Low Handgrip Strength Research Articles

Cystatin-c / total cholesterol ratio as a predictor of probable sarcopenia in geriatric population from 12 European countries

BackgroundA low handgrip strength (HGS) is associated with several diseases in older adults. However, predictive biomarkers of future low HGS are poorly known. We investigated the prognostic efficacy of the ratio of plasma cystatin-c and total cholesterol (CT ratio) levels for predicting future low HGS in Europe.MethodsThe data was collected from the Survey of Health, Ageing, and Retirement in Europe (SHARE) between 2015 and 2021-22. The study participants were geriatric adults aged 50 or above (n = 17,698) from 12 European countries. The baseline data in 2015 included the measurements of CT ratio from participants with normal HGS. The participants who developed low HGS in subsequent years were included. We also investigated the quality of life, difficulties performing daily activities, and several comorbidities in the study population.ResultsIn a multivariate-adjusted model, male gender, advancing age, poor quality of life, difficulties performing daily activities, and the presence of depression, high blood pressure, diabetes mellitus, Alzheimer’s disease, and osteoarthritis were associated with a higher risk of developing low HGS. CT ratio exhibited significant prognostic accuracy for low HGS among men and women aged 60–79, irrespective of the quality of life, degree of depression, difficulties performing daily activities, and the presence of comorbidities, including depression, high blood pressure, diabetes mellitus, Alzheimer’s disease, and osteoarthritis.ConclusionCollectively, the CT ratio exhibits adequate prognostic accuracy for low HGS, which is not significantly affected by comorbidities and functional limitations. Our findings have clinical and policy implications in timely identifying older adults at risk of developing low HGS.

Identification of Association Between Mitochondrial Dysfunction and Sarcopenia Using Summary-Data-Based Mendelian Randomization and Colocalization analyses.

Mitochondrial dysfunction has been demonstrated to be an important hallmark of sarcopenia, yet its specific mechanism remains obscure. In this study, mitochondrial-related genes were used as instrumental variables to proxy for mitochondrial dysfunction, and summary data for sarcopenia-related traits were used as outcomes to examine their genetic association. A total of 1136 mitochondrial-related genes from the human MitoCarta3.0 database were extracted. Genetic instruments for them were obtained from gene expression quantitative trait locus (eQTLs) study (n = 31 684). Aggregated data for sarcopenia-related traits including low hand grip strength (LHGS), appendiceal lean mass (ALM), and usual walking pace (UWP) were provided by large-scale genome-wide association studies (GWASs). We integrated eQTLs data with GWAS data to estimate genetic association between mitochondrial dysfunction and sarcopenia using summary-data-based Mendelian randomization (SMR) analysis. Additionally, we implemented colocalization analysis to strengthen their association. Finally, eQTLs data from skeletomuscular tissue (n = 706) was used to validate the primary findings. By integrating the analysis results from the 3 sarcopenia-related traits, 2 mitochondrial genes genetically associated with sarcopenia were identified, namely UQCC1 (tier 2 evidence) and ETFDH (tier 3 evidence). Specifically, elevated expression levels of UQCC1 increased LHGS risk (OR = 1.114; 95% CI, 1.078-1.152; P-FDR = 1.70 × 10-7), which matched the negative association between it and UWP (Beta = -0.015; 95% CI, -0.021 to -0.010; P-FDR = 6.70 × 10-5). Furthermore, elevated expression levels of ETFDH were found to be associated with both lower ALM (Beta = 0.031; 95% CI, 0.020-0.042; P-FDR = 1.41 × 10-6) and UWP (Beta = 0.013; 95% CI, 0.006-0.021; P-FDR = 0.029). Of note, consistent results were replicated in specific skeletomuscular tissues, further suggesting our findings were robust. Our analyses revealed the genetic association between 2 mitochondrial-related genes, ie, UQCC1 and ETFDH, and sarcopenia, highlighting the pivotal role of mitochondrial dysfunction driven by these genes in the pathogenesis of sarcopenia. Importantly, these candidate genes represent potential clinical drug targets for the treatment of sarcopenia.

Abdominal adiposity is negatively associated with physical function among people with HIV.

To examine the relationship between body mass index (BMI), abdominal adiposity, handgrip strength and physical function in people with HIV (PWH), and to explore the potential influence of physical activity (PA) and diet on this relationship. Cross-sectional analyses. The PROSPER-HIV Study was conducted at four clinical sites across the United States. Eligible participants were on antiretroviral therapy and had a viral load <200 copies/mL. Measures included: a) handgrip strength; b) physical function, assessed with the Short Physical Performance Battery (SPPB); c) BMI; d) abdominal adiposity, estimated using waist circumference (WC); e) PA levels, measured using accelerometers; and f) diet quality, measured using triple-pass 24-hour recalls. Data were analyzed using quantile regression between covariates and median of the outcomes. Among PWH (n = 409, 59.0 years old [51.0-65.0], 76.5% male), 71.4% were overweight or obese, 72.4% had high WC, 12.7% had low handgrip strength, and 11.5% had low SPPB. After controlling for age and sex, there was a negative association between SPPB and WC (β=-0.011, p = 0.02). When PA and diet variables were considered in the model, moderate-to-vigorous PA (MVPA) and step count were significant (p < 0.05) and influenced the relationship between WC and SPPB. Although there was a moderate negative correlation between WC and SPPB for the lowest quartiles of MVPA and steps, this correlation weakens as the activity levels increase. Increased abdominal adiposity is associated with poorer physical function among PWH. Participants with higher MVPA and steps presented higher physical function even in the presence of high WC.

The association of sarcopenia and frailty in diabetes-related foot disease: A 3-year prospective evaluation.

To prospectively evaluate the association of various markers of sarcopenia and frailty with clinical outcomes in diabetes-related foot disease (DRFD), namely wound healing, amputation-free survival, and death over 3years. This was an observational study of patients with DRFD at a quaternary multidisciplinary diabetic foot service. Initial assessment includes classification of DRFDs using WIfI classification, assessment of frailty using the FRAIL scale, and measurement of handgrip strength (HGS) using a dynamometer. Muscle mass was ascertained by measuring the psoas muscle area at the level of L3 vertebrae on computed tomography. Patients were followed up for 3years and primary outcomes were wound healing, amputation-free survival, and death. One hundred patients with a median age of 71 were included in the analysis. The majority of the patients were male (75%). Forty-seven percent of patients were considered as frail, with 37 patients recorded to have low HGS. Patients with high HGS had significantly higher odds of wound healing by 3.83 times when compared to those with low HGS (odds ratio=3.83. 95% CI 1.35-10.92). Patients with low psoas muscle index (PMI) and low HGS were observed to have a higher risk of death based on the following hazard ratios: HGS (high vs. low), HR=0.46, 95% CI: 0.22-0.997; PMI (low vs. high), HR=2.15, 95% CI: 1.17-3.96. There was a significant prevalence of frailty and reduced HGS among our patients with DRFD. Low HGS was associated with poor wound healing and increased mortality in patients with DRFD. Additionally, low muscle mass was associated with increased mortality in this population. This research highlights the need for more precise tests and future studies of the links between sarcopenia, frailty, and outcomes in DRFD.

Hypozincemia Is Associated With Increased Tyrosine Levels, Low Handgrip Strength, Increased Incidence of HCC, and Liver Disease Progression-A Cross-Sectional Study.

Serum zinc levels decrease in chronic liver disease (CLD), but their effects on liver reserve function, tyrosine, skeletal muscle mass, handgrip strength (HGS), and hepatocellular carcinoma (HCC) development remain poorly understood. A retrospective, cross-sectional study was conducted on 516 CLD cases. Patients were divided into a low zinc group (< 80 μg/dL) and a high zinc group (≥ 80 μg/dL). Serum zinc levels were analyzed with liver reserve function (assessed by modified albumin-bilirubin [mALBI] grade), tyrosine, branched-chain amino acid/tyrosine ratio (BTR), and HCC development. In 180 cases, the relationship between serum zinc levels and skeletal muscle characteristics, including sarcopenia and HGS, was investigated. Tyrosine levels increased significantly with mALBI grade progression. Patients in the low zinc group had higher tyrosine levels (76.9 vs. 67.2 μmol/L, p < 0.001), a greater proportion of high tyrosine levels (5.3% vs. 1.7%, p < 0.001), and more HCC cases (10.5% vs. 3.7%, p < 0.005). Zinc levels were lower with more severe CLD (81 μg/dL [mALBI grade 1] vs. 35.2 μg/dL [grade 3], p < 0.001). Tyrosine levels were higher in HCC patients than in non-HCC patients (93.1 vs. 70.7 μmol/L, p < 0.001). Sarcopenia prevalence did not differ between groups (56.6% vs. 52.0%, p = 0.344), but low HGS was more frequent in low zinc patients (61.2% vs. 46.3%, p = 0.032). In a subset of patients with low zinc levels (n = 12), zinc supplementation reduced tyrosine levels after 3 months (86.3 vs. 73.3 μmol/L, p = 0.017). Hypozincemia is linked to elevated tyrosine levels, reduced HGS, increased HCC incidence, and CLD progression.

Exploring the causal relationship between delirium and sarcopenia using bidirectional two-sample Mendelian randomization study.

Exploring the causal relationship between delirium and sarcopenia using bidirectional two-sample Mendelian randomization study.

Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults.

Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults.

Sarcopenic obesity and the risk of atrial fibrillation in non-diabetic older adults: A prospective cohort study.

Sarcopenic obesity and the risk of atrial fibrillation in non-diabetic older adults: A prospective cohort study.

Leucine-included liquid diet as medical nutrition therapy improved handgrip strength and mid-upper circumference in clinically malnourished pulmonary tuberculosis patient with high neutrophil lymphocyte ratio

Background and objectives: Muscle weakness delays clinical improvement in pulmonary tuberculosis patients. Higher neutrophil lymphocyte ratio, low handgrip strength, mid-upper arm circumference indicates bad clinical outcome. Weight loss must be managed from the start of treatment. Good muscle condition has benefits to the recovery rate. Leucine provides benefits in increasing the synthesis of muscle mass so as the clinical conditions. Unfortunately, leucine has not been the routine part of medical nutrition therapy in tuberculosis patients. Methods: This is a case report of a female patient with body weight 42 kg and height 150 cm, admitted to Universitas Indonesia Hospital, with lung tuberculosis. Leucine given, started from 1.95 g/day to the maximum amount of 7,34 g/day through the hospital tailored-made liquid food. There was an improvement of clinical signs and symptoms during 14 days of hospitalization. Mid-upper arm circumferences at day 1, 8, and 15 were 21.1, 21.4, and 12.9 21.9 cm in a row. The right and left handgrip strength at day 1, 8, and 15 were 9.7 kg and 8.1 kg, 10.9 kg and 8.9 kg, 15.1 kg and 13.4 kg, respectively. While the neutrophil lymphocyte ratio at day 0, 6, and 9 were increasing, at 6.89, 6.89, and 13.8, in a row. Conclusions: Leucine 1.95–7.34 g/day, in tailored-made liquid food, as part of tuberculosis management therapy, though the NLR 13.8, can improve the mid-upper arm circumference, handgrip strength, clinical signs and symptoms in 14 days of hospitalization.

Lower-extremity muscle strength is associated with prognosis in patients with advanced or recurrent lung cancer: a retrospective, observational study

BackgroundWe aimed to examine associations between various sarcopenia indices—including skeletal muscle index (SMI), handgrip strength, lower-extremity muscle strength, a combined measure of handgrip and lower-extremity muscle strength, sarcopenia (defined as a combination of SMI and muscle strength), and the SARC–F questionnaire—and all-cause mortality in patients with advanced or recurrent lung cancer. Moreover, we aimed to identify factors influencing sarcopenia indices that demonstrate strong correlations with prognosis, aiming to inform the development of targeted interventional strategies.MethodsThis retrospective observational study enrolled outpatients with lung cancer who underwent chemotherapy. Patients were evaluated for sarcopenia indices, including SMI, handgrip strength, five-repetition sit-to-stand test (5STS), and SARC–F. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ–SF). The log-rank test and Cox proportional hazards model, adjusted for confounders, were used to examine the association between the sarcopenia index and prognosis. Harrell’s concordance index (C-index) was used to quantify the predictive power of the resultant model. To examine the significant factors associated with sarcopenia indices, which are associated with prognosis, multivariate logistic regression analysis was performed.ResultsThere was a significant association between low handgrip strength (hazard ratio [HR], 2.73; 95% confidence interval [CI], 1.20–6.25; P = 0.017), 5STS ≥ 12 s (low lower-extremity muscle strength) (HR, 2.32; 95% CI, 1.23–4.36; P < 0.01), the combination of low handgrip strength and 5STS ≥ 12 s (HR, 2.37; 95% CI, 1.23–4.57; P = 0.010), and sarcopenia (defined as a combination of SMI and muscle strength) (HR, 2.07; 95% CI, 1.02–4.21; P = 0.044) and survival, whereas there was no significant association between SMI (HR, 1.62; 95% CI, 0.74–3.53; P = 0.20) and SARC–F (HR, 2.07; 95% CI, 0.97–4.43; P = 0.061) and survival. The C-index for handgrip strength and 5STS was 0.625 (95% CI: 0.624–0.627) and 0.635 (95% CI: 0.634–0.636), respectively. Multivariate logistic analysis adjusted for age, sex, clinical stage, and treatment line showed that IPAQ–SF was an independent significant factor associated with 5STS ≥ 12 s (odds ratio [OR], 9.31; 95% CI, 2.93–29.58; P < 0.001), the combination of low handgrip strength and 5STS ≥ 12 s (OR, 6.45; 95% CI, 2.10–19.81; P = 0.001), and sarcopenia (OR, 4.90; 95% CI, 1.52–15.84; P = 0.008).ConclusionsHandgrip strength and lower-extremity muscle strength were stronger predictors of prognosis compared to the SMI. Furthermore, physical inactivity was significantly associated with lower-extremity muscle strength. From a clinical perspective, evaluating lower-extremity strength and physical activity is essential, and implementing exercise interventions, including strategies to enhance physical activity levels, should be considered.

Accelerometery 24-hour movement behaviours and health markers in the European old population: iso-temporal substitution regression

BackgroundThe amount of physical activity, sleep, and sedentary behaviour affect several age-related diseases. However, no relevant study about their associations with cardiovascular and musculoskeletal diseases from European older adults is known.MethodsWe investigated the associations of the volumes of physical activity, sleep, and sedentary behaviour with low handgrip strength (HGS), heart attack, hip fracture, rheumatoid arthritis, stroke, and osteoarthritis among European older adults (age ≥ 50 years, n = 819) from ten countries using cross-sectional data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted between 2019 and 2021. We used iso-temporal regression analysis to investigate the associations of lifestyle factors with age-related diseases.ResultsThe participants who met the weekly recommendation for 150 min of moderate-to-vigorous physical activity (MVPA) had lower prevalence of low HGS, difficulty lifting 5 kg of weight, heart attack, hip fracture, rheumatoid arthritis, stroke, and osteoarthritis. The iso-temporal regression analysis revealed that more light physical activity or MVPA was associated with lower prevalence of difficulty lifting 5 kg of weight and stroke. Lastly, longer sleep or less MVPA was associated with higher prevalence of stroke and difficulty lifting 5 kg of weight.ConclusionsCollectively, our data shows the associations of several age-related diseases and optimal LPA, MVPA, and an optimal sleep. Our observations may be useful in optimizing lifestyle to combat age-related disorders in European older adults.

FACTORS ASSOCIATED WITH THE KIHON CHECKLIST IN OLDER WOMEN: A CROSS-SECTIONAL STUDY IN A UNIVERSITY OUTPATIENT CLINIC

Introduction: Population aging is a global phenomenon that has increased the prevalence of conditions such as frailty syndrome, which compromises the autonomy and quality of life of older adults. Frailty is characterized by a reduction in physiological reserves and raises the likelihood of adverse outcomes, such as falls and functional dependence. Objective: To analyze markers of frailty syndrome in older women attending a university hospital in Brazil. Methods: This cross-sectional and exploratory study included a convenience sample of women aged 60 years or older, attending an outpatient clinic in northeastern Brazil. Participants were evaluated through questionnaires, anthropometric measurements, and physical tests, including education level, physical activity, medication use, frailty index (KCL), sarcopenia (SARC-F), body fat percentage, appendicular mass, handgrip strength, and gait speed. Data were statistically analyzed by independent samples T test, Mann-Whitney test, chi-square, and partial correlation. Results: Frail older women performed less physical activity, had lower handgrip strength and gait speed, and higher scores on SARC-F, reflecting greater functional impairment. They also presented higher scores on KCL, except for the nutrition subcategory. Frailty showed negative correlations with muscle mass index, physical activity, handgrip strength, and gait speed, and a positive correlation with SARC-F, indicating that worse functional performances are associated with greater frailty. Conclusion: This study provides evidence of the relationship between KCL and various factors related to health and physical function in older women. Early identification of factors associated with frailty can contribute to more effective interventions aimed at maintaining independence in this population.

Age-Specific Relationship between Prolonged Sedentary Time and Low Handgrip Strength: Stronger Impact Among Young Korean Workers (KNHANES 2016-2019).

This study examined the relationship between sedentary time and handgrip strength with age-group stratification. This study used 11,295 Korean workers. Participants were divided into two age groups: ≤39 and ≥ 40 years. Handgrip strength was measured, and sedentary time was self-reported. Multiple logistic and linear regression models were used to examine the association between sedentary time and handgrip strength. Those with ≥6 hours of daily sedentary time had slightly higher odds of low handgrip strength, though not significant overall (OR 1.09, 95% CI 0.95-1.26). However, younger adults with high sedentary time showed significantly higher odds (OR 1.55, 95% CI 1.13-2.12). Linear regression also indicated a stronger negative association in younger adults. Interventions to reduce sedentary time could help maintain muscle strength, especially in younger populations.

Association of Self-Perceived Fatigue, Muscle Fatigue, and Sleep Disorders with Cognitive Function in Older Adults: A Cross-Sectional Study.

Association of Self-Perceived Fatigue, Muscle Fatigue, and Sleep Disorders with Cognitive Function in Older Adults: A Cross-Sectional Study.

Two-year survival in patients with oncological disease with low muscle reserve, risk of sarcopenia and probable sarcopenia: A post hoc analysis.

Two-year survival in patients with oncological disease with low muscle reserve, risk of sarcopenia and probable sarcopenia: A post hoc analysis.

Device-Measured Physical Activity, Sedentary Behaviour and Risk of Chronic Kidney Diseases Across Levels of Grip Strength.

The study aimed to investigate whether the associations of accelerometer-measured physical activity (PA) and sedentary behaviour (SB) with incident chronic kidney disease (CKD) vary based on different levels of hand grip strength, identifying the modifying role of grip strength in these associations. The study included 87 487 adults from the UK Biobank. PA and SB were quantified using accelerometers over 7-day period, while grip strength was assessed using a hand dynamometer. CKD events were ascertained through hospital records or death registries. Participants had a mean age of 62.3 years, with 57.2% (50 062) identifying as female and 97% as White. Over a median follow-up of 7.0 years, the total incidence rate of CKD was 4.7 per 1000 person-years. Participants who performed higher volumes of PA were more likely to be younger; have better control of body weight, blood glucose and blood pressure; and have fewer major comorbidities (p < 0.001). Total PA, moderate-to-vigorous intensity PA (MVPA), and light intensity PA (LPA), were inversely associated with CKD risk in a dose-response manner (all poverall < 0.050). In contrast, SB was associated with a higher risk of CKD (poverall < 0.001). Hand grip strength significantly modified the relationship between PA, SB, and CKD risk (pinteraction < 0.10). The associations of total PA (HR, 0.70; 95% CI, 0.59-0.84), MVPA (HR, 0.75; 95% CI, 0.65-0.88), LPA (HR, 0.81; 95% CI, 0.69-0.94), and SB (HR, 1.43; 95% CI, 1.21-1.69) with CKD risk were more remarkable among individuals with lower hand grip strength. Of note, physical inactivity ranked higher in relative strength for predicting CKD than hypertension, diabetes, and obesity. Hand grip strength could significantly modify the associations of accelerometer-measured PA and SB with the risk of CKD. Regardless of intensity, PA consistently correlates with reduced risk of CKD, while SB is associated with increased risk, especially among individuals with lower grip strength. Notably, physical inactivity was found to be as predictive of CKD as traditional risk factors, highlighting the importance of promoting PA, especially among those with lower grip strength.

Which pathway of the possible sarcopenia algorithm of the AWGS 2019 guideline is the best in Korean community-dwelling older men and women?

Which pathway of the possible sarcopenia algorithm of the AWGS 2019 guideline is the best in Korean community-dwelling older men and women?

Causal Association Between Chronic Inflammatory Arthropathies and Sarcopenia and the Mediation Role of Inflammatory Factors.

Although chronic inflammatory arthropathies (CIA) are associated with sarcopenia, sarcopenia plays a role in their pathogenesis remains unknown. This study investigated the causal relationship between sarcopenia and CIA and to identify potential mediating factors. We examined data from 458 910 participants in the UK Biobank to analyze the association between sarcopenia-related traits and CIA. Associations between hand-grip strength, muscle mass, walking pace, and CIA were analyzed using Cox regression models. Then, we performed a mediation analysis to explore the underlying mechanisms. Individuals with low hand-grip strength exhibited a 1.88-fold (95% CI 1.73-2.05), 2.22-fold (95% CI 2.02-2.45), and 1.36-fold (95% CI 1.32-1.41) increased risk of rheumatoid arthritis (RA), spondyloarthritis (SpA), and osteoarthritis (OA), respectively. The HRs for sarcopenia were 1.64 (95% CI 1.15-2.32) for RA, 1.83 (95% CI 1.21-2.77) for SpA, and 1.26 (95% CI 1.09-1.45) for OA. Additionally, individuals with a slow walking pace exhibited a 1.83-fold (95% CI 1.66-2.02), 3.58-fold (95% CI 3.25-3.95), and 1.82-fold (95% CI 1.77-1.88) increased risk of RA, SpA, and OA, respectively. Furthermore, we identified inflammatory markers as possible mediators of the causal effects of low hand-grip strength on the development of CIA. Our findings suggest that sarcopenia is independently associated with an increased risk of CIA, which is partially mediated by inflammation factors.

Risk prediction of functional disability among middle-aged and older adults with arthritis: A nationwide cross-sectional study using interpretable machine learning.

Risk prediction of functional disability among middle-aged and older adults with arthritis: A nationwide cross-sectional study using interpretable machine learning.

Correlation of the Geriatric Nutritional Risk Index (GNRI) With Other Indicators of Nutrition in Chronic Hemodialysis Patients.

The GNRI (Geriatric Nutritional Risk Index1) is an index used in geriatrics to predict the risk of complications and mortality associated with malnutrition. It considers serum albumin levels and the ratio of current weight or BMI to the ideal theoretical weight/BMI. The aim of this study was to evaluate this index in a population of metabolically stable chronic hemodialysis patients aged > 60 years and associate it with other nutritional markers. The studied patient cohort was divided into two groups based on their Geriatric Nutritional Risk Index (GNRI) scores: Gr 1 with GNRI score < 97 and Gr 2 with GNRI ≥ 97. We registered the anthropometric, clinical, and biological data of the study population. One hundred seventy-seven patients (102 M-75F) undergoing chronic hemodialysis were included. There were no differences in age, muscle mass estimated by bioimpedance analysis, potassium levels, phosphorus levels, and nPCR between the groups. However, there were significant differences between the two groups concerning the primary disease. Gr 1 presented with a higher prevalence of diabetes and cardiovascular comorbidities. Additionally, Gr 1 presented with lower handgrip strength (Mean ± standard deviation in kg, 19.79 ± 9.37 vs. 26.83 ± 11.63, p = 0.05), lower fat mass index estimated by bioimpedance analysis (Mean ± standard deviation in kg/m2, 7.31 ± 4.55 vs. 15.24 ± 6.47, p < 0.001), and higher CRP levels (Mean ± standard deviation in mg/l, 22.27 ± 23.49 vs. 8.13 ± 10.14, p < 0.001). In conclusion, the GNRI, an easy calculation tool for nutrition assessment, is associated with important nutritional status parameters in chronic hemodialysis patients.