Handgrip Strength Asymmetry Research Articles

Short sleeping duration is associated with a higher risk of asymmetric handgrip strength among older Chinese males: a cross-sectional study evidence from the China health and retirement longitudinal study.

This study aimed to explore the potential correlation between sleeping duration and the risk of handgrip strength (HGS) asymmetry in older Chinese adults. The data of participants (65+ years of age) were obtained from the first Wave 1 (2011) of the China Health and Retirement Longitudinal Study (CHARLS). Information on sleeping duration during the previous month was collected from self-reports and was divided into three groups: long (>8 h), normal (6-8 h), and short (< 6 h). HGS was computed as the average of two tests per hand and asymmetric HGS was diagnosed when the ratio of average non-dominant to average dominant HGS was greater than 1.1 or less than 0.9. Logistic regression analyses were employed to gauge the relationship between sleeping duration and asymmetric HGS risk. In total, 3,174 participants were enrolled in this analysis, of whom 51.54% (1,636/3,174) were male. The proportions of asymmetric HGS were 42.18% in males and 41.87% in females. The sleeping duration (hours) in the asymmetric and non-asymmetric HGS groups were 6 h (5,8) and 7 h (5,8) in males with a significant difference between them (p = 0.015), and 6 h (5,8) and 6 h (5,8) in females with no significant difference (p = 0.415). Compared with non-asymmetric HGS individuals, the proportions of normal, short, and long sleeping duration were 40.4, 47.3, and 37.7% in males with a significant difference (p = 0.023), and 42.4, 40.3, and 43.8% in females with no significant differences (p = 0.685). An adjusted logistic regression analysis model confirmed that short sleeping duration was significantly associated with asymmetric HGS risk among older males (p = 0.048, OR = 1.252, 95%CI:1.002-1.565). The results demonstrated that short sleeping duration (<6 h) was a risk factor for increased HGS asymmetry among older Chinese males.

The relationship between low handgrip strength with or without asymmetry and fall risk among middle-aged and older males in China: evidence from the China Health and Retirement Longitudinal Study.

This study sought to explore the potential correlation between low handgrip strength (HGS) with or without asymmetry and fall risk in middle-aged and older Chinese adults. Baseline characteristic data from participants 45+ years of age and data regarding fall events collected from two rounds (2011-2013) of the China Health and Retirement Longitudinal Study were utilized for the present analyses. HGS and HGS asymmetry was defined according to the updated American Society of Hand Therapist. Fall events were identified through self- or proxy-reported details. Logistic regression analyses were employed to gauge the potential relationship between abnormal HGS and fall risk. In total, 10 563 participants were enrolled in this analysis, of whom 47.49% (5016/10 563) were male. The proportions of low HGS alone, HGS asymmetry alone, and low HGS with asymmetry were 22.23%, 18.34%, and 22.75%, respectively, in males, but just 3.64%, 35.12%, and 6.62% in females. A total of 693 and 1019 fall events were recorded for male (13.82%) and female (18.37%) participants over the 2-year follow-up period, respectively. Significant differences in fall event incidence among different HGS groups were only observed among males. An adjusted logistic regression analysis model confirmed that low HGS with dominant asymmetry was closely related to fall risk among middle-aged and older males [P = 0.014, odds ratio = 1.332, 95% confidence interval: 1.059-1.676). These results demonstrated that low HGS with dominant asymmetry is a risk factor linked to increased fall risk among middle-aged and older Chinese males. What is already known on this topic Low HGS or HGS asymmetry is been reported to be linked to an increased risk of falls in middle-aged and older adults; however, little is known about the association between fall risk and low HGS and/or HGS asymmetry. Main messages The prevalence of low HGS alone and low HGS asymmetry in men was significantly higher than in women, while HGS alone asymmetry was more common in women than men. The risk factor for the increased risk of falls in Chinese middle-aged and older men is low and asymmetric HGS, rather than low or asymmetric HGS alone. Low HGS with dominant asymmetry rather than nondominant asymmetry is associated with future fall risk among middle-aged and older Chinese males. Current research questions What is the mechanism for the significant difference in the proportion of abnormal HGS components between the sexes? If female subjects with low HGS and asymmetric HGS were added, would an association be observed between low HGS and asymmetric HGS falls? Is there an association between the severity of asymmetric HGS with weakness and falls?

Handgrip strength asymmetry as a new biomarker for sarcopenia and individual sarcopenia signatures

BackgroundAlthough handgrip strength (HGS) asymmetry has clinical screening utility, its relevance to sarcopenia is unknown. This study examined the relationship between HGS asymmetry and sarcopenia signatures, and explored the relevance of circulating neural/neuromuscular markers.Methods9403 individuals aged 18–92 years participated in this study. Maximal HGS and skeletal muscle index (SMI) were determined using hand dynamometry and DXA. Sarcopenia was diagnosed upon the presence of low HGS and low SMI, according to cohort-specific thresholds. Plasma biomarkers were measured by ELISA in a sub-group of 269 participants aged 50–83 years. Asymmetry was determined as the highest recorded HGS divided by the highest recorded HGS of the opposite hand. Individuals with a ratio > 1.10 were classified as having asymmetrical HGS.ResultsSubjects with asymmetrical HGS had significantly lower SMI (7.67 kg/m2 vs 7.71 kg/m2, p = 0.004) and lower HGS (37.82 kg vs 38.91 kg, p < 0.001) than those with symmetrical HGS. In those aged ≥ 50 years asymmetrical HGS was associated with 2.67 higher odds for sarcopenia [95% confidence interval: (CI) = 1.557–4.561, p < 0.001], 1.83 higher odds for low HGS only (CI 1.427–2.342, p < 0.001), and 1.79 higher odds for low SMI only (CI 1.257–2.554, p = 0.001). HGS asymmetry demonstrated acceptable diagnostic accuracy for sarcopenia (AUC = 0.727, CI 0.658–0.796, p < 0.001). Plasma neural cell adhesion molecule concentrations were 19.6% higher in individuals with asymmetrical HGS (185.40 ng/mL vs 155.00 ng/mL, p < 0.001) than those with symmetrical HGS.DiscussionOur findings demonstrate the utility of HGS asymmetry as a screening tool that may complement existing strategies seeking to combat sarcopenia. Biomarker analyses suggest that heightened denervation may be an important aetiological factor underpinning HGS asymmetry.

Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome.

Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012). Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.

Low handgrip strength with or without asymmetry is associated with elevated all-cause mortality risk in older Chinese males.

This study aimed to examine the link between handgrip strength (HGS) asymmetry and mortality risk among older Chinese adults. These analyses were conducted using data from adults aged 60 years and older from the 2011-2013 waves of the China Health and Retirement Longitudinal Study, using baseline participant data collected in 2011. Proxy-reported information was used to assess the mortality outcomes of the participants over a 2-year follow-up. The highest recorded HGS values for each hand were used to compute the HGS asymmetry ratio (non-dominant HGS/dominant HGS) and HGS weakness (Male<26 kg, Female<16 kg). Covariate-adjusted Cox models were employed to gauge the relationship between abnormal HGS and mortality risk. Overall, 5083 adults were enrolled in this study, of whom 50.15% (2549/5083) were male. The proportions of low HGS alone, HGS asymmetry alone, and asymmetric and low HGS were 6.43%, 30.95%, and 9.22%, respectively, in males, and 4.81%, 35.87%, and 9.55%, respectively, in females. A total of 96 and 78 deaths were recorded for male (3.77%) and female (3.08%) participants, respectively, over the 2-year follow-up period. Significant differences in mortality were observed between the different HGS groups for both sexes. An adjusted Cox regression analysis model confirmed that only low HGS (P = 0.047, hazard ratio [HR] = 1.949, 95% confidence interval [95% CI]: 1.008-3.768) and low HGS with asymmetry (P = 0.007, HR = 2.152, 95% CI: 1.231-3.764) were significantly associated with mortality risk in older males. The results revealed that low HGS with or without asymmetry was associated with a higher risk of death over a 2-year follow-up interval in older Chinese males. Geriatr Gerontol Int 2023; 23: 692-699.

Tracking handgrip strength asymmetry from childhood to mid-life.

Determine if asymmetric handgrip strength exists in childhood and adulthood and quantify the degree of tracking of handgrip strength asymmetry over time. Participants from the Childhood Determinants of Adult Health Study had their right and left handgrip strength measured using handgrip dynamometry in childhood (1985: 9-15 y), young adulthood (2004-06: 26-36 y) and/or mid-adulthood (2014-19: 36-49 y). Handgrip strength asymmetry was calculated as: strongest handgrip strength/strongest handgrip strength on the other hand. Participants were categorised based on the degree of their asymmetry (0.0%-10.0%, 10.1%-20.0%, 20.1%-30.0%, >30.0%). Tracking was quantified using Spearman's correlations and log binomial regression. Handgrip strength asymmetry was present in childhood and adulthood (>30.0% asymmetry: childhood = 6%, young adulthood = 3%, mid-adulthood = 4%). Handgrip strength asymmetry did not track between childhood and young- (r = 0.06, 95% CI = -0.02, 0.12) and mid-adulthood (r = 0.01, 95% CI = -0.09, 0.10). Tracking was more apparent between young- and mid-adulthood (r = 0.16, 95% CI = 0.09, 0.22). Participants with >30.0% asymmetry were at greater risk to maintain this status between childhood and young- (RR = 3.53, 95% CI = 1.15, 10.87) and mid-adulthood (RR = 2.14, 95% CI = 0.45, 10.20). Although handgrip strength asymmetry tracked relatively poorly, asymmetric handgrip strength was apparent in children and adults. Handgrip strength asymmetry does not exclusively affect older adults and should be considered in protocols to better understand its role across the life course.

Preoperative low handgrip strength (HGS) with HGS asymmetry is associated with adverse outcomes among older adults with gastric cancer

IntroductionThis study aimed to explore the associations of low hand grip strength (HGS), HGS asymmetry, their combinations, and frailty on hospital readmissions, total complications, and prolonged length of stay (PLOS) among older adults with gastric cancer. Materials and MethodsThis study included 342 patients with gastric cancer aged ≥60 years who were scheduled to undergo radical surgery. The Tilburg Frailty Indicator (TFI) was used to collect information on frailty. HGS was measured twice for each hand using an electronic handgrip dynamometer. The highest HGS readings on each hand were used for calculating the HGS asymmetry ratio: non-dominant HGS (kg)/dominant HGS (kg). The Fine and Gray proportional subdistribution hazard model and the logistic regression model were used for the analyses, with covariates adjusted. ResultsLow HGS (subdistribution hazard ratios [SHR] = 2.10, 95% confidence interval [CI] = 1.05–3.93, P = 0.036) and low HGS with HGS asymmetry (SHR = 3.95, 95% CI = 1.50–10.36, P = 0.005) were significantly associated with hospital readmissions. Frailty was associated with total complications (odds ratio [OR] = 2.87, 95% CI = 1.61–5.13, P < 0.001) and PLOS (OR = 1.98, 95% CI = 1.19–3.29, P < 0.001). Low HGS, HGS asymmetry, and their combinations were not significantly associated with total complications and PLOS. DiscussionPreoperative low HGS and low HGS with HGS asymmetry were associated with hospital readmissions, while frailty was associated with total complications and PLOS among older adults with gastric cancer. In the future, more rigorously designed studies are needed to verify our results further to improve preoperative clinical assessment and frailty evaluation among older adults with gastric cancer.

Association between handgrip strength asymmetry and cognitive function across ethnicity in rural China: a cross-sectional study.

Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/non-dominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [β = -0.67, 95% confidence interval (CI): -1.26 ∼-0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(β = -0.60, 95% CI: -1.35 ∼ 0.15, P = 0.115) and asymmetric non-dominant HGS (β = -0.56, 95% CI: -1.42 ∼ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric non-dominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ∼ 1.74; OR per 5 kg decrease = 1.10, 95% CI: 1.01 ∼ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ∼ 1.78; OR per 5 kg decrease = 1.10, 95% CI: 1.02 ∼ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ∼ 1.67) and lower HGS (OR per 5 kg decrease = 1.21, 95% CI: 1.10 ∼ 1.32) were associated with impairment of visuoperception. HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups.

Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study.

Motoric cognitive risk (MCR) syndrome is a type of pre-dementia. It is defined as the co-occurrence of subjective cognitive complaints and a slow gait speed. A recent study found that handgrip strength (HGS) asymmetry is associated with an increased risk of neurodegenerative disorders. We aimed to investigate the associations of HGS weakness and asymmetry separately and together with MCR incidence among older Chinese adults. Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. HGS values <28 kg for male participants and <18 kg for female participants were considered HGS weaknesses. HGS asymmetry was assessed by the ratio of nondominant to dominant HGS. We used 3 different cutoff values of HGS ratio to define asymmetry, including 10%, 20%, and 30%. Specifically, HGS ratios <0.90 or >1.10 (10%), <0.80 or >1.20 (20%), and <0.70 or >1.30 (30%) were classified as asymmetry. The participants were classified into 4 groups: neither weakness nor asymmetry (neither), asymmetry only, weakness only, and weakness and asymmetry (both). The association between baseline HGS status and 4-year incidence of MCR was examined using logistic regression analyses. A total of 3,777 participants 60 years and older were included in the baseline analysis. The prevalence of MCR at the baseline was 12.8%. Participants with asymmetry only, weakness only, and both showed significantly increased risk of MCR. After excluding participants with MCR at baseline, 2,328 participants were included in the longitudinal analysis. There were 111 MCR cases (4.77%) over the 4-year follow-up period. Participants with HGS weakness and asymmetry together at baseline had increased odds of incident MCR (HGS ratio at 10%: odds ratio [OR] 4.48, p < 0.001; HGS ratio at 20%: OR 5.43, p < 0.001; HGS ratio at 30%: OR 6.02, p < 0.001). These results show that the presence of both HGS asymmetry and weakness is associated with MCR incidence. The early recognition of HGS asymmetry and weakness may be helpful in the prevention and treatment of cognitive dysfunction.

Associations Between Fall Risk and Handgrip Strength Asymmetry Among Older Korean Women: A Cross-Sectional Study Using National Survey Data.

Associations Between Fall Risk and Handgrip Strength Asymmetry Among Older Korean Women: A Cross-Sectional Study Using National Survey Data.

Influence of handgrip strength on pharyngeal transit time in individuals with chronic obstructive pulmonary disease.

To investigate the relationship between Handgrip Strength (HGS), dysphagia classification, nutritional aspects, and Pharyngeal Transit Time (PTT) in subjects with Chronic Obstructive Pulmonary Disease (COPD). Study based on the analysis of secondary data from a database. The sample comprised 15 COPD patients of both sexes and a mean age of 65.7 years. We collected information on HGS, videofluoroscopic swallowing study, Volume-Viscosity Swallow Test (V-VST), and Body Mass Index (BMI). We applied correlation, effect size, and logistic regression tests at the 5% significance level. Most individuals had severe COPD (66.7%), mean dominant HGS of 28.2, and non-dominant HGS of 25.3. Five subjects were malnourished, five were well-nourished, and five were obese. Most of them had normal swallowing (40%), normal V-VST results (60%), and PTT of 0.89 s (liquid) and 0.81 s (pudding-thick). There was no significant correlation between the swallowing classification and the other variables. We obtained a significant correlation (p = 0.015), though weak (r = -0.611), between non-dominant HGS and PTT. Regarding the binary logistic regression, HGS variables and HGS asymmetry were not enough to be considered a risk to clinically abnormal swallowing (V-VST). Subjects with COPD in this study had a longer PTT than reported in the literature for normal subjects and a weak correlation between PTT and non-dominant HGS. The variables related to muscle condition were not considered predictors for abnormal swallowing.

Handgrip Measurement Method Affects Asymmetry but Not Weakness Identification in Community-Dwelling Older Adults.

The Asian Working Group for Sarcopenia (AWGS) 2019 recommends different measurement protocols for handgrip strength (HGS). We aimed to explore (1) whether these protocols induce a significant difference in HGS; (2) whether these differences be clinically meaningful; and (3) whether these protocols affect the identification of HGS weakness or asymmetry. Cross-sectional study. A total of 356 community-dwelling older adults (mean age 67.9years; 146 women). Maximal HGS was measured according to protocols from the National Health and Nutrition Examination Survey (Method A, standing with full elbow extended) and the American Society of Hand Therapists (Method B, sitting with elbow flexed at 90°). HGS was analyzed using the maximal value of 2 or 3 repetitions of the dominant hand or 4 or 6 repetitions of both hands. The difference in maximal HGS between Method A and Method B might have clinical meaning in approximately half of the participants. When measured using Method A, respective proportions of individuals with differences in HGS between the 6 repetitions group and the other repetition groups beyond the noninferiority threshold were 42%, 20%, and 25% in men and 39%, 21%, and 17% in women. Using Method B, the corresponding percentages were 25%, 18%, and 6% in men, and 27%, 20%, and 5% in women, respectively. Different protocols did not significantly affect the identification of HGS weakness, as different protocols reached diagnostic accuracies of 0.910 to 0.967 in men and 0.911 to 0.986 in women when using Method A (6 repetitions) as the reference standard. However, different protocols significantly affected the identification of HGS asymmetry, as different protocols had diagnostic accuracies of 0.667 to 0.886 in men and 0.658 to 0.863 in women. The different protocols recommended by the AWGS 2019 update significantly affect maximal HGS values and the identification of HGS asymmetry but not HGS weakness.

Prevalence and Trends of Handgrip Strength Asymmetry in the United States.

Strength asymmetries are a type of muscle function impairment that is associated with several health conditions. However, the prevalence of these asymmetries among adults from the United States remains unknown. We sought to estimate the prevalence and trends of handgrip strength (HGS) asymmetry in American adults. The unweighted analytic sample included 23,056 persons aged at least 50-years with information on HGS for both hands from the 2006-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured HGS, with the highest recorded values for each hand used to calculate asymmetry. Persons were categorized into the following asymmetry severity categories: (1) >10%, (2) >20.0%, and (3) >30.0%. Survey weights were used to generate nationally-representative asymmetry estimates. Overall, there were no statistically significant trends in HGS asymmetry categories over time. The prevalence of HGS asymmetry in the 2014-2016 wave was 53.4% (CI: 52.2-54.4), 26.0% (CI: 25.0-26.9), and 11.7% (CI: 10.9-12.3) for asymmetry at >10%, >20%, and >30%, respectively. HGS asymmetry was generally higher in older Americans compared to middle-aged adults at each wave. In the 2014-2016 wave, >30% asymmetry prevalence was 13.7% (CI: 12.7-14.6) in females and 9.3% (CI: 8.4-10.2) in males. Some differences in asymmetry prevalence by race and ethnicity were observed. The prevalence of asymmetry was generally high, especially in women and older adults. Ongoing surveillance of strength asymmetry will help monitor trends in muscle dysfunction, guide screening for disablement, identify subpopulations at risk for asymmetry, and inform relevant interventions.

Handgrip Strength is Related to Regional Brain Volumes in a Cohort of Cognitively Impaired Older Adults with Confirmed Amyloid Burden

AbstractBackgroundHandgrip strength is important for performing activities of daily living[1]. In older adults, weaker handgrip strength and asymmetry are associated with poorer cognition. o better understand mechanisms, we sought to quantify the relationship between handgrip strength and regional volumes quantified on brain MR imaging.MethodWe selected 32 participants (mean age=70.8±7.3 [range 57‐89] years, 53.1% female, 90.6% right‐handed, mean body mass index BMI=23.9±4.1) from the Pacific Brain Health Center at Providence St. John’s Health Center, with Alzheimer dementia biomarker evidence of amyloidosis[2]. Mean Montreal Cognitive Assessment score for all participants was 21.3±3.8 points. Handgrip strength on dominant and non‐dominant hands was measured using the NIH Motor Toolbox[3] as part of a cognitive fitness assessment using a hydraulic hand dynamometer. The resulting scores included handgrip strength and percentile comparisons to normative data. Asymmetry scores were calculated. Regional brain volumes, including lobar structures and the hippocampus, were measured from T1‐weighted MR images using Neuroreader[4]. Partial correlations (rp), adjusting for age, sex, BMI and total intracranial volume modeled handgrip strength, asymmetry, and brain volumes with a significance threshold of p&lt;0.05.ResultIn the dominant hand, higher handgrip strength scores and percentiles were associated with larger volumes in the left frontal lobe (rp=+0.51, p=0.007; rp =+0.47, p=0.01) and right parietal lobe (rp=+0.40, p=0.03; rp=+0.39, p=0.04). In the non‐dominant hand, higher handgrip strength score and percentiles were associated with smaller total cerebral spinal fluid (CSF) volume (rp =‐0.55, p=0.004; rp =‐0.52, p =0.006) and larger volumes within the left hippocampus (rp=+0.45, p=0.01; rp=+.43, p=0.02), right hippocampus (rp=+0.47, p=0.01; rp=+0.43, p=0.02), and right parietal lobe (rp=+0.39, p=0.04; rp=+0.44, p=0.02). Handgrip strength asymmetry was inversely related to right hippocampal volume (rp=‐0.58, p=0.002) and positively correlated to CSF volume (rp=+0.39, p=0.04).ConclusionGreater handgrip strength was related to larger regional brain volumes. A higher number of brain regions were related to the non‐dominant hand. Asymmetry was associated with lower right hippocampal volume and higher CSF volume. Interventions focused on improving handgrip strength may seek to include quantified brain volumes on MR imaging as endpoints.

Handgrip strength effectiveness and optimal measurement timing for predicting functional outcomes of a geriatric hip fracture

Handgrip strength (HGS) now draws attention as one of the predictors of outcomes following geriatric hip fracture; however, its effectiveness and the optimal time to assess HGS remain unknown. Herein, we aimed to determine the usefulness of HGS in predicting the outcomes of geriatric hip fracture and to find the most effective time to measure HGS in both the low muscle strength and normal hip fracture groups. The study was performed prospectively for 79 geriatric hip fracture patients. HGS was measured during the admission period and the one-week postoperative period. Walking ability and quality of life were assessed using Koval scores and the European Quality of Life Five Dimension (EQ-5D) scale at the admission period and postoperatively at 3, 6, and 12 months, respectively. The relationship between pre/postoperative HGS and functional outcomes was assessed, and the functional score between the “low muscle strength” and “normal muscle strength” groups was compared. The association between HGS asymmetry and low strength with functional limitations was determined. For the preoperative HGS, the Koval score showed a significant relationship in the postoperative 6-month (r = −0.295, P = 0.008) and 12-month (r = −0.266, P = 0.019) periods; also, the EQ-5D score showed a significant relationship in the postoperative 6-month and 12-month periods (r = 0.344, P < 0.001, and r = 0.386, P = 0.001, respectively). For the postoperative HGS, the Koval score showed a significant relationship in the 6-month (r = −0.432, P < 0.001) and 12-month (r = −0.344, P = 0.002) postoperative periods. Also, the EQ-5D score showed a significant relationship in the 3-month (r = 0.340, P = 0.010), 6-month (r = 0.476, P < 0.001), and 12-month (r = 0.471, P < 0.001) postoperative periods. The incidence of preoperative and postoperative low HGS was 78.5% and 70.9%, respectively. The “low-strength” group had poor Koval scores and EQ-5D at postoperative month 12 and poor functional outcomes earlier in the follow-up (postoperative 6- and 12-month Koval scores and postoperative 3-, 6-, and 12-month EQ-5D), respectively (P = 0.008 and P = 0.003; P = 0.003, P = 0.001, and P = 0.001). The effect of HGS asymmetry and low strength on functional limitations remained undetermined. Both preoperative and postoperative HGS reflected functional outcomes of patients with hip fracture during the 12-month follow-up. Postoperative HGS had a higher prognostic value than preoperative HGS.

Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults

BackgroundHandgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. MethodsA cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0–10.0% (reference group), 10.1–20.1%, 20.1–30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index “[(HGS asymmetry*HGS)/(BMI*Age)]*100” cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). ResultsCompared to HGS reference group, those with HGS asymmetry of 10.1–20%, 20.1–30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). ConclusionsHGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

Handgrip Strength Asymmetry Is Associated With Future Accumulating Morbidities In Older Americans

Functional asymmetries are an often-observed form of poor muscle function during aging that is typically not evaluated in handgrip strength (HGS) protocols. Examining such asymmetries in older populations may help in identifying persons at risk for future morbidities linked to poor muscle function. PURPOSE: We sought to determine the association between asymmetric HGS and future accumulating morbidities in older Americans. METHODS: The analytic sample included 18,506 participants aged 65.0 ± 10.2 years from the 2006-2016 waves of the Health and Retirement Study. HGS was collected on each hand with a handgrip dynamometer. The highest HGS on each hand was used for determining HGS asymmetry ratio: (non-dominant HGS/dominant HGS). Persons with HGS asymmetry ratio < 1.0 had their ratio inverted to make all ratios ≥1.0. Participants were categorized into asymmetry groups based on their inverted HGS asymmetry ratio: 1) 0.0%-10.0%, 2) 10.1%-20.0%, 3) 20.1%-30.0%, and 4) >30.0%. Each person reported the presence of healthcare provider diagnosed morbidities: hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, psychiatric problems, and arthritis. Separate covariate-adjusted ordinal generalized estimating equations were used for the analyses. RESULTS: Every 0.10 (i.e., 10%) increase in HGS asymmetry ratio was associated with 1.21 (95% confidence interval (CI): 1.09-1.35) greater odds for future accumulating morbidities. Compared to those with HGS asymmetry 0.0%-10.0%, persons with wider asymmetry had greater odds for future accumulating morbidities: 1.07 (CI: 1.02-1.12) for HGS asymmetry 10.1%-20.0%, 1.09 (CI: 1.02-1.16) for HGS asymmetry at 20.1%-30.0%, and 1.22 (CI: 1.11-1.35) for HGS asymmetry >30.0%. CONCLUSIONS: Functional asymmetries between limbs, as another form of muscle dysfunction, are associated with future morbidity accumulation in during aging. Moreover, wider strength asymmetries between limbs may especially elevate risk for future morbidity accumulation. We recommend that health practitioners evaluate HGS asymmetry as a simple screening mode for helping to determine poor muscle function and future morbidity risk.

Associations of low handgrip strength and hand laterality with cognitive function and functional mobility – the Yishun Study

BackgroundEmerging evidence suggest that in addition to low hand grip strength (HGS), HGS asymmetry is associated with declining cognitive and physical functions. We examined the associations of low HGS and asymmetry with cognitive function and functional mobility in older adults.MethodsCross-sectional data of 330 community-dwelling adults (55.2% women) aged ≥ 55 years included HGS, Repeated Battery for the Assessment of Neuropsychological Status (RBANS), and Timed-Up-and-Go (TUG). Low HGS was defined as < 28 kg for men and < 18 kg for women. Participants with HGS above 10% stronger on either hand were considered as having HGS asymmetry. Multiple linear regression models were adjusted for sociodemographic, smoking, education, comorbidity count, physical activity participation, obesity, self-rated health and hand dominance.ResultsLow HGS, but not asymmetry, was independently associated with lower functional mobility performance (β = 1.3, 95%CI = 0.6,1.9), global cognitive function (β = -10.4, 95%CI = -17.0,-3.8), immediate (β = -2.6, 95%CI = -4.5,-0.7) and delayed (β = -2.8, 95%CI = -5.0,-0.7) memory. Compared to normal and symmetric HGS participants, low HGS in combination with HGS asymmetry was associated with poorer language scores. In participants with normal HGS, asymmetric HGS was associated with slower TUG than corresponding groups with symmetric HGS.ConclusionLow HGS, but not asymmetry, was associated with lower cognition and functional mobility. Associations of combined low HGS and asymmetry with cognitive and physical functions were driven by grip strength rather than asymmetry.

Handgrip strength weakness and asymmetry together are associated with cardiovascular outcomes in older outpatients: A prospective cohort study

AimThe evaluations of handgrip strength (HGS) weakness and asymmetry have implications for the comprehensive geriatric assessment. The aim of this study was to investigate the association of HGS weakness and asymmetry on cardiovascular outcomes in older outpatients.MethodsThis was a prospective observational cohort study of 364 Geriatrics outpatients aged ≥60 years, in which all participants carried out HGS tests at baseline. Patients with HGS <28 kg for men and <18 kg for women were diagnosed as HGS weakness, and HGS ratio <0.90 or >1.10 were diagnosed as HGS asymmetry. Primary outcomes defined as the major adverse cardiovascular event and composite end‐points were assessed during a 21‐month median follow‐up.ResultsAmong 364 participants, 155 (42.6%) showed HGS weakness, and 160 (44.0%) showed HGS asymmetry. HGS weakness was associated with major adverse cardiovascular events (HR 2.76, 95% CI 1.22–6.27) and composite end‐points (HR 2.84, 95% CI 1.40–5.77). However, no significant correlation between HGS asymmetry and cardiovascular outcomes was observed. Compared with the normal and symmetric HGS group, older adults with HGS weakness and asymmetry together had a higher risk of major adverse cardiovascular events (HR 5.23, 95% CI 1.56–17.54) and composite end‐points (HR 4.00, 95% CI 1.56–10.28).ConclusionsHGS weakness and asymmetry together might increase the risk of cardiovascular outcomes in older outpatients. HGS asymmetry offers complementary information to HGS weakness when making a comprehensive assessment of HGS. Geriatr Gerontol Int 2022; 22: 759–765.

Associations of Handgrip Asymmetry With Impaired Health-Related Quality of Life Among Older Adults in South Korea: A Cross-Sectional Study Using National Survey Data.

This study aimed to examine the associations of handgrip strength (HGS) and asymmetry with health-related quality of life among South Korean older adults. We enrolled 7395 older adults from the Korea National Health and Nutrition Examination Survey. Health-related quality of life was measured using the EuroQol-5 Dimension. Weakness was defined as a HGS of <26 kg for men and <18 kg for women. Handgrip strength symmetry was defined as an HGS ratio of 0.9:1.1, and HGS asymmetry was defined as a ratio outside that range. Data were analyzed using the Rao-Scott χ2, F test, and multivariate logistic regression. Compared with those in the "symmetric HGS and not weak" group, those in the "asymmetric HGS and weak" group had impaired health-related quality of life for all variables among men (odds ratios [ORs] = 1.67-3.75). A greater risk of impaired self-care (SC; odds ratio [OR] = 2.33) and anxiety/depression (AD; OR = 1.40) was observed among women in the "asymmetric HGS and weak" group. Handgrip weakness and asymmetry are associated with impaired health-related quality of life. Handgrip asymmetry can be a clinical marker of health-related quality of life in older adults and must be measured alongside HGS.