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      Importance of Handgrip Strength as a Health Indicator in the Elderly

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      Korean Journal of Family Medicine
      Korean Academy of Family Medicine

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          Abstract

          See original paper on 38 A decline in physical function is a natural phenomenon associated with aging. However, as it is also associated with an increased risk of falls, health care use, levels of dependence, and premature death [1], it is a major public health issue. Handgrip strength (HGS) is a commonly used measure of physical function. In recent years, there has been an increase in literature investigating the association between HGS and health outcomes. There are reports of a correlation between HGS and dyslipidemia [2], cognitive function [3], and diabetes. Most of the studies to date have addressed a single disease endpoint; some studies report an association between baseline HGS and mortality risk. However, there are few studies on the relationship between the degree of change in HGS and the risk of mortality. Additionally, there are no studies conducted on a Korean population. In the present issue, Bae et al. [3] investigated the association between HGS and mortality among older adults in Korea. In particular, this study investigated the trajectories of HGS using the 2006–2016 Korean Longitudinal Study of Aging. The results of the study revealed that, compared with the highest HGS group, the adjusted hazard ratio of all-cause-mortality in the group with the lowest HGS was 3.46 (95% confidence interval [CI], 2.17–6.69) in men, and 2.69 (95% CI, 1.39–5.21) in women. In addition, the authors identified four distinct trajectory groups of HGS among men, and three among women. In both men and women, the risk of mortality was inversely proportional to the HGS. As the risk of all-cause mortality in both men and women, increased with rapid decline in hand grip strength, it may be inferred that measuring HSG in the elderly is helpful in measuring health status. A sedentary life style has been suggested as one of the factors related to a decline in HGS [4]. However, a clear mechanism to explain the relevance of HGS scores to these health outcomes has not been elucidated. In order to implement intervention programs, further research may be required.

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          Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies

          • We carried out an umbrella review of systematic reviews with meta-analyses of observational studies on handgrip strength and all health outcomes. • Three outcomes (lower all-cause mortality, lower cardiovascular mortality, and lower risk of disability) were found to have highly suggestive evidence. • One outcome (chair rise performance over time) was found to have suggestive evidence. • Five outcomes (walking speed, inability to balance, hospital admissions, cardiac death, and mortality in those with chronic kidney disease) were found to have weak evidence. Purpose The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes. Methods An umbrella review of systematic reviews with meta-analyses of observational studies was conducted. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV). Results From 504 articles returned in a search of the literature, 8 systematic reviews were included in our review, with a total of 11 outcomes. Overall, nine of the 11 of the outcomes reported nominally significant summary results ( p < 0.05), with 4 associations surviving the application of the more stringent p value ( p  < 10 −6 ). No outcome presented convincing evidence. Three associations showed Class II evidence (i.e., highly suggestive): (1) higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population ( n  = 34 studies; sample size = 1,855,817; relative risk = 0.72, 95% confidence interval (95%CI): 0.67–0.78), (2) cardiovascular death risk in mixed populations ( n  = 15 studies; relative risk = 0.84, 95%CI: 0.78–0.91), and (3) incidence of disability ( n  = 7 studies; relative risk = 0.76, 95%CI: 0.66–0.87). Conclusion The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality, as well as disability. To further inform intervention strategies, future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.
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            Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014–2015 Korea National Health and Nutrition Examination Survey

            Background Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia. Methods We included 6,027 adults (2,934 men, 3,093 women) aged 30–69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia. Results After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00–1.83), 1.29 (0.98–1.70), 1.23 (0.95– 1.60) in men and 1.81 (1.30–2.50), 1.81 (1.32–2.47), 1.39 (1.07–1.81) in women, respectively. Conclusion Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.
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              Relationship between Sedentary Time and Handgrip Strength in Healthy Korean Women: Korea National Health and Nutrition Examination Survey 2014–2016

              Background This study aimed to examine the association between sitting time and handgrip strength in healthy Korean women. Methods A total of 5,437 participants were included from the Korea National Health and Nutrition Examination Survey 2014–2016. The overall daily sitting time was estimated using health interview surveys, and handgrip strength was assessed using a digital hand dynamometer. The relationship between sitting time and handgrip strength was calculated with a weighted analysis of covariance after adjusting for confounding variables. Results Participants in each age group (19–39, 40–64, ≥65 years) were divided into three categories according to sitting time: ≤5, 6–9, and ≥10 h/d. The handgrip strength tended to decrease as sitting time increased after adjusting for age, body mass index, alcohol intake, cigarette smoking, resistance exercise, aerobic physical activity, household income, education level, hypertension, diabetes mellitus, dyslipidemia, and depression in all age groups (all P<0.001). Conclusion We observed the inverse relationship between sitting time and handgrip strength in healthy Korean women.
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                Author and article information

                Journal
                Korean J Fam Med
                Korean J Fam Med
                KJFM
                Korean Journal of Family Medicine
                Korean Academy of Family Medicine
                2005-6443
                2092-6715
                January 2021
                20 January 2021
                : 42
                : 1
                : 1
                Affiliations
                Department of Family Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
                Author notes
                [* ]Corresponding Author: Soo Young Kim Tel: +82-2-2224-2409, Fax: +82-2-2224-2409, E-mail: hallymfm@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-3205-9408
                Article
                kjfm-42-1E
                10.4082/kjfm.42.1E
                7884897
                33524249
                bfa75719-dc01-4efa-a1a4-f20c9a5970dd
                Copyright © 2021 The Korean Academy of Family Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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