36-49 y). Handgrip strength asymmetry was calculated as: strongest handgrip strength/strongest handgrip strength on the other hand. Participants were categorised based on the degree of their asymmetry (0.0%-10.0%, 10.1%-20.0%, 20.1%-30.0%, >30.0%). Tracking was quantified using Spearman's correlations and log binomial regression. RESULTS Handgrip strength asymmetry was present in childhood and adulthood (>30.0% asymmetry: childhood = 6%, young adulthood = 3%, mid-adulthood = 4%). Handgrip strength asymmetry did not track between childhood and young- (r = 0.06, 95% CI = -0.02, 0.12) and mid-adulthood (r = 0.01, 95% CI = -0.09, 0.10). Tracking was more apparent between young- and mid-adulthood (r = 0.16, 95% CI = 0.09, 0.22). Participants with >30.0% asymmetry were at greater risk to maintain this status between childhood and young- (RR = 3.53, 95% CI = 1.15, 10.87) and mid-adulthood (RR = 2.14, 95% CI = 0.45, 10.20). CONCLUSION Although handgrip strength asymmetry tracked relatively poorly, asymmetric handgrip strength was apparent in children and adults. Handgrip strength asymmetry does not exclusively affect older adults and should be considered in protocols to better understand its role across the life course.
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Affiliation(s)
- Brooklyn J. Fraser
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Leigh Blizzard
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Grant R. Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Ryan McGrath
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
- Healthy Aging North Dakota (HAND)North Dakota State UniversityFargoNorth DakotaUSA
- Department of Health, Nutrition, and Exercise SciencesNorth Dakota State UniversityFargoNorth DakotaUSA
- Fargo VA Healthcare SystemFargoNorth DakotaUSA
| | - Terence Dwyer
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- The Nuffield Department of Women's & Reproductive HealthUniversity of OxfordOxfordUK
- Murdoch Children's Research InstituteMelbourneVictoriaAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Alison J. Venn
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Costan G. Magnussen
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
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Morera Á, Calatayud J, Casaña J, Núñez-Cortés R, Andersen LL, López-Bueno R. Handgrip strength and work limitations: A prospective cohort study of 70,820 adults aged 50 and older. Maturitas 2023; 177:107798. [PMID: 37481913 DOI: 10.1016/j.maturitas.2023.107798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The purpose of the study was to investigate the association between handgrip strength and the incidence of work limitations in European adults aged 50 and older. We conducted a prospective cohort study among adults aged 50 and older from 27 European countries and Israel. Data were collected from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, and 7. Handgrip strength was measured using a hand dynamometer (Smedley, S Dynamometer, TTM) and participants replied to questions about work limitations. Cox regression was conducted for statistical analyses. A total of 70,820 older adults (mean age 61 ± 7.7 years; 54.3 % women) were followed during a mean of 3.8 ± 2.9 years. The fully adjusted model showed that participants with low handgrip strength (<16 kg in women and <27 kg in men) had a significantly higher risk of work limitations compared with participants with normal values of handgrip strength (hazard ratio: 1.36; 95 % confidence interval: 1.28-1.44). Kaplan-Meier trajectories revealed that the survival probability to experience work limitations in the normal handgrip category was 20 % lower than in the low handgrip category in most of the follow-up period. We identified low level of handgrip strength as a risk factor for work limitations in adults aged 50 years or older. This could be used as an accessible measure to screen workers at risk of developing work limitations.
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Affiliation(s)
- Álvaro Morera
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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Zhang Y, Chen W, Cao B, Lin L, Li J, Guo VY. Associations of handgrip weakness and asymmetry with new-onset stroke in Chinese middle-aged and older adults: a cohort study. Front Public Health 2023; 11:1251262. [PMID: 37908684 PMCID: PMC10615130 DOI: 10.3389/fpubh.2023.1251262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/31/2023] [Indexed: 11/02/2023] Open
Abstract
Background Weak handgrip strength (HGS) has been linked to adverse health outcomes including stroke. However, the joint associations of HGS weakness and asymmetry between limbs with stroke incidence remain underexplored. Methods This cohort study analyzed data of participants aged ≥45 years from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study. Weak HGS was defined according to the recommendation of European Working Group on Sarcopenia in Older People. Asymmetric HGS was defined if the HGS ratio of both hands was over 1.1 or below 0.9. New-onset stroke was confirmed through self-report of physician's diagnosis. Results A total of 10,966 participants without stroke at baseline were included in the analysis. During the 4 years follow-up, there were 262 (2.39%) new-onset stroke cases. Compared to individuals with non-weak and symmetric HGS, those with HGS asymmetry alone and weakness alone were associated with hazards of 1.09 (95% confidence interval [CI]: 0.80-1.48) and 1.27 (95%CI: 0.86-1.88) for new-onset stroke, respectively, while co-occurrence of both HGS asymmetry and weakness was associated with 1.80 (95%CI: 1.24-2.60) greater hazard for new-onset stroke after controlling for confounders. Such associations were consistent in older adults aged ≥60 years, but not in those aged<60 years. Conclusion Individuals with both weak and asymmetric HGS tended to have greater risk of new-onset stroke, compared to those with normal HGS, or with either weak or asymmetric HGS alone. Our finding suggested that examining HGS asymmetry alongside weakness may help to improve the risk-stratification and target prevention of stroke, particularly in the older population.
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Affiliation(s)
- Yuying Zhang
- Department of Child Healthcare, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bing Cao
- Department of Neurosurgery, Wu Tsai Neuroscience Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Wang Y, Li M, Chen X. Short sleeping duration is associated with a higher risk of asymmetric handgrip strength among older Chinese males: a cross-sectional study evidence from the China health and retirement longitudinal study. Front Public Health 2023; 11:1246008. [PMID: 37869187 PMCID: PMC10588631 DOI: 10.3389/fpubh.2023.1246008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Objective This study aimed to explore the potential correlation between sleeping duration and the risk of handgrip strength (HGS) asymmetry in older Chinese adults. Methods The data of participants (65+ years of age) were obtained from the first Wave 1 (2011) of the China Health and Retirement Longitudinal Study (CHARLS). Information on sleeping duration during the previous month was collected from self-reports and was divided into three groups: long (>8 h), normal (6-8 h), and short (< 6 h). HGS was computed as the average of two tests per hand and asymmetric HGS was diagnosed when the ratio of average non-dominant to average dominant HGS was greater than 1.1 or less than 0.9. Logistic regression analyses were employed to gauge the relationship between sleeping duration and asymmetric HGS risk. Results In total, 3,174 participants were enrolled in this analysis, of whom 51.54% (1,636/3,174) were male. The proportions of asymmetric HGS were 42.18% in males and 41.87% in females. The sleeping duration (hours) in the asymmetric and non-asymmetric HGS groups were 6 h (5,8) and 7 h (5,8) in males with a significant difference between them (p = 0.015), and 6 h (5,8) and 6 h (5,8) in females with no significant difference (p = 0.415). Compared with non-asymmetric HGS individuals, the proportions of normal, short, and long sleeping duration were 40.4, 47.3, and 37.7% in males with a significant difference (p = 0.023), and 42.4, 40.3, and 43.8% in females with no significant differences (p = 0.685). An adjusted logistic regression analysis model confirmed that short sleeping duration was significantly associated with asymmetric HGS risk among older males (p = 0.048, OR = 1.252, 95%CI:1.002-1.565). Conclusion The results demonstrated that short sleeping duration (<6 h) was a risk factor for increased HGS asymmetry among older Chinese males.
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Affiliation(s)
- Yilin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, Sichuan Province, China
- Zigong Institute of Brain Science, Zigong, Sichuan Province, China
| | - Mei Li
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, Sichuan Province, China
| | - Xiaoyan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, Sichuan Province, China
- Zigong Institute of Brain Science, Zigong, Sichuan Province, China
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Cai D, Zhang H, Wang Y. Low handgrip strength with or without asymmetry is associated with elevated all-cause mortality risk in older Chinese males. Geriatr Gerontol Int 2023; 23:692-699. [PMID: 37572042 DOI: 10.1111/ggi.14652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
AIM This study aimed to examine the link between handgrip strength (HGS) asymmetry and mortality risk among older Chinese adults. METHODS These analyses were conducted using data from adults aged 60 years and older from the 2011-2013 waves of the China Health and Retirement Longitudinal Study, using baseline participant data collected in 2011. Proxy-reported information was used to assess the mortality outcomes of the participants over a 2-year follow-up. The highest recorded HGS values for each hand were used to compute the HGS asymmetry ratio (non-dominant HGS/dominant HGS) and HGS weakness (Male<26 kg, Female<16 kg). Covariate-adjusted Cox models were employed to gauge the relationship between abnormal HGS and mortality risk. RESULTS Overall, 5083 adults were enrolled in this study, of whom 50.15% (2549/5083) were male. The proportions of low HGS alone, HGS asymmetry alone, and asymmetric and low HGS were 6.43%, 30.95%, and 9.22%, respectively, in males, and 4.81%, 35.87%, and 9.55%, respectively, in females. A total of 96 and 78 deaths were recorded for male (3.77%) and female (3.08%) participants, respectively, over the 2-year follow-up period. Significant differences in mortality were observed between the different HGS groups for both sexes. An adjusted Cox regression analysis model confirmed that only low HGS (P = 0.047, hazard ratio [HR] = 1.949, 95% confidence interval [95% CI]: 1.008-3.768) and low HGS with asymmetry (P = 0.007, HR = 2.152, 95% CI: 1.231-3.764) were significantly associated with mortality risk in older males. CONCLUSIONS The results revealed that low HGS with or without asymmetry was associated with a higher risk of death over a 2-year follow-up interval in older Chinese males. Geriatr Gerontol Int 2023; 23: 692-699.
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Affiliation(s)
- Duanfang Cai
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
| | - Hongli Zhang
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yilin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
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Miao X, Ding L, Lu J, Zhu H, Zhao K, Xu X, Zhu S, Chen L, Hu J, Xu Q. Preoperative low handgrip strength (HGS) with HGS asymmetry is associated with adverse outcomes among older adults with gastric cancer. J Geriatr Oncol 2023; 14:101583. [PMID: 37429105 DOI: 10.1016/j.jgo.2023.101583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION This study aimed to explore the associations of low hand grip strength (HGS), HGS asymmetry, their combinations, and frailty on hospital readmissions, total complications, and prolonged length of stay (PLOS) among older adults with gastric cancer. MATERIALS AND METHODS This study included 342 patients with gastric cancer aged ≥60 years who were scheduled to undergo radical surgery. The Tilburg Frailty Indicator (TFI) was used to collect information on frailty. HGS was measured twice for each hand using an electronic handgrip dynamometer. The highest HGS readings on each hand were used for calculating the HGS asymmetry ratio: non-dominant HGS (kg)/dominant HGS (kg). The Fine and Gray proportional subdistribution hazard model and the logistic regression model were used for the analyses, with covariates adjusted. RESULTS Low HGS (subdistribution hazard ratios [SHR] = 2.10, 95% confidence interval [CI] = 1.05-3.93, P = 0.036) and low HGS with HGS asymmetry (SHR = 3.95, 95% CI = 1.50-10.36, P = 0.005) were significantly associated with hospital readmissions. Frailty was associated with total complications (odds ratio [OR] = 2.87, 95% CI = 1.61-5.13, P < 0.001) and PLOS (OR = 1.98, 95% CI = 1.19-3.29, P < 0.001). Low HGS, HGS asymmetry, and their combinations were not significantly associated with total complications and PLOS. DISCUSSION Preoperative low HGS and low HGS with HGS asymmetry were associated with hospital readmissions, while frailty was associated with total complications and PLOS among older adults with gastric cancer. In the future, more rigorously designed studies are needed to verify our results further to improve preoperative clinical assessment and frailty evaluation among older adults with gastric cancer.
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Affiliation(s)
- Xueyi Miao
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Lingyu Ding
- Department of Colorectal Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Jinling Lu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Xinyi Xu
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Li Chen
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Jieman Hu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China.
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Sánchez-Delgado JC, Cohen DD, Camacho-López PA, Carreño-Robayo J, Castañeda-Hernández A, García-González D, Martínez-Bello D, Aroca-Martinez G, Parati G, Lopez-Jaramillo P. Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome. Biomedicines 2023; 11:2435. [PMID: 37760876 PMCID: PMC10525985 DOI: 10.3390/biomedicines11092435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. OBJECTIVE To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. METHODS We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. RESULTS Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012). CONCLUSIONS Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.
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Affiliation(s)
- Juan Carlos Sánchez-Delgado
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel D. Cohen
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94T9PX Limerick, Ireland
| | | | - Javier Carreño-Robayo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Alvaro Castañeda-Hernández
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Daniel García-González
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel Martínez-Bello
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Gustavo Aroca-Martinez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Gianfranco Parati
- Istituto Auxologico Italuano & University of Milano-Bicocca, Department of Medicine and Surgery, Piazza Brescia, 20149 Milan, Italy
| | - Patricio Lopez-Jaramillo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
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McGrath R, Lang JJ, Clark BC, Cawthon PM, Black K, Kieser J, Fraser BJ, Tomkinson GR. Prevalence and Trends of Handgrip Strength Asymmetry in the United States. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2023; 5:e230006. [PMID: 37502008 PMCID: PMC10373124 DOI: 10.20900/agmr20230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Strength asymmetries are a type of muscle function impairment that is associated with several health conditions. However, the prevalence of these asymmetries among adults from the United States remains unknown. We sought to estimate the prevalence and trends of handgrip strength (HGS) asymmetry in American adults. Methods The unweighted analytic sample included 23,056 persons aged at least 50-years with information on HGS for both hands from the 2006-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured HGS, with the highest recorded values for each hand used to calculate asymmetry. Persons were categorized into the following asymmetry severity categories: (1) >10%, (2) >20.0%, and (3) >30.0%. Survey weights were used to generate nationally-representative asymmetry estimates. Results Overall, there were no statistically significant trends in HGS asymmetry categories over time. The prevalence of HGS asymmetry in the 2014-2016 wave was 53.4% (CI: 52.2-54.4), 26.0% (CI: 25.0-26.9), and 11.7% (CI: 10.9-12.3) for asymmetry at >10%, >20%, and >30%, respectively. HGS asymmetry was generally higher in older Americans compared to middle-aged adults at each wave. In the 2014-2016 wave, >30% asymmetry prevalence was 13.7% (CI: 12.7-14.6) in females and 9.3% (CI: 8.4-10.2) in males. Some differences in asymmetry prevalence by race and ethnicity were observed. Conclusions The prevalence of asymmetry was generally high, especially in women and older adults. Ongoing surveillance of strength asymmetry will help monitor trends in muscle dysfunction, guide screening for disablement, identify subpopulations at risk for asymmetry, and inform relevant interventions.
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Affiliation(s)
- Ryan McGrath
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND 58102, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA
- Fargo VA Healthcare System, Fargo, ND 58102, USA
- Department of Geriatrics, University of North Dakota, Grand Forks, ND 58202, USA
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, 5000, Australia
| | - Justin J. Lang
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, 5000, Australia
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A0K9, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N6N5, Canada
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, USA
- Department of Biomedical Sciences, Ohio University, Athens, OH 45701, USA
- Division of Geriatric Medicine, Ohio University, Athens, OH 45701, USA
| | - Peggy M. Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA 94107, USA
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Kennedy Black
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND 58102, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA
| | - Jacob Kieser
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND 58102, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA
| | - Brooklyn J. Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7001, Australia
| | - Grant R. Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, 5000, Australia
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Jia S, Zhao W, Ge M, Zhou L, Sun X, Zhao Y, Dong B. Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study. Neurology 2023; 100:e2342-e2349. [PMID: 37076310 PMCID: PMC10256126 DOI: 10.1212/wnl.0000000000207308] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/03/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Motoric cognitive risk (MCR) syndrome is a type of pre-dementia. It is defined as the co-occurrence of subjective cognitive complaints and a slow gait speed. A recent study found that handgrip strength (HGS) asymmetry is associated with an increased risk of neurodegenerative disorders. We aimed to investigate the associations of HGS weakness and asymmetry separately and together with MCR incidence among older Chinese adults. METHODS Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. HGS values <28 kg for male participants and <18 kg for female participants were considered HGS weaknesses. HGS asymmetry was assessed by the ratio of nondominant to dominant HGS. We used 3 different cutoff values of HGS ratio to define asymmetry, including 10%, 20%, and 30%. Specifically, HGS ratios <0.90 or >1.10 (10%), <0.80 or >1.20 (20%), and <0.70 or >1.30 (30%) were classified as asymmetry. The participants were classified into 4 groups: neither weakness nor asymmetry (neither), asymmetry only, weakness only, and weakness and asymmetry (both). The association between baseline HGS status and 4-year incidence of MCR was examined using logistic regression analyses. RESULTS A total of 3,777 participants 60 years and older were included in the baseline analysis. The prevalence of MCR at the baseline was 12.8%. Participants with asymmetry only, weakness only, and both showed significantly increased risk of MCR. After excluding participants with MCR at baseline, 2,328 participants were included in the longitudinal analysis. There were 111 MCR cases (4.77%) over the 4-year follow-up period. Participants with HGS weakness and asymmetry together at baseline had increased odds of incident MCR (HGS ratio at 10%: odds ratio [OR] 4.48, p < 0.001; HGS ratio at 20%: OR 5.43, p < 0.001; HGS ratio at 30%: OR 6.02, p < 0.001). DISCUSSION These results show that the presence of both HGS asymmetry and weakness is associated with MCR incidence. The early recognition of HGS asymmetry and weakness may be helpful in the prevention and treatment of cognitive dysfunction.
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Affiliation(s)
- Shuli Jia
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Wanyu Zhao
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Meiling Ge
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Lixing Zhou
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Xuelian Sun
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Yunli Zhao
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu
| | - Birong Dong
- From the Center of Gerontology and Geriatrics and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu.
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Feng W, Ma M, Gao H, Yuan W, Li R, Guo H, Gu C, Sun Z, Zhang Y, Zheng L. Association between handgrip strength asymmetry and cognitive function across ethnicity in rural China: a cross-sectional study. Front Aging Neurosci 2023; 15:1191197. [PMID: 37273648 PMCID: PMC10235480 DOI: 10.3389/fnagi.2023.1191197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Background Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. Method The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/non-dominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. Result A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [β = -0.67, 95% confidence interval (CI): -1.26 ∼-0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(β = -0.60, 95% CI: -1.35 ∼ 0.15, P = 0.115) and asymmetric non-dominant HGS (β = -0.56, 95% CI: -1.42 ∼ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric non-dominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ∼ 1.74; OR per 5 kg decrease = 1.10, 95% CI: 1.01 ∼ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ∼ 1.78; OR per 5 kg decrease = 1.10, 95% CI: 1.02 ∼ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ∼ 1.67) and lower HGS (OR per 5 kg decrease = 1.21, 95% CI: 1.10 ∼ 1.32) were associated with impairment of visuoperception. Conclusion HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups.
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Affiliation(s)
- Wenjing Feng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Mingfeng Ma
- Department of Cardiology, Fenyang Hospital of Shanxi Province, Fenyang, Shanxi, China
| | - Hanshu Gao
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Wei Yuan
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Ruixue Li
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Hui Guo
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Cuiying Gu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yao Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ventura J, Downer B, Li CY, Snih SA. Nativity differences in the relationship between handgrip strength and cognitive impairment in older Mexican Americans over 20 years of follow-up. Arch Gerontol Geriatr 2023; 107:104903. [PMID: 36584560 PMCID: PMC9974812 DOI: 10.1016/j.archger.2022.104903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period. METHODS Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates. RESULTS US-born and foreign-born participants in the 4th quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1st (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3rd and 4th HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3rd and 4th HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates. CONCLUSION Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.
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Affiliation(s)
- Juan Ventura
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Brian Downer
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy/School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA; Division of Geriatrics & Palliative Medicine/Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
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Abdalla PP, Bohn L, Sebastião E, Pereira Dos Santos A, Fernando Tasinafo Junior M, da Silva LSL, Alves TC, Gomide EBG, Venturini ACR, Mota J, Machado DRL. Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults. Arch Gerontol Geriatr 2023; 106:104869. [PMID: 36442405 DOI: 10.1016/j.archger.2022.104869] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. METHODS A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). RESULTS Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). CONCLUSIONS HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.
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Affiliation(s)
- Pedro Pugliesi Abdalla
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil.
| | - Lucimere Bohn
- Faculty of Psychology, Education and Sport, Lusófona University of Porto, Porto, Portugal; Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Emerson Sebastião
- Health and Exercise Research Group, Department of Kinesiology and Physical Education, Northern Illinois University, IL, USA
| | - André Pereira Dos Santos
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil; College of Nursing at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcio Fernando Tasinafo Junior
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil
| | - Leonardo Santos Lopes da Silva
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil
| | - Thiago Cândido Alves
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil
| | - Euripedes Barsanulfo Gonçalves Gomide
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil; College of Nursing at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Claudia Rossini Venturini
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil; College of Nursing at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes n° 3900, University Campus - Monte Alegre, Ribeirão Preto, SP 14040-902, Brazil; College of Nursing at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Chen X, Liu G, Li S, Lin X, Han Z, Hu X, Wu J, Yang M. Handgrip Measurement Method Affects Asymmetry but Not Weakness Identification in Community-Dwelling Older Adults. J Am Med Dir Assoc 2023; 24:284-291.e3. [PMID: 36423678 DOI: 10.1016/j.jamda.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The Asian Working Group for Sarcopenia (AWGS) 2019 recommends different measurement protocols for handgrip strength (HGS). We aimed to explore (1) whether these protocols induce a significant difference in HGS; (2) whether these differences be clinically meaningful; and (3) whether these protocols affect the identification of HGS weakness or asymmetry. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 356 community-dwelling older adults (mean age 67.9 years; 146 women). METHODS Maximal HGS was measured according to protocols from the National Health and Nutrition Examination Survey (Method A, standing with full elbow extended) and the American Society of Hand Therapists (Method B, sitting with elbow flexed at 90°). HGS was analyzed using the maximal value of 2 or 3 repetitions of the dominant hand or 4 or 6 repetitions of both hands. RESULTS The difference in maximal HGS between Method A and Method B might have clinical meaning in approximately half of the participants. When measured using Method A, respective proportions of individuals with differences in HGS between the 6 repetitions group and the other repetition groups beyond the noninferiority threshold were 42%, 20%, and 25% in men and 39%, 21%, and 17% in women. Using Method B, the corresponding percentages were 25%, 18%, and 6% in men, and 27%, 20%, and 5% in women, respectively. Different protocols did not significantly affect the identification of HGS weakness, as different protocols reached diagnostic accuracies of 0.910 to 0.967 in men and 0.911 to 0.986 in women when using Method A (6 repetitions) as the reference standard. However, different protocols significantly affected the identification of HGS asymmetry, as different protocols had diagnostic accuracies of 0.667 to 0.886 in men and 0.658 to 0.863 in women. CONCLUSIONS AND IMPLICATIONS The different protocols recommended by the AWGS 2019 update significantly affect maximal HGS values and the identification of HGS asymmetry but not HGS weakness.
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Affiliation(s)
- Xiaoyan Chen
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Gongxiang Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Siyuan Li
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiufang Lin
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenli Han
- Health Management Department, Shangjin Nanfu Hospital, Sichuan University, Chengdu, China
| | - Xiaoyi Hu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Health Management Department, Shangjin Nanfu Hospital, Sichuan University, Chengdu, China
| | - Jinhui Wu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
| | - Ming Yang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
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Meysami S, Raji CA, Glatt RM, Popa ES, Ganapathi AS, Bookheimer T, Slyapich CB, Pierce KP, Richards CJ, Lampa MG, Gill JM, Rapozo MK, Hodes JF, Tongson YM, Wong CL, Kim M, Porter VR, Kaiser SA, Panos SE, Dye RV, Miller KJ, Bookheimer SY, Martin NA, Kesari S, Kelly DF, Bramen JE, Siddarth P, Merrill DA. Handgrip Strength Is Related to Hippocampal and Lobar Brain Volumes in a Cohort of Cognitively Impaired Older Adults with Confirmed Amyloid Burden. J Alzheimers Dis 2023; 91:999-1006. [PMID: 36530088 PMCID: PMC9912728 DOI: 10.3233/jad-220886] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strength and mobility are essential for activities of daily living. With aging, weaker handgrip strength, mobility, and asymmetry predict poorer cognition. We therefore sought to quantify the relationship between handgrip metrics and volumes quantified on brain magnetic resonance imaging (MRI). OBJECTIVE To model the relationships between handgrip strength, mobility, and MRI volumetry. METHODS We selected 38 participants with Alzheimer's disease dementia: biomarker evidence of amyloidosis and impaired cognition. Handgrip strength on dominant and non-dominant hands was measured with a hand dynamometer. Handgrip asymmetry was calculated. Two-minute walk test (2MWT) mobility evaluation was combined with handgrip strength to identify non-frail versus frail persons. Brain MRI volumes were quantified with Neuroreader. Multiple regression adjusting for age, sex, education, handedness, body mass index, and head size modeled handgrip strength, asymmetry and 2MWT with brain volumes. We modeled non-frail versus frail status relationships with brain structures by analysis of covariance. RESULTS Higher non-dominant handgrip strength was associated with larger volumes in the hippocampus (p = 0.02). Dominant handgrip strength was related to higher frontal lobe volumes (p = 0.02). Higher 2MWT scores were associated with larger hippocampal (p = 0.04), frontal (p = 0.01), temporal (p = 0.03), parietal (p = 0.009), and occipital lobe (p = 0.005) volumes. Frailty was associated with reduced frontal, temporal, and parietal lobe volumes. CONCLUSION Greater handgrip strength and mobility were related to larger hippocampal and lobar brain volumes. Interventions focused on improving handgrip strength and mobility may seek to include quantified brain volumes on MR imaging as endpoints.
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Affiliation(s)
- Somayeh Meysami
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
| | - Ryan M. Glatt
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Emily S. Popa
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Aarthi S. Ganapathi
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Tess Bookheimer
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Colby B. Slyapich
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Kyron P. Pierce
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Casey J. Richards
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Melanie G. Lampa
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Jaya M. Gill
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - Molly K. Rapozo
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
| | - John F. Hodes
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Ynez M. Tongson
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Claudia L. Wong
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Mihae Kim
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Verna R. Porter
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Scott A. Kaiser
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Stella E. Panos
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Richelin V. Dye
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Behavioral Health Institute, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Karen J. Miller
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Susan Y. Bookheimer
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Neil A. Martin
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Santosh Kesari
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Daniel F. Kelly
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Jennifer E. Bramen
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
| | - Prabha Siddarth
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - David A. Merrill
- Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
- Saint John’s Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA
- Providence Saint John’s Health Center, Santa Monica, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Huang X, Alcantara LS, Tan CS, Ng YL, van Dam RM, Hilal S. Handgrip Strength and Cognitive Performance in a Multiethnic Cohort in Singapore. J Alzheimers Dis 2022; 90:1547-1555. [PMID: 36314200 DOI: 10.3233/jad-220531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Handgrip strength (HGS) is an important marker of frailty but there is limited research on lifestyle and vascular determinants of HGS and its relationship with cognitive impairment. OBJECTIVE To identify determinants of HGS and the association of HGS with cognitive impairment in a multiethnic cohort from Singapore. METHODS This study (n = 2,109, median [Q1, Q3] age: 53 [48, 60] years, 59.6% women) was based on cross-sectional data from Singapore Multi-Ethnic Cohort. HGS was collected using hand-held Electronic Dynamometer. The potential determinants of HGS included age, sex, ethnicity, smoking, physical activity, serum cholesterol and history of hypertension, diabetes, and stroke. Cognition, assessed with the Mini-Mental State Examination (MMSE), was analyzed as both continuous and binary outcome (cognitively impaired [scores < 26] and cognitively normal [scores≥26]). RESULTS In total, 239 (11.3%) participants were cognitively impaired. Older age, female sex, Malay or Indian compared with Chinese ethnicity, and diabetes history were associated with decreased HGS, whereas higher education, higher body mass index, and more physical activity were associated with higher HGS. Higher HGS was associated with higher MMSE scores (β: 0.34, 95% CI: 0.20, 0.49) and 37% lower odds of cognitive impairment (OR: 0.63, 95% CI: 0.49-0.82). These associations were significantly stronger in participants who were older (50-90 years), female, of Malay and Indian ethnicity (compared with Chinese), and less educated. CONCLUSION In this multi-ethnic Asian population, demographics, vascular risk factors, and lifestyle behaviors were associated with HGS. Additionally, higher HGS was associated with substantially better cognitive function, which association was modified by age, sex, ethnicity, and education level.
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Affiliation(s)
- Xiangyuan Huang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Leicester Shawn Alcantara
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yi Lin Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Memory Aging and Cognition Center, National University Health System, Singapore
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Afable SB, Cruz G, Saito Y, Malhotra R. Normative values of hand grip strength of older Filipinos aged 60 to 85 years. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Upper Extremity Skeletal Muscle Mass Asymmetry Exacerbated by Shoulder Imbalance in Lenke1A Adolescent Idiopathic Scoliosis. J Clin Med 2022; 11:jcm11237117. [PMID: 36498691 PMCID: PMC9735978 DOI: 10.3390/jcm11237117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/11/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Limb muscle strength asymmetry affects many physical abilities. The present study (1) quantified limb muscle asymmetry in patients with adolescent idiopathic scoliosis (AIS); (2) compared AIS patients with major thoracolumbar/lumbar (TL/L) or major thoracic (MT) curves; (3) examined correlations between limb muscle asymmetry and radiographic parameters. Patients with AIS with major TL/L curves (Lenke type 5C) and MT curves (Lenke Type 1A) who underwent posterior spinal fusion at our university hospitals were included. Patients with left hand dominance were excluded. Body composition was measured using whole-body dual-energy X-ray absorptiometry and asymmetry of left and right side skeletal muscles were evaluated. Upper extremity skeletal muscles on the dominant side were significantly larger than those on the nondominant side in both Lenke1A and 5C groups. The asymmetry of upper extremity skeletal muscles was significantly greater in the Lenke1A group than in the Lenke5C group. Additionally, the size of the asymmetry did not correlate with the magnitude of the major curve and rotational deformation but did correlate with a right shoulder imbalance in the Lenke1A group. These results suggest that in AIS with a constructive thoracic curve, right shoulder imbalance is an independent risk factor for upper extremity skeletal muscle asymmetry.
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Chen KK, Lee SY, Pang BWJ, Lau LK, Jabbar KA, Seah WT, Tou NX, Yap PLK, Ng TP, Wee SL. Associations of low handgrip strength and hand laterality with cognitive function and functional mobility - the Yishun Study. BMC Geriatr 2022; 22:677. [PMID: 35974301 PMCID: PMC9382769 DOI: 10.1186/s12877-022-03363-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Emerging evidence suggest that in addition to low hand grip strength (HGS), HGS asymmetry is associated with declining cognitive and physical functions. We examined the associations of low HGS and asymmetry with cognitive function and functional mobility in older adults. Methods Cross-sectional data of 330 community-dwelling adults (55.2% women) aged ≥ 55 years included HGS, Repeated Battery for the Assessment of Neuropsychological Status (RBANS), and Timed-Up-and-Go (TUG). Low HGS was defined as < 28 kg for men and < 18 kg for women. Participants with HGS above 10% stronger on either hand were considered as having HGS asymmetry. Multiple linear regression models were adjusted for sociodemographic, smoking, education, comorbidity count, physical activity participation, obesity, self-rated health and hand dominance. Results Low HGS, but not asymmetry, was independently associated with lower functional mobility performance (β = 1.3, 95%CI = 0.6,1.9), global cognitive function (β = -10.4, 95%CI = -17.0,-3.8), immediate (β = -2.6, 95%CI = -4.5,-0.7) and delayed (β = -2.8, 95%CI = -5.0,-0.7) memory. Compared to normal and symmetric HGS participants, low HGS in combination with HGS asymmetry was associated with poorer language scores. In participants with normal HGS, asymmetric HGS was associated with slower TUG than corresponding groups with symmetric HGS. Conclusion Low HGS, but not asymmetry, was associated with lower cognition and functional mobility. Associations of combined low HGS and asymmetry with cognitive and physical functions were driven by grip strength rather than asymmetry. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03363-2.
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Affiliation(s)
- Kexun Kenneth Chen
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore.,Adelaide Medical School, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Shuen Yee Lee
- Faculty of Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, 138683, Singapore
| | - Benedict Wei Jun Pang
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Lay Khoon Lau
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Khalid Abdul Jabbar
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Wei Ting Seah
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Nien Xiang Tou
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Philip Lin Kiat Yap
- Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Tze Pin Ng
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore.,Department of Psychological Medicine, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore
| | - Shiou-Liang Wee
- Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Singapore, 768024, Singapore. .,Faculty of Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, 138683, Singapore.
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Lin S, Wang F, Huang Y, Yuan Y, Huang F, Zhu P. Handgrip strength weakness and asymmetry together are associated with cardiovascular outcomes in older outpatients: A prospective cohort study. Geriatr Gerontol Int 2022; 22:759-765. [PMID: 36058626 PMCID: PMC9544274 DOI: 10.1111/ggi.14451] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/27/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
Aim The evaluations of handgrip strength (HGS) weakness and asymmetry have implications for the comprehensive geriatric assessment. The aim of this study was to investigate the association of HGS weakness and asymmetry on cardiovascular outcomes in older outpatients. Methods This was a prospective observational cohort study of 364 Geriatrics outpatients aged ≥60 years, in which all participants carried out HGS tests at baseline. Patients with HGS <28 kg for men and <18 kg for women were diagnosed as HGS weakness, and HGS ratio <0.90 or >1.10 were diagnosed as HGS asymmetry. Primary outcomes defined as the major adverse cardiovascular event and composite end‐points were assessed during a 21‐month median follow‐up. Results Among 364 participants, 155 (42.6%) showed HGS weakness, and 160 (44.0%) showed HGS asymmetry. HGS weakness was associated with major adverse cardiovascular events (HR 2.76, 95% CI 1.22–6.27) and composite end‐points (HR 2.84, 95% CI 1.40–5.77). However, no significant correlation between HGS asymmetry and cardiovascular outcomes was observed. Compared with the normal and symmetric HGS group, older adults with HGS weakness and asymmetry together had a higher risk of major adverse cardiovascular events (HR 5.23, 95% CI 1.56–17.54) and composite end‐points (HR 4.00, 95% CI 1.56–10.28). Conclusions HGS weakness and asymmetry together might increase the risk of cardiovascular outcomes in older outpatients. HGS asymmetry offers complementary information to HGS weakness when making a comprehensive assessment of HGS. Geriatr Gerontol Int 2022; 22: 759–765.
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Affiliation(s)
- Siyang Lin
- Shengli Clinical Medical College of Fujian Medical University Fuzhou China
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
| | - Fang Wang
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
- Fujian Health College Fuzhou China
- Nursing School of Fujian Medical University Fuzhou China
| | - Yanjie Huang
- Shengli Clinical Medical College of Fujian Medical University Fuzhou China
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
- Fujian Provincial Center for Geriatrics Fuzhou China
- Fujian Provincial Key Laboratory of Geriatrics Fuzhou China
| | - Yin Yuan
- Shengli Clinical Medical College of Fujian Medical University Fuzhou China
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
- Fujian Provincial Center for Geriatrics Fuzhou China
- Fujian Provincial Key Laboratory of Geriatrics Fuzhou China
| | - Feng Huang
- Shengli Clinical Medical College of Fujian Medical University Fuzhou China
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
- Fujian Provincial Center for Geriatrics Fuzhou China
- Fujian Provincial Key Laboratory of Geriatrics Fuzhou China
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University Fuzhou China
- Department of Geriatric Medicine Fujian Provincial Hospital Fuzhou China
- Fujian Provincial Center for Geriatrics Fuzhou China
- Fujian Provincial Key Laboratory of Geriatrics Fuzhou China
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Baek J, Kim Y, Kim HY. Associations of Handgrip Asymmetry With Impaired Health-Related Quality of Life Among Older Adults in South Korea: A Cross-Sectional Study Using National Survey Data. Asia Pac J Public Health 2022; 34:649-659. [PMID: 35730491 DOI: 10.1177/10105395221106629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to examine the associations of handgrip strength (HGS) and asymmetry with health-related quality of life among South Korean older adults. We enrolled 7395 older adults from the Korea National Health and Nutrition Examination Survey. Health-related quality of life was measured using the EuroQol-5 Dimension. Weakness was defined as a HGS of <26 kg for men and <18 kg for women. Handgrip strength symmetry was defined as an HGS ratio of 0.9:1.1, and HGS asymmetry was defined as a ratio outside that range. Data were analyzed using the Rao-Scott χ2, F test, and multivariate logistic regression. Compared with those in the "symmetric HGS and not weak" group, those in the "asymmetric HGS and weak" group had impaired health-related quality of life for all variables among men (odds ratios [ORs] = 1.67-3.75, 95% confidence interval [CI] [1.14, 6.27]). A greater risk of impaired self-care (SC; odds ratio [OR] = 2.33, 95% CI [1.67, 3.25]) and anxiety/depression (AD; OR = 1.40, 95% CI [1.04, 1.88]) was observed among women in the "asymmetric HGS and weak" group. Handgrip weakness and asymmetry are associated with impaired health-related quality of life. Handgrip asymmetry can be a clinical marker of health-related quality of life in older adults and must be measured alongside HGS.
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Affiliation(s)
- Jihyun Baek
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Yunmi Kim
- College of Nursing, Eulji University, Seongnam-si, Republic of Korea
| | - Hyun-Young Kim
- Department of Nursing Science, Jeonju University, Jeonju-si, Republic of Korea
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Choi JY, Lee S, Min JY, Min KB. Asymmetrical Handgrip Strength Is Associated with Lower Cognitive Performance in the Elderly. J Clin Med 2022; 11:2904. [PMID: 35629029 PMCID: PMC9144314 DOI: 10.3390/jcm11102904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Several studies have reported that handgrip strength (HGS) may be a sign of lower cognitive performance. However, studies supporting an association between asymmetrical HGS and cognitive function are lacking. This study aimed to determine the association between asymmetrical HGS and cognitive performance among the elderly. (2) Methods: The study sample included 2729 individuals aged ≥60 years-old who participated in the 2011-2014 National Health and Nutrition Examination Survey. The cognitive tests consisted of the word learning and recall modules from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency Test, and Digit Symbol Substitution Test (DSST). HGS was measured using a handgrip dynamometer, and asymmetrical HGS was used to calculate HGS. (3) Results: Of the 2729 participants, 53.0% were aged 60 to 69 years-old, and 47.0% were aged 70 years and older. All cognitive performance scores were significantly correlated with asymmetrical HGS in both age groups. After adjusting for confounders, there was a significant association between DSST and HGS asymmetry in both age groups. Contrastingly, a significant association was only observed for the relationship between the CERAD test and HGS asymmetry in the ≥70 year-old group. (4) Conclusions: We found that low cognitive function was associated with asymmetrical HGS in elderly participants in the United States. Thus, asymmetrical HGS may be an important predictor of cognitive deficits. However, further research is required to confirm our results and to establish possible mechanisms.
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Affiliation(s)
- Ju-Young Choi
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (J.-Y.C.); (S.L.)
| | - Sohyae Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (J.-Y.C.); (S.L.)
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (J.-Y.C.); (S.L.)
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McGrath R, Lang JJ, Ortega FB, Chaput JP, Zhang K, Smith J, Vincent B, Piñero JC, Garcia MC, Tomkinson GR. Handgrip Strength Asymmetry is Associated with Slow Gait Speed and Poorer Standing Balance in Older Americans. Arch Gerontol Geriatr 2022; 102:104716. [DOI: 10.1016/j.archger.2022.104716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022]
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Krupp S, Freiberger E, Renner C, Hofmann W. [Assessment of mobility/motor skills in old age : Based on the S1 guideline "Geriatric assessment level 2, living guideline"]. Z Gerontol Geriatr 2022; 55:239-248. [PMID: 35441870 DOI: 10.1007/s00391-022-02060-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/27/2022] [Indexed: 10/18/2022]
Abstract
In addition to locomotion, mobility also includes any motor performance that serves other purposes and movements that are unplanned. This article presents the instruments mentioned in the S1 guideline "Geriatric assessment level 2, living guideline", as well as additional ones that are less known. The classification is into three categories: instruments that focus on the upper extremities, instruments without performance, which mainly focus on the functions and capabilities of the lower extremities, and those that do this using performance tests.
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Affiliation(s)
- S Krupp
- Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Marlistr. 10, 23566, Lübeck, Deutschland.
| | - E Freiberger
- Institut für Biomedizin des Alterns, FAU Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nürnberg, Deutschland
| | - C Renner
- MediClin Waldkrankenhaus Bad Düben, Gustav-Adolf-Str. 15a, 04849, Bad Düben, Deutschland
| | - W Hofmann
- Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
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Poon PKM, Tam KW, Zhang D, Yip BHK, Woo J, Wong SYS. Handgrip strength but not SARC-F score predicts cognitive impairment in older adults with multimorbidity in primary care: a cohort study. BMC Geriatr 2022; 22:342. [PMID: 35440016 PMCID: PMC9020051 DOI: 10.1186/s12877-022-03034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Assessing motor function is a simple way to track cognitive impairment. We analysed the associations between cognitive and motor function and assessed the predictive value of two motor function measuring tools for cognitive impairment in older adults with multimorbidity in primary care settings. Methods We conducted a prospective cohort study with a 1 year follow-up. Patients aged ≥60 years with ≥2 morbidities were recruited from four primary care clinics. Motor function was assessed using handgrip strength and a sarcopenia screening scale (SARC-F). Cognitive function was measured using the Hong Kong Montreal Cognitive Assessment (HK-MoCA). We defined cognitive impairment as an HK-MoCA score < 22. The associations between cognitive and motor functions were examined from a bidirectional perspective. Results We included 477 participants (mean age 69.4, 68.6% female) with a mean (SD) HK-MoCA score of 25.5 (3.38), SARC-F score of 1.1 (1.36), and handgrip strength of 21.2 (6.99) kg at baseline. Multivariable linear regression models showed bidirectional cross-sectional associations of the HK-MoCA score and cognitive impairment with SARC-F score and handgrip strength at baseline and 1 year. Cox regression revealed a longitudinal association between baseline handgrip strength and cognitive impairment at 1 year (hazard ratio: 0.48, 95% CI 0.33–0.69) but no longitudinal association between SARC-F and cognitive impairment. Variation in the SARC-F score increased with decreasing HK-MoCA score (Brown–Forsythe test F statistic = 17.9, p < 0.001), while variability in the handgrip strength remained small (modified signed-likelihood ratio test, p < 0.001). Conclusions Primary healthcare providers may use handgrip strength to track cognitive function decline in older adults with multimorbidity. However, the SARC-F scale may not have the same predictive value. Further research is needed to evaluate the performance and variability of the SARC-F score in individuals with poor cognitive function. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03034-2.
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Affiliation(s)
- Paul Kwok Ming Poon
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Samuel Yeung Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Chen Z, Ho M, Chau PH. Handgrip strength asymmetry is associated with the risk of neurodegenerative disorders among Chinese older adults. J Cachexia Sarcopenia Muscle 2022; 13:1013-1023. [PMID: 35178892 PMCID: PMC8977973 DOI: 10.1002/jcsm.12933] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/19/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Neurodegenerative disorders, as the irreversible condition, have a long, silent preclinical period. Recognition of early physical signs of neurodegenerative disorders had important practical implications for identifying at-risk population. The aim of this study was to investigate whether handgrip strength (HGS) asymmetry was associated with the incidence of neurodegenerative disorders among Chinese older adults. METHODS This study used the data of participants aged 60 years and over from three waves (2011-2015) of China Health and Retirement Longitudinal Study. HGS asymmetry was measured with HGS ratio (maximal non-dominant HGS/maximal dominant HGS), with the value less than 0.9 or more than 1.1 considered as HGS asymmetry. Physician-diagnosed neurodegenerative disorders were identified by self-reported or proxy-reported information. Competing risk analysis was conducted to examine the association between HGS asymmetry and incident neurodegenerative disorders, with mortality treated as the competing event. RESULTS A total of 4925 participants were included in the analysis [mean (SD) age: 68.1(6.68); female: 49.7%]. Eight hundred and eighty-eight (18.0%) participants had low HGS and 2227 (45.2%) had HGS asymmetry. During the 4 years of follow-up, there were 156 cases of neurodegenerative disorders and 422 cases of mortality. The incidence of neurodegenerative disorders was 8.7 per 1000 person-years [95% confidence interval (CI): 7.4-10.2], and the incidence of mortality was 23.5 per 1000 person-years (95% CI: 21.4-25.9). Both the cause-specific model and the Fine-Gray subdistribution hazard model showed that participants with HGS asymmetry had increased hazard of neurodegenerative disorders [hazard ratio (HR) = 1.66, P = 0.002, 95% CI: 1.202-2.297; subdistribution hazard ratio (SHR) = 1.65, P = 0.002, 95% CI: 1.202-2.285]. Low HGS, but not HGS asymmetry, was related to the higher hazard of mortality (HR = 1.61, P < 0.001, 95% CI: 1.297-1.995; SHR = 1.58, P < 0.001, 95% CI: 1.286-1.951). CONCLUSIONS Handgrip strength asymmetry was associated with the future risk of neurodegenerative disorders among Chinese older adults. Public healthcare providers could consider examining HGS asymmetry along with the maximal HGS as a way to identify those at elevated risk of neurodegenerative disorders.
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Affiliation(s)
- Zi Chen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
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Parker K, Vincent B, Rhee Y, Choi BJ, Robinson-Lane SG, Hamm JM, Klawitter L, Jurivich DA, McGrath R. The estimated prevalence of no reported dementia-related diagnosis in older Americans living with possible dementia by healthcare utilization. Aging Clin Exp Res 2022; 34:359-365. [PMID: 34524654 PMCID: PMC8925882 DOI: 10.1007/s40520-021-01980-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Screening for dementia in relevant healthcare settings may help in identifying low cognitive functioning for comprehensive cognitive assessments and subsequent dementia treatment after diagnosis. AIMS This study sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally-representative sample of older Americans with a cognitive impairment consistent with dementia (CICD) by healthcare utilization. METHODS The unweighted analytical sample included 1514 Americans aged ≥ 65 years that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. An adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores ≤ 6 had a CICD. Dementia-related diagnosis was self-reported. Respondents indicated if they visited a physician, received home healthcare, or experienced an overnight nursing home stay in the previous two years. RESULTS The prevalence of no reported dementia-related diagnosis in persons with a CICD who visited a physician was 89.9% (95% confidence interval (CI): 85.4%-93.1%). Likewise, the prevalence of no reported diagnosis in those with a CICD who received home healthcare was 84.3% (CI: 75.1-90.5%). For persons with a CICD that had an overnight nursing home stay, the prevalence of no reported dementia-related diagnosis was 83.0% (CI: 69.1-91.4%). DISCUSSION Although the prevalence of no reported dementia-related diagnosis in individuals with a CICD differed across healthcare settings, the prevalence was generally high nonetheless. CONCLUSIONS We recommend increased awareness and efforts be given to dementia screenings in various clinical settings.
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Affiliation(s)
- Kelly Parker
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept 2620, PO Box 6050, Fargo, ND 58108, USA
| | - Brenda Vincent
- Department of Statistics, North Dakota State University, Fargo, ND, USA
| | - Yeong Rhee
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept 2620, PO Box 6050, Fargo, ND 58108, USA,Department of Statistics, North Dakota State University, Fargo, ND, USA,Department of Public Health, North Dakota State University, Fargo, ND, USA
| | - Bong-Jin Choi
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept 2620, PO Box 6050, Fargo, ND 58108, USA,Department of Statistics, North Dakota State University, Fargo, ND, USA,Department of Public Health, North Dakota State University, Fargo, ND, USA
| | | | - Jeremy M. Hamm
- Department of Psychology, North Dakota State University, Fargo, ND, USA
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept 2620, PO Box 6050, Fargo, ND 58108, USA
| | - Donald A. Jurivich
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept 2620, PO Box 6050, Fargo, ND, 58108, USA. .,Fargo VA Healthcare System, Fargo, ND, USA.
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Herold F, Labott BK, Grässler B, Halfpaap N, Langhans C, Müller P, Ammar A, Dordevic M, Hökelmann A, Müller NG. A Link between Handgrip Strength and Executive Functioning: A Cross-Sectional Study in Older Adults with Mild Cognitive Impairment and Healthy Controls. Healthcare (Basel) 2022; 10:healthcare10020230. [PMID: 35206845 PMCID: PMC8872145 DOI: 10.3390/healthcare10020230] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/16/2023] Open
Abstract
Older adults with amnestic mild cognitive impairment (aMCI) who in addition to their memory deficits also suffer from frontal-executive dysfunctions have a higher risk of developing dementia later in their lives than older adults with aMCI without executive deficits and older adults with non-amnestic MCI (naMCI). Handgrip strength (HGS) is also correlated with the risk of cognitive decline in the elderly. Hence, the current study aimed to investigate the associations between HGS and executive functioning in individuals with aMCI, naMCI and healthy controls. Older, right-handed adults with amnestic MCI (aMCI), non-amnestic MCI (naMCI), and healthy controls (HC) conducted a handgrip strength measurement via a handheld dynamometer. Executive functions were assessed with the Trail Making Test (TMT A&B). Normalized handgrip strength (nHGS, normalized to Body Mass Index (BMI)) was calculated and its associations with executive functions (operationalized through z-scores of TMT B/A ratio) were investigated through partial correlation analyses (i.e., accounting for age, sex, and severity of depressive symptoms). A positive and low-to-moderate correlation between right nHGS (rp (22) = 0.364; p = 0.063) and left nHGS (rp (22) = 0.420; p = 0.037) and executive functioning in older adults with aMCI but not in naMCI or HC was observed. Our results suggest that higher levels of nHGS are linked to better executive functioning in aMCI but not naMCI and HC. This relationship is perhaps driven by alterations in the integrity of the hippocampal-prefrontal network occurring in older adults with aMCI. Further research is needed to provide empirical evidence for this assumption.
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Affiliation(s)
- Fabian Herold
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Correspondence:
| | - Berit K. Labott
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Bernhard Grässler
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Nicole Halfpaap
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Corinna Langhans
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Patrick Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Achraf Ammar
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Milos Dordevic
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Anita Hökelmann
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Notger G. Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), 39118 Magdeburg, Germany
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Klawitter L, Vincent BM, Choi BJ, Smith J, Hammer KD, Jurivich DA, Dahl LJ, McGrath R. Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans. J Strength Cond Res 2022; 36:106-112. [PMID: 34941610 DOI: 10.1519/jsc.0000000000004166] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
ABSTRACT Klawitter, L, Vincent, BM, Choi, BJ, Smith, J, Hammer, KD, Jurivich, DA, Dahl, LJ, and McGrath, R. Handgrip strength asymmetry and weakness are associated with future morbidity accumulation in americans. J Strength Cond Res 36(1): 106-112, 2022-Identifying strength asymmetries in physically deconditioned populations may help in screening and treating persons at risk for morbidities linked to muscle dysfunction. Our investigation sought to examine the associations between handgrip strength (HGS) asymmetry and weakness on accumulating morbidities in aging Americans. The analytic sample included 18,506 Americans aged ≥50 years from the 2006-2016 Health and Retirement Study. Handgrip strength was measured on each hand with a handgrip dynamometer, and persons with an imbalance in strength >10% between hands had HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered as weak. Subjects reported the presence of healthcare provider-diagnosed morbidities: hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, arthritis, and psychiatric problems. Covariate-adjusted ordinal generalized estimating equations analyzed the associations for each HGS asymmetry and weakness group on future accumulating morbidities. Of those included in our study, subjects at baseline were aged 65.0 ± 10.2 years, 9,570 (51.7%) had asymmetric HGS, and 996 (5.4%) were weak. Asymmetry alone and weakness alone were associated with 1.09 (95% confidence interval [CI]: 1.04-1.14) and 1.27 (CI: 1.11-1.45) greater odds for future accumulating morbidities, respectively. Having both HGS asymmetry and weakness was associated with 1.46 (CI: 1.29-1.65) greater odds for future accumulating morbidities. Handgrip-strength asymmetry, as another potential indicator of impaired muscle function, is associated with future morbidity status during aging. Exercise professionals and related practitioners should consider examining asymmetry and weakness with handgrip dynamometers as a simple and noninvasive screening method for helping to determine muscle dysfunction and future chronic disease risk.
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Affiliation(s)
- Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Brenda M Vincent
- Department of Statistics, North Dakota State University, Fargo, North Dakota
| | - Bong-Jin Choi
- Department of Statistics, North Dakota State University, Fargo, North Dakota
- Department of Public Health, North Dakota State University, Fargo, North Dakota
| | - Joseph Smith
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Kimberly D Hammer
- Fargo Virginia Healthcare System, Fargo, North Dakota
- Department of Internal Medicine, University of North Dakota, Grand Forks, North Dakota; and
| | - Donald A Jurivich
- Department of Geriatrics, University of North Dakota, Grand Forks, North Dakota
| | - Lindsey J Dahl
- Department of Geriatrics, University of North Dakota, Grand Forks, North Dakota
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
- Fargo Virginia Healthcare System, Fargo, North Dakota
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Kim H, Kim SH, Jeong W, Jang SI, Park EC, Kim Y. Association between change in handgrip strength and cognitive function in Korean adults: a longitudinal panel study. BMC Geriatr 2021; 21:671. [PMID: 34852792 PMCID: PMC8638365 DOI: 10.1186/s12877-021-02610-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muscular function, such as handgrip strength, has been suggested as an associated factor for cognitive impairment. This study investigated the association between temporal change in handgrip strength and cognitive function using longitudinal, nationwide data from Korean older adults. METHODS Our study used data from the Korean Longitudinal Study of Aging (KLoSA). The analysis covered 6696 participants who had taken the handgrip strength test and Mini-Mental State Examination (MMSE) from 2006 to 2018. We adopted general estimating equations to assess the temporal effect of handgrip strength change on cognitive function. RESULTS After adjusting for covariates, we observed an association between handgrip strength and low MMSE scores (β = - 0.3142 in men, β = - 0.2685 in women). Handgrip strength as a continuous variable was positively correlated with MMSE scores after adjustment (β = 0.0293 in men, β = 0.0347 in women). The group with decreased handgrip strength over time also showed greater odds for mild cognitive impairment (OR = 1.23, 95%CI = 1.05-1.27 in men, OR = 1.15, 95%CI = 1.05-1.27 in women) and dementia (OR = 1.393, 95%CI = 1.18-1.65 in men, OR = 1.19, 95%CI = 1.08-1.32 in women). CONCLUSIONS This study identified the relationship between handgrip strength change and cognitive function among South Korean adults. According to our large, longitudinal sample, decreasing handgrip strength was associated with decline in cognitive function.
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Affiliation(s)
- Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Wonjeong Jeong
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Youseok Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Hospital administration, Graduate School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Parodi JF, Runzer-Colmenares FM. [Impact of social support on limited mobility in older people in high Andean communities in PeruImpacto do apoio social na mobilidade reduzida em idosos de comunidades do altiplano andino no Peru]. Rev Panam Salud Publica 2021; 45:e88. [PMID: 34475884 PMCID: PMC8369112 DOI: 10.26633/rpsp.2021.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/16/2021] [Indexed: 12/25/2022] Open
Abstract
Objetivo. Determinar si existe relación entre la movilidad física y la falta de soporte social en personas mayores que viven en comunidades altoandinas de Perú. Métodos. Estudio observacional, analítico y retrospectivo a partir de la base de datos de una investigación previa de corte trasversal con información de 449 personas de 60 años o más participantes en el proyecto ANDES-FRAIL. La variable dependiente fue la movilidad, evaluada según el instrumento Short Physical Performance Battery; la variable independiente fue el soporte social, evaluado mediante un ítem del cuestionario de fragilidad de Edmonton. Como covariables se utilizaron parámetros sociodemográficos, comorbilidades, el número de fármacos de consumo habitual y los puntajes recibidos en varios instrumentos: el índice de Barthel para determinar la funcionalidad en personas mayores, el cuestionario de Yesavage para evaluar la depresión en ancianos, entre otros. Se calcularon las frecuencias y los porcentajes de las variables categóricas. Se elaboró un modelo ajustado con las variables que resultaron estadísticamente significativas en el análisis de regresión logística bifactorial. Resultados. La frecuencia de movilidad limitada en la población estudiada fue 58,6% (n = 263) y la de inadecuado soporte social fue 58,1% (n = 261). Los participantes con inadecuado soporte social tuvieron una frecuencia de movilidad limitada del 70,7% (n = 186). Según el modelo de regresión ajustado, el soporte social inadecuado incrementaría en 2,5 veces (IC95%: 1,3-4,5) las probabilidades de tener movilidad limitada, independientemente de las covariables confusoras. Conclusiones. La falta de apoyo social está asociada con la movilidad limitada de las personas mayores que habitan en comunidades altoandinas peruanas.
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Affiliation(s)
- José F Parodi
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martín de Porres Lima Perú Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martín de Porres, Lima, Perú
| | - Fernando M Runzer-Colmenares
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur Lima Perú CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
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Handgrip strength asymmetry is associated with future falls in older Americans. Aging Clin Exp Res 2021; 33:2461-2469. [PMID: 33247424 DOI: 10.1007/s40520-020-01757-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Examining handgrip strength (HGS) asymmetry could extend the utility of handgrip dynamometers for screening future falls. AIMS We sought to determine the associations of HGS asymmetry on future falls in older Americans. METHODS The analytic sample included 10,446 adults aged at least 65 years from the 2006-2016 waves of the Health and Retirement Study. Falls were self-reported. A handgrip dynamometer measured HGS. The highest HGS on each hand was used for determining HGS asymmetry ratio: (non-dominant HGS/dominant HGS). Those with HGS asymmetry ratio < 1.0 had their ratio inverted to make all HGS asymmetry ratios ≥ 1.0. Participants were categorized into asymmetry groups based on their inverted HGS asymmetry ratio: (1) 0.0-10.0%, (2) 10.1-20.0%, (3) 20.1-30.0%, and (4) > 30.0%. Generalized estimating equations were used for the analyses. RESULTS Every 0.10 increase in HGS asymmetry ratio was associated with 1.26 (95% confidence interval (CI) 1.07-1.48) greater odds for future falls. Relative to those with HGS asymmetry 0.0-10.0%, participants with HGS asymmetry > 30.0% had 1.15 (CI 1.01-1.33) greater odds for future falls; however, the associations were not significant for those with HGS asymmetry 10.1-20.0% (odds ratio: 1.06; CI 0.98-1.14) and 20.1-30.0% (odds ratio: 1.10; CI 0.99-1.22). Compared to those with HGS asymmetry 0.0-10.0%, participants with HGS asymmetry > 10.0% and > 20.0% had 1.07 (CI 1.01-1.16) and 1.12 (CI 1.02-1.22) greater odds for future falls, respectively. DISCUSSION Asymmetric HGS, as a possible biomarker of impaired neuromuscular function, may help predict falls. CONCLUSIONS We recommend that HGS asymmetry be considered in HGS protocols and fall risk assessments.
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Liu M, Liu S, Sun S, Tian H, Li S, Wu Y. Sex Differences in the Associations of Handgrip Strength and Asymmetry With Multimorbidity: Evidence From the English Longitudinal Study of Ageing. J Am Med Dir Assoc 2021; 23:493-498.e1. [PMID: 34389337 DOI: 10.1016/j.jamda.2021.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine the sex-specific associations of handgrip strength (HGS) and asymmetry with incident multimorbidity and examine whether these relationships differ by sex. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS Secondary analyses of data from the English Longitudinal Study of Ageing (ELSA, waves 2-8). The analytic sample included 3977 participants (51.4% female) aged ≥50 years who had data for HGS on both hands and were living without multimorbidity at baseline. MEASURES HGS was assessed with a handheld dynamometer. Individuals in the lowest tertile of sex-specific age-adjusted HGS were defined as having low HGS. The largest HGS readings from the nondominant and dominant hand were used to calculate HGS ratio [nondominant HGS (kg)/dominant HGS (kg)]. Those with HGS ratio <0.90 or >1.10 had any HGS asymmetry. Further, those with HGS ratio <0.90 had dominant HGS asymmetry, whereas those with HGS ratio >1.10 had nondominant HGS asymmetry. Multimorbidity was defined as the coexistence of ≥2 chronic diseases. Cox proportional hazards regression models were conducted for analyses. RESULTS Low HGS was associated with multimorbidity among older men [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.03-1.40] and women (HR 1.19, 95% CI 1.03-1.38). No significant effect modification by sex was observed (P-interaction = .71). HGS asymmetry increased the risk of multimorbidity in women only (HR 1.23, 95% CI 1.07-1.41). The relationship between HGS asymmetry and multimorbidity risk differed by sex (P-interaction = .01). Similarly, both dominant HGS asymmetry (HR 1.21, 95% CI 1.05-1.40) and nondominant HGS asymmetry (HR 1.32, 95% CI 1.03-1.68) were related to incident multimorbidity in women only. There was a significant interaction between dominant HGS asymmetry and sex (P-interaction = .02). CONCLUSIONS AND IMPLICATIONS Examining HGS asymmetry in HGS test protocols can provide novel insights for the predictive power of HGS in the accumulation of diseases, particularly in women.
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Affiliation(s)
- Mengli Liu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Shuqin Liu
- Department of Emergency, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shuqin Sun
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Huimin Tian
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Suyun Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China.
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Lu S, Herold F, Zhang Y, Lei Y, Kramer AF, Jiao C, Yu Q, Doig S, Li J, Yan Z, Kuang J, Wang T, Zou L. Higher Handgrip Strength Is Linked to Better Cognitive Performance in Chinese Adults with Hypertension. Brain Sci 2021; 11:brainsci11080985. [PMID: 34439604 PMCID: PMC8391417 DOI: 10.3390/brainsci11080985] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023] Open
Abstract
Objective: There is growing evidence that in adults, higher levels of handgrip strength (HGS) are linked to better cognitive performance. However, the relationship between HGS and cognitive performance has not been sufficiently investigated in special cohorts, such as individuals with hypertension who have an intrinsically higher risk of cognitive decline. Thus, the purpose of this study was to examine the relationship between HGS and cognitive performance in adults with hypertension using data from the Global Ageing and Adult Health Survey (SAGE). Methods: A total of 4486 Chinese adults with hypertension from the SAGE were included in this study. Absolute handgrip strength (aHGS in kilograms) was measured using a handheld electronic dynamometer, and cognitive performance was assessed in the domains of short-term memory, delayed memory, and language ability. Multiple linear regression models were fitted to examine the association between relative handgrip strength (rHGS; aHGS divided by body mass index) and measures of cognitive performance. Results: Overall, higher levels of rHGS were associated with higher scores in short-term memory (β = 0.20) and language (β = 0.63) compared with the lowest tertiles of rHGS. In male participants, higher HGS was associated with higher scores in short-term memory (β = 0.31), language (β = 0.64), and delayed memory (β = 0.22). There were no associations between rHGS and cognitive performance measures in females. Conclusion: We observed that a higher level of rHGS was associated with better cognitive performance among hypertensive male individuals. Further studies are needed to investigate the neurobiological mechanisms, including sex-specific differences driving the relationship between measures of HGS and cognitive performance in individuals with hypertension.
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Affiliation(s)
- Shenghua Lu
- Hunan Academy of Education Sciences, Changsha 225002, China;
- College of Sports Science, Jishou University, Jishou 416000, China
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany;
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen 518172, China
- Correspondence: (Y.Z.); (Y.L.)
| | - Yuruo Lei
- Institute of Urban Governance, Shenzhen University, Shenzhen 518060, China
- Correspondence: (Y.Z.); (Y.L.)
| | - Arthur F. Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA;
- Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Can Jiao
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Qian Yu
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Scott Doig
- Department of Physical Education, Limestone University, Gaffney, SC 29340, USA;
| | - Jinming Li
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Zhe Yan
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Jin Kuang
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Ting Wang
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Liye Zou
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
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Go YJ, Lee DC, Lee HJ. Association between handgrip strength asymmetry and falls in elderly Koreans: A nationwide population-based cross-sectional study. Arch Gerontol Geriatr 2021; 96:104470. [PMID: 34243024 DOI: 10.1016/j.archger.2021.104470] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/07/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to investigate the association between handgrip strength (HGS) asymmetry and fall risk in elderly Koreans. METHODS This study used data from the 2016-2018 Korea National Health and Nutrition Examination Survey. A total of 3407 participants aged ≥ 65 years were included. HGS asymmetry was defined as an HGS asymmetry ratio (nondominant HGS/dominant HGS) of ≥ 1.2 or ≤ 0.8. The presence of a fall was defined as a self-reported fall event that needed treatment at a hospital or emergency department in the previous year. Multivariate logistic regression analysis was performed to analyze the association between HGS asymmetry and fall risk. RESULTS The odds ratio for falls was 1.89 times higher in the group with HGS asymmetry than in the group without HGS asymmetry after adjusting for age, sex, multimorbidity, obesity, current smoking, alcohol drinking, and physical exercise (95% confidence interval, 1.03-3.49; P < 0.05). CONCLUSIONS This study revealed that HGS asymmetry is significantly associated with an increased risk of falls in the Korean elderly population. Therefore, early identification and treatment of HGS asymmetry in the elderly could reduce the incidence of falls and be a potential preventive strategy.
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Affiliation(s)
- Young Joo Go
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Duk Chul Lee
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Hye Jun Lee
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea.
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