Abstract
Older individuals' handgrip strength is a predictor of functional health and their self-perceptions of health may influence functional health and disability. Hence, the study explored the associations between handgrip strength and self-reported functional difficulties in activities of daily living (ADL) and instrumental ADL (IADL) among older adults. The study also explored the moderation and mediation effects of self-rated health (SRH) in those associations. Data for the study were drawn from the baseline survey of Longitudinal Ageing Study in India (LASI, 2017-18). This study was conducted on respondents aged 60years and above with a total sample of 27,707 older adults (men-13,199 and women-14,508). The study assessed handgrip strength using a handheld Smedley's Hand Dynamometer with a cut-off of 19.5kg for males and 12.5kg for females. Moderated multivariable regression models and the Karlson-Holm-Breen (KHB) method adjusting for many confounders, were used to explore the moderation and mediation effects of SRH in the association of handgrip strength and functional difficulties. A proportion of 25.80% of men and 26.24% of women of our sample had weak grip strength. A large proportion of older persons experienced difficulty in ADL (23.77%) and IADL (48.36%) in the study. Older adults with weak handgrip strength had higher odds of suffering from functional difficulties in ADL [adjusted odds ratio (aOR): 1.34; 95% confidence interval (CI):1.14-1.57] and IADL [aOR: 1.38; 95%CI: 1.18-1.60] than older adults with strong handgrip. Older adults who had weak handgrip strength and poor SRH had higher odds of difficulty in ADL [aOR: 2.72; 95%CI: 1.61-3.22] and IADL [aOR: 1.87; CI: 1.28-2.74] compared to those with strong handgrip and good SRH. Further, the association between handgrip strength and functional health was mediated by SRH (percent effect mediated: 26% for ADL and 16.84% for IADL). The findings provide further evidence that handgrip strength is connected with the disabling process and moderating and mediating role of SRH in these associations suggest that enhancement of self-perceptions of health among older adults may help prevent ADL and IADL-related issues in the later phase of life.
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