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      Hand Grip Strength: age and gender stratified normative data in a population-based study

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          Abstract

          Background

          The North West Adelaide Health Study is a representative longitudinal cohort study of people originally aged 18 years and over. The aim of this study was to describe normative data for hand grip strength in a community-based Australian population. Secondary aims were to investigate the relationship between body mass index (BMI) and hand grip strength, and to compare Australian data with international hand grip strength norms.

          Methods

          The sample was randomly selected and recruited by telephone interview. Overall, 3 206 (81% of those recruited) participants returned to the clinic during the second stage (2004-2006) which specifically focused on the collection of information relating to musculoskeletal conditions.

          Results

          Following the exclusion of 435 participants who had hand pain and/or arthritis, 1366 men and 1312 women participants provided hand grip strength measurement. The study population was relatively young, with 41.5% under 40 years; and their mean BMI was 28.1 kg/m 2 (SD 5.5). Higher hand grip strength was weakly related to higher BMI in adults under the age of 30 and over the age of 70, but inversely related to higher BMI between these ages. Australian norms from this sample had amongst the lowest of the hand grip strength of the internationally published norms, except those from underweight populations.

          Conclusions

          This population demonstrated higher BMI and lower grip strength in younger participants than much of the international published, population data. A complete exploration of the relationship between BMI and hand grip strength was not fully explored as there were very few participants with BMI in the underweight range. The age and gender grip strength values are lower in younger adults than those reported in international literature.

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          Most cited references27

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          Hand-grip dynamometry predicts future outcomes in aging adults.

          One use of clinical measures is the prediction of future outcomes. The purpose of this systematic review was to summarize the literature addressing the value of grip strength as a predictor of important outcomes. Relevant literature was located using 4 bibliographic databases, searching article reference lists, and perusing personal files. Forty-five relevant research articles were found. The research involved both healthy subjects and patients; it tended to focus on middle-aged and older adults. The primary outcome addressed was mortality/survival (24 articles), but disability (9 articles), complications and/or increased length of stay (12 articles), and other outcomes were also examined. Low grip strength was shown consistently to be associated with a greater likelihood of premature mortality, the development of disability, and an increased risk of complications or prolonged length of stay after hospitalization or surgery. Given its predictive validity and simplicity, dynamometrically measured grip strength should be considered as a vital sign useful for screening middle-aged and older adults.
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            Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism.

            To examine the association between muscle strength and total and cause-specific mortality and the plausible contributing factors to this association, such as presence of diseases commonly underlying mortality, inflammation, nutritional deficiency, physical inactivity, smoking, and depression. Prospective population-based cohort study with mortality surveillance over 5 years. Elderly women residing in the eastern half of Baltimore, Maryland, and part of Baltimore County. Nine hundred nineteen moderately to severely disabled women aged 65 to 101 who participated in handgrip strength testing at baseline as part of the Women's Health and Aging Study. Cardiovascular disease (CVD), cancer, respiratory disease, other measures (not CVD, respiratory, or cancer), total mortality, handgrip strength, and interleukin-6. Over the 5-year follow-up, 336 deaths occurred: 149 due to CVD, 59 due to cancer, 38 due to respiratory disease, and 90 due to other diseases. The unadjusted relative risk (RR) of CVD mortality was 3.21 (95% confidence interval (CI) = 2.00-5.14) in the lowest and 1.88 (95% CI = 1.11-3.21) in the middle compared with the highest tertile of handgrip strength. The unadjusted RR of respiratory mortality was 2.38 (95% CI = 1.09-5.20) and other mortality 2.59 (95% CI = 1.59-4.20) in the lowest versus the highest grip-strength tertile. Cancer mortality was not associated with grip strength. After adjusting for age, race, body height, and weight, the RR of CVD mortality decreased to 2.17 (95% CI = 1.26-3.73) in the lowest and 1.56 (95% CI = 0.89-2.71) in the middle, with the highest grip-strength tertile as the reference. Further adjustments for multiple diseases, physical inactivity, smoking, interleukin-6, C-reactive protein, serum albumin, unintentional weight loss, and depressive symptoms did not materially change the risk estimates. Similar results were observed for all-cause mortality. In older disabled women, handgrip strength was a powerful predictor of cause-specific and total mortality. Presence of chronic diseases commonly underlying death or the mechanisms behind decline in muscle strength in chronic disease, such as inflammation, poor nutritional status, disuse, and depression, all of which are independent predictors of mortality, did not explain the association. Handgrip strength, an indicator of overall muscle strength, may predict mortality through mechanisms other than those leading from disease to muscle impairment. Grip strength tests may help identify patients at increased risk of deterioration of health.
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              Is grip strength a useful single marker of frailty?

              chronological age is widely used as a marker of frailty in clinical practice. However there can be wide variation in frailty between individuals of a similar age. Grip strength is a powerful predictor of disability, morbidity and mortality which has been used in a number of frailty scores but not as a single marker of frailty. to investigate the potential of grip strength as a single marker of frailty in older people of similar chronological age. cross-sectional study with prospective collection of mortality data. North Hertfordshire, UK. 717 men and women, aged 64-74, born and still living in North Hertfordshire, who took part in a previous study to investigate the relationship between size at birth and ageing processes in later life. the number of significant associations between grip strength and the ageing markers was compared with numbers between chronological age and the ageing markers. in men, lower grip strength correlated significantly with ten ageing markers compared to chronological age which was significantly associated with seven. In women, there were six significant relationships for grip compared to three for age. The greater number of relationships between grip strength and ageing markers was not explained by the association between grip strength and age, and remained after adjustment for adult size. grip strength was associated with more markers of frailty than chronological age within the narrow age range studied. Grip strength may prove a more useful single marker of frailty for older people of similar age than chronological age alone. Its validity in a clinical setting needs to be tested.
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                Author and article information

                Journal
                BMC Res Notes
                BMC Research Notes
                BioMed Central
                1756-0500
                2011
                14 April 2011
                : 4
                : 127
                Affiliations
                [1 ]University of South Australia, School of Health Sciences Adelaide, South Australia SA 5000, Australia
                [2 ]Population Research and Outcome Studies Unit, Department of Health, Adelaide, South Australia, Australia
                [3 ]Department of Medicine, University of Adelaide, Adelaide, South Australia SA 5000, Australia
                [4 ]Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
                [5 ]Rheumatology Unit, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville South Australia 5011, Australia
                [6 ]The Health Observatory, University of Adelaide, Adelaide, South Australia SA 5000, Australia
                Article
                1756-0500-4-127
                10.1186/1756-0500-4-127
                3101655
                21492469
                94d011eb-9c20-4949-ac42-16fee509396e
                Copyright ©2011 Massy-Westropp et al; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 October 2010
                : 14 April 2011
                Categories
                Research Article

                Medicine
                Medicine

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