Abstract
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity—a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO’s Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.
Highlights
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults
We found a stronger effect of wealth in young old ages of 50–60 among men, but this effect narrowed with older ages over 60, supporting literature that suggests the role of mortality selection and age-as-leveller hypothesis that socioeconomic differences in health weakens with a ge[43,44]
Our results suggest on one hand, handgrip strength is an important measure of overall intrinsic capacity, and on the other, approaches to improve handgrip strength such as through interventions that improve nutritional status that reach all older adults who would benefit, are important for longevity, increasing equity, and promoting healthy a geing[46]
Summary
A measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. Muscle weakness was found to be associated with lower cognitive c apacity[7,8,9,10], poor psychological outcomes such as geriatric depression, mood and sleep quality and depressive symptoms[11,12], and as noted, reduced overall intrinsic c apacity[13], including one measure of locomotor capacity, namely gait s peed[14] It is associated with difficulties in activities of daily living[10], increased hospitalisation[13] and overall higher burden of premature morbidity and mortality in older a dults[15,16]. A few studies conducted in LMICs showed significant association of handgrip strength with single domains of IC, such as cognition, psychological capacity (includes depression), and other health-related outcomes including mortality. Another study conducted in rural Ghana showed a significant association between weaker handgrip strength and higher mortality among older adults aged 50 and a bove[19]
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