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      Reference values for handgrip strength and their association with intrinsic capacity domains among older adults

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          Abstract

          Objective

          The purposes of this study were three‐fold: (i) to describe handgrip strength in older individuals aged ≥60 years in Colombia; (ii) to identify sex‐specific and age‐specific muscle weakness cut‐off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut‐off points, as compared with their weaker counterparts.

          Methods

          A cross‐sectional study was conducted in Colombia, among 5237 older adults aged ≥60 years old (58.5% women, 70.5 ± 7.8 years), according to ‘SABE Survey 2015’. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio‐economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co‐morbid chronic diseases. Sex‐stratified analyses were conducted with logistic regression models.

          Results

          Handgrip strength was greater among men than among women (26.7 ± 8.5 vs. 16.7 ± 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut‐off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts.

          Conclusions

          This study is the first to describe handgrip strength values and cut‐off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut‐off points, non‐weakness was associated with a decreased odds of intrinsic capacity impairments. These cut‐off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.

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          Most cited references43

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          Dementia prevention, intervention, and care

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            Physical performance measures in the clinical setting.

            To assess the ability of gait speed alone and a three-item lower extremity performance battery to predict 12-month rates of hospitalization, decline in health, and decline in function in primary care settings serving older adults. Prospective cohort study. Primary care programs of a Medicare health maintenance organization (HMO) and Veterans Affairs (VA) system. Four hundred eighty-seven persons aged 65 and older. Lower extremity performance Established Population for Epidemiologic Studies of the Elderly (EPESE) battery including gait speed, chair stands, and tandem balance tests; demographics; health care use; health status; functional status; probability of repeated admission scale (Pra); and primary physician's hospitalization risk estimate. Veterans had poorer health and higher use than HMO members. Gait speed alone and the EPESE battery predicted hospitalization; 41% (21/51) of slow walkers (gait speed 1.0 m/s) (P <.0001). The relationship was stronger in the HMO than in the VA. Both performance measures remained independent predictors after accounting for Pra. The EPESE battery was superior to gait speed when both Pra and primary physician's risk estimate were included. Both performance measures predicted decline in function and health status in both health systems. Performance measures, alone or in combination with self-report measures, were more able to predict outcomes than self-report alone. Gait speed and a physical performance battery are brief, quantitative estimates of future risk for hospitalization and decline in health and function in clinical populations of older adults. Physical performance measures might serve as easily accessible "vital signs" to screen older adults in clinical settings.
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              Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants

              Abstract Objective To investigate the association of grip strength with disease specific incidence and mortality and whether grip strength enhances the prediction ability of an established office based risk score. Design Prospective population based study. Setting UK Biobank. Participants 502 293 participants (54% women) aged 40-69 years. Main outcome measures All cause mortality as well as incidence of and mortality from cardiovascular disease, respiratory disease, chronic obstructive pulmonary disease, and cancer (all cancer, colorectal, lung, breast, and prostate). Results Of the participants included in analyses, 13 322 (2.7%) died over a mean of 7.1 (range 5.3-9.9) years’ follow-up. In women and men, respectively, hazard ratios per 5 kg lower grip strength were higher (all at P<0.05) for all cause mortality (1.20, 95% confidence interval 1.17 to 1.23, and 1.16, 1.15 to 1.17) and cause specific mortality from cardiovascular disease (1.19, 1.13 to 1.25, and 1.22, 1.18 to 1.26), all respiratory disease (1.31, 1.22 to 1.40, and 1.24, 1.20 to 1.28), chronic obstructive pulmonary disease (1.24, 1.05 to 1.47, and 1.19, 1.09 to 1.30), all cancer (1.17, 1.13 to 1.21, 1.10, 1.07 to 1.13), colorectal cancer (1.17, 1.04 to 1.32, and 1.18, 1.09 to 1.27), lung cancer (1.17, 1.07 to 1.27, and 1.08, 1.03 to 1.13), and breast cancer (1.24, 1.10 to 1.39) but not prostate cancer (1.05, 0.96 to 1.15). Several of these relations had higher hazard ratios in the younger age group. Muscle weakness (defined as grip strength <26 kg for men and <16 kg for women) was associated with a higher hazard for all health outcomes, except colon cancer in women and prostate cancer and lung cancer in both men and women. The addition of handgrip strength improved the prediction ability, based on C index change, of an office based risk score (age, sex, diabetes diagnosed, body mass index, systolic blood pressure, and smoking) for all cause (0.013) and cardiovascular mortality (0.012) and incidence of cardiovascular disease (0.009). Conclusion Higher grip strength was associated with a range of health outcomes and improved prediction of an office based risk score. Further work on the use of grip strength in risk scores or risk screening is needed to establish its potential clinical utility.

                Author and article information

                Contributors
                robin640@hotmail.com
                Journal
                J Cachexia Sarcopenia Muscle
                J Cachexia Sarcopenia Muscle
                10.1007/13539.2190-6009
                JCSM
                Journal of Cachexia, Sarcopenia and Muscle
                John Wiley and Sons Inc. (Hoboken )
                2190-5991
                2190-6009
                06 March 2019
                April 2019
                : 10
                : 2 ( doiID: 10.1002/jcsm.v10.2 )
                : 278-286
                Affiliations
                [ 1 ] Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud Universidad del Rosario Bogotá, D.C. Colombia
                [ 2 ] Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud Universidad de Santiago de Chile, USACH Santiago Chile
                [ 3 ] Instituto de Envejecimiento, Semillero de Neurociencias y Envejecimiento, Facultad de Medicina Pontificia Universidad Javeriana, Hospital Universitario San Ignacio Bogotá Colombia
                [ 4 ] Department of Health Sciences, Navarrabiomed, CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Pamplona Public University of Navarre Navarre Spain
                Author notes
                [*] [* ]Correspondence to: Robinson Ramírez‐Vélez, Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Cra. 24 No. 63C‐69, Bogotá, D.C., Colombia. Phone: +57 (1) 2970200 ext. 3428, Email: robin640@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0003-3075-6960
                https://orcid.org/0000-0002-0646-2316
                https://orcid.org/0000-0002-1397-7182
                https://orcid.org/0000-0001-5680-7880
                https://orcid.org/0000-0002-1506-4272
                Article
                JCSM12373 JCSM-D-18-00225
                10.1002/jcsm.12373
                6463468
                30843369
                5bd99d84-657c-4d74-b4af-5c37397c4103
                © 2019 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 12 July 2018
                : 03 November 2018
                Page count
                Figures: 2, Tables: 3, Pages: 9, Words: 3614
                Funding
                Funded by: Colciencias y Ministerio de Salud y la Protección Social de Colombia
                Funded by: Mikel Izquierdo is funded by ISCIII and Fondos FEDER
                Award ID: PI17/01814
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                jcsm12373
                April 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.2.1 mode:remove_FC converted:15.04.2019

                Orthopedics
                skeletal muscle,handgrip,older adults,locomotion,vitality,cognition,mental health
                Orthopedics
                skeletal muscle, handgrip, older adults, locomotion, vitality, cognition, mental health

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