Weak Handgrip Research Articles

Prevalence of Anemia and Factors Associated With Handgrip Strength in Indonesian Elderly Population.

Introduction: Anemia is a common blood disorder in the elderly which is associated with numerous poor medical outcomes. However, there is currently no study that assesses anemia prevalence of the Indonesian elderly population aged ≥60 years old in multiple provinces and analyzes its association with handgrip muscle strength using a large sample size.Aim: We aimed to elucidate the prevalence of anemia and analyze factors associated with handgrip strength in elderly.Method: This was a cross-sectional study using data from the Indonesian Family Life Survey-5 (IFLS-5). All participants aged ≥60 years old were included in this study. Exclusion criteria were: (1) respondents who refused to take health measurements (hemoglobin (Hb) level, handgrip strength, weight, stature, and waist circumference); (2) respondents with incomplete or missing data; (3) respondents with history of stroke; and (4) respondents with history of pain, swelling, inflammation, injury, and surgery on one or both hands within the last 6 months. The dependent variable for this study was handgrip strength. Subjects were classified as weak if the handgrip strength was <28 kg for men and <18 kg for women based on classification from the Asian Working Group for Sarcopenia (AWGS) 2019. The independent variables were Hb level, gender, age, body mass index (BMI), waist circumference, smoking history, comorbidities, and current use of drug therapies. Based on WHO standard, male and female participants with Hb less than 13 g/dL and 12 g/dL, respectively, are defined as anemic. Statistical analyses used included correlation, bivariate logistic regression, and multivariate logistic regression.Result: A total of 3192 individuals were selected for analysis. Overall, 38.8% of participants had anemia, and the prevalence of anemia increases with age. A total of 56.30% of participants aged ≥80 years had anemia. There was a positive correlation between Hb level and handgrip strength in the Indonesian elderly population (r: 0.349; p value: <0.001). Multivariate analysis showed that anemia was significantly associated with weak handgrip strength (OR: 1.557; 95% CI: 1.314-1.846; p value: <0.001). Age ≥ 80 years (OR: 5.234), age 70-79 years (OR: 3.152), low BMI (OR: 1.827), and hypertension (OR: 1.340) were associated with weak handgrip strength in multivariate analysis.Conclusion: The prevalence of anemia in the Indonesian elderly was 38.8% and anemia was associated with weak handgrip strength. The association of anemia with weak handgrip strength is more pronounced in males and the elderly aged ≥80 years.

Weak Hand Grip Strength Is Associated with Alexithymia in Outpatients in a Mexican Population.

Hand grip strength has been considered as a possible marker for metabolic and psychiatric disease. To date, however, no research has focused on the association between alexithymia and hand grip strength. The objective of the present study was to investigate the correct association between hand grip strength and alexithymia. A cross-sectional study was carried out in Comalcalco, Tabasco, México. A total of 246 individuals were included. Hand grip strength was evaluated in the dominant hand using a Takei® portable digital dynamometer. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Two linear regression models adjusted by confounders were used to determine the association between alexithymia and hand grip strength. The rate for positive alexithymia was 39.0% (n = 94). Individuals with alexithymia showed a weaker hand grip strength than the comparison group (t = 2.4, 244 df, p = 0.01). Individuals with alexithymia had significantly reduced levels of hand grip strength (β = −0.39 ± 0.14; p = 0.006); after additional adjustment for clinical variables, decreased hand grip strength remained (β = 8.00 ± 1.86; p ≤ 0.001). Our results suggest that a decrease in hand grip strength could be associated with alexithymia. This measurement could be useful as a predictive marker for the identification of alexithymia in Mexican individuals who attend outpatient clinics.

Dietary Quality, Sleep Quality and Muscle Mass Predicted Frailty among Chinese Postmenopausal Women in Malaysia.

The older adult population is growing faster than any age group, which increases their risk of frailty. Studies conducted among older adult are relatively scarce in Malaysia, especially among Chinese postmenopausal women, who have the longest life expectancy. Thus, the present study aimed to determine the prevalence of frailty and its associated factors among Chinese postmenopausal women. A total of 220 eligible respondents were recruited, with information on sociodemographic background, comorbidities, dietary intake and lifestyle behaviour were obtained using a structured questionnaire, while anthropometry indicators were assessed according to standard protocol. Fasting blood was withdrawn for the analysis of serum 25(OH)D. Multinomial logistic regression was used to determine factors that predict pre-frailty and frailty. Prevalence of pre-frailty and prevalence of frailty were 64.5 and 7.3%, respectively, and most of the respondents presented with weak handgrip strength. Pre-frailty was prevalent among the younger population. Dietary quality was unsatisfactory among the respondents, and the majority of them presented with a high percentage of body fat. An increased dietary quality index (DQI), poor sleep and low muscle mass were factors that contributed to frailty. In conclusion, nutritional factors should be considered in developing health-related policies and programs in reducing and delaying the onset of frailty.

Muscular Function as an Alternative to Identify Cognitive Impairment: A Secondary Analysis From SABE Colombia.

BackgroundIdentification of cognitive impairment is based traditionally on the neuropsychological tests and biomarkers that are not available widely. This study aimed to establish the association between motor function (gait speed and handgrip strength) and cognitive performance in the Mini-Mental State Examination, globally and by domains. A secondary goal was calculating a cut-off point for gait speed and handgrip strength to classify older adults as cognitively impaired.MethodsThis is a secondary analysis of SABE Colombia (Salud, Bienestar & Envejecimiento), a survey that was conducted in 2015 on health, wellbeing, and aging in Colombia. This study used linear regression models to search for an association between motor function and cognitive performance. The accuracy of motor function measurements in identifying cognitive impairment was assessed with receiver operating characteristic (ROC) curves. This study also analyzed other clinical and sociodemographical variables.ResultsGait speed was associated with orientation (r2 = 0.16), language (r2 = 0.15), recall memory (r2 = 0.14), and counting (r2 = 0.08). Similarly, handgrip strength was associated with orientation (r2 = 0.175), language (r2 = 0.164), recall memory (r2 = 0.137), and counting (r2 = 0.08). To differentiate older adults with and without cognitive impairment, a gait speed cut-off point of 0.59 m/s had an area under the curve (AUC) of 0.629 (0.613–0.646), and a weak handgrip (strength below 17.5 kg) had an AUC of 0.653 (0.645-0.661). The cut-off points for handgrip strength and gait speed were significantly higher in male participants.ConclusionsGait speed and handgrip strength are similarly associated with the cognitive performance, exhibiting the most extensive association with orientation and language domains of the Mini-Mental State Examination. Gait speed and handgrip strength can easily be measured by any clinician, and they prove to be useful screening tools to detect cognitive impairment.

Sleep duration and sarcopenia in adults aged ≥ 65years from low and middle-income countries.

Sleep duration may influence risk for sarcopenia but studies on this topic are scarce, especially from low and- middle-income countries (LMICs). Thus, the aim of the present study was to investigate the association between sleep duration and sarcopenia among adults aged ≥ 65years from five LMICs (China, Ghana, India, Russia, South Africa). Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. Self-reported sleep duration in the past two nights were averaged and classified as ≤ 6, > 6 to ≤ 9, and ≥ 9h/day. Multivariable logistic regression analysis was conducted. Data on 13,210 adults aged ≥ 65years [mean (SD) age 72.6 (11.3) years; 55.0% females] were analyzed. In the overall sample, compared to > 6 to ≤ 9h/day of sleep duration, > 9h/day was associated with 1.70 (95% CI 1.15-2.51) and 1.75 (95% CI 1.08-2.84) times higher odds for sarcopenia and severe sarcopenia, respectively. No significant associations were observed among males, but associations were particularly pronounced among females [i.e., OR = 2.19 (95% CI 1.26-3.81) for sarcopenia, and OR = 2.26 (95% CI 1.20-4.23) for severe sarcopenia]. Long sleep duration was associated with an increased odds of sarcopenia and severe sarcopenia in LMICs, particularly in females. Future studies should investigate whether addressing long sleep duration among females can lead to lower risk for sarcopenia onset in LMICs.

Prediagnostic Progressive Supranuclear Palsy – Insights from the UK Biobank

IntroductionPrediagnostic features of Parkinson's Disease are well described but prediagnostic Progressive Supranuclear Palsy (PSP) is less understood. The diagnosis of PSP is delayed by an average of three years after symptom onset. Understanding the changes that occur in the prediagnostic period will aid earlier diagnosis, clarify the natural history, and may aid the design of early disease-modifying therapy trials. We set out to identify motor and cognitive markers of prediagnostic PSP, with Parkinson's disease as a comparator condition, in a large prospective cohort. MethodsBaseline UK Biobank data from 502,504 individuals were collected between 2006 and 2010. Subsequent PSP and Parkinson's disease cases were identified from primary and secondary care electronic health records' diagnostic coding data and death registry, with 5404 matched controls. Results176 PSP cases (time to diagnosis 7.8 ± 2.8 years) and 2526 Parkinson's disease cases (time to diagnosis 7.8 ± 2.9 years) were identified. At baseline, those later diagnosed with PSP had slower reaction times, weaker hand grip, lower fluid intelligence, prospective memory, self-rated health scores and digit recall than controls. Reaction times were correlated with time to diagnosis. The PSP group had higher mortality than both Parkinson's disease and control groups. ConclusionsMotor slowing, cognitive dysfunction, and postural instability are clinical diagnostic features of PSP that are typically symptomatic three years before diagnosis. Objective markers of these features were evident on average 7.8 years before diagnosis. Our findings suggest the existence of a long prediagnostic phase in PSP, with subtle changes in motor and cognitive function.

Animal Naming Test Is Associated With Poor Patient-Reported Outcomes and Frailty in People With and Without Cirrhosis: A Prospective Cohort Study.

INTRODUCTION:Cognitive dysfunction is a major driver of care complexity, poor patient-reported outcomes, and frailty for people with cirrhosis. The performance and clinical associations of the animal naming test (ANT) in the general population are unknown. We evaluated ANT performance in a representative sample of older Americans with and without chronic liver disease (CLD).METHODS:We analyzed 6,661 subjects enrolled in the 2010–2016 Health and Retirement Survey, a representative cohort of >30,000 US adults. Average age of participants was 75 years. We evaluated 3 subject subgroups: (i) without CLD, (ii) noncirrhosis CLD, and (iii) cirrhosis. We determined the association between the ANT (overall) and S-ANT1 <10 (adjusted for age and education) and health status, basic and instrumental activities of daily living, healthcare utilization (care hours received and hospitalizations), and frailty measures (hand grip and walk speed).RESULTS:Overall, 8.2% of the sample had noncirrhotic CLD and 1.3% had cirrhosis. CLD or cirrhosis was not independently associated with ANT. Poor ANT performance was associated with poor health status and frailty overall. An S-ANT <10 was associated with fair-poor self-reported health (odds ratio [OR] 1.37; 95% confidence interval [CI]: 1.20–1.56), care hours received (incidence rate ratio [IRR] 2.39; 95% CI: 1.79–3.19), and hospitalizations (IRR 1.14; 95% CI: 1.03–1.26). S-ANT <10 was also associated with activities of daily living disability (OR 1.31; 95% CI: 1.13–1.51), instrumental activities of daily living disability (OR 1.85; 95% CI: 1.59–2.14), weaker hand grip (IRR 0.94; 95% CI: 0.92–0.96), and time to walk 2.5 m (IRR 1.23; 95% CI: 1.17–1.29).DISCUSSION:ANT performance is not specific to CLD/cirrhosis but is associated with patient-reported outcomes and frailty in a nationally representative sample of elderly subjects with and without CLD.

Muscular function: An alternative way to identify cognitive impairment—secondary analysis from SABE‐Colombia

AbstractBackgroundTraditionally, the identification of cognitive impairment is based on neuropsychological tests and supported with not widely available biomarkers. This study aimed to establish the association between motor function (Gait Speed and Handgrip Strength) and the performance in a global cognitive performance and various cognitive domains. Our secondary objective was to determine a cut‐off point for Gait Speed and Handgrip Strength to classify older adults as cognitively impaired.MethodThis is a secondary analysis from the SABE Colombia study (Health, Well‐Being, and Aging) conducted in 2015. We performed linear regression models, to establish association with motor function, clinical, and sociodemographic variables, and predict the scores of the Mini‐mental State Examination and its domains (i.e. orientation, recall, counting, and language). The evaluation of the motor function variables as an instrument to separate cognitively impaired older adults was evaluated by developing a receiving operating characteristic curve (ROC).ResultGait speed was associated with orientation (r2 = 0.16), language (r2 = 0.15), recall memory (r2 = 0.14) and counting (r2 = 0.08). Similarly, handgrip strength was associated with orientation (r2 = 0.175), language (r2 = 0.164), recall memory (r2 = 0.137), and counting (r2 = 0.08). Slow gait had a cut‐off point of 0,59 m/s, with an area under the curve (AUC) of 0.629 (0.613‐0.646), whereas a weak handgrip strength had an AUC of 0.653 (0.645‐0.661), with a cut‐off point of 17.50 Kg for separating those older adults with cognitive impairment.ConclusionGait Speed or Handgrip Strength are similarly associated with cognitive performance, exhibiting the larger associations with orientation and language domains. Gait Speed and Handgrip Strength can be easily performed by any clinician and seems to be useful screening tools to detect cognitive impairment.

Effects of changes in depressive symptoms on handgrip strength in later life: A four-year longitudinal study in England

BackgroundFew studies have examined the associations between changes in depressive symptoms and handgrip strength in older people. This study aimed to examine the magnitude of the association between depressive symptoms over 2 years and weak handgrip strength on the 4 years of follow-up. MethodsWe conducted a longitudinal study using data from the English Longitudinal Study of Aging, a nationally representative panel survey of older adults in England. Data were derived from waves 4 (2008–2009), 5 (2010–2011), and 6 (2012–2013). A total of 5,080 participants were included in the analysis. Depressive symptoms were dichotomized using the eight-item Center for Epidemiological Studies Depression Scale in waves 4 and 5 and were regarded as the exposure. Handgrip strength measurements objectively measured in wave 6 were dichotomized according to the 25th percentile of the British norm and used as the outcome. The targeted maximum likelihood estimation model was utilized to assess time-variant depressive symptoms on handgrip strength, adjusted for time-variant and time-invariant covariates. ResultsThe maintenance of non-depressive symptoms (relative risk [RR], 0.72; 95% confidence interval [CI], 0.59–0.87) or improvement of depressive symptoms (RR, 0.71; 95% CI, 0.55–0.91) had a protective effect on weak handgrip strength compared with the persistence of depressive symptoms. LimitationThis study is not a randomized control trial but a longitudinal observational study, indicating that our study finding may still have been affected by unknown confounders. ConclusionOur findings suggest the importance of managing depressive symptoms to prevent poor physical function.

First Case of Association between Autoimmune Autonomic Ganglionopathy (AAG) and Myeloproliferative Neoplasms (MPNs)

IntroductionAutoimmune autonomic ganglionopathy (AAG) is a rare disease that presents with different autonomic symptoms and positive autoantibodies against the ganglionic acetylcholine receptor (gAChR) in 50 % of the cases. Eighty percent of seropositive patient has extra-autonomic manifestations. Extra-autonomic manifestations include sensory disturbance, central nervous system involvement, endocrine disorders autoimmune diseases, and cancers. It has been reported with various malignancies, such as small lung cancer, thymoma, ovarian tumors and others.MethodWe report a case from MD Anderson cancer center (MDACC) and to our knowledge it is first case in literature of a patient Autoimmune autonomic ganglionopathy associated with primary myelofibrosisResultA 55-year-old African American male diagnosed with JAK2 V617F positive primary myelofibrosis in 2005 and placed on observation until September 2012 when he was referred to MDACC for further management. He was started on protocol with Ruxolitinib + lenalidomide and did well initially, but during the course of treatment, he started to experience leg weakness. Initially in the left leg and then the right leg. lenalidomide was placed on hold and in April 2015, ruxolitinib was held as well. On examination he has left leg weakness in addition to weak hand grip on the same side.On Further evaluation, he was diagnosed with inclusion body myositis after muscle biopsy He was then lost to follow up and followed with outside hematologistIn February 2020, he developed cytopenias and was referred back to MDACC for management. He was seen and we performed a bone marrow shortly thereafter. He continued to have PMF, molecular, cytogenetics could not be performed on bone marrow due to dry tap. Patient started on “investigational agent. In early 2021 patient started to have orthostatic hypotension and syncope. Serum paraneoplastic antibody panel revealed acetylcholine Receptor Gang Neuronal Ab.The above finding along with his automimic symptoms consists with diagnosis of autoimmune autonomic ganglionopathy.ConclusionAutoimmune autonomic ganglionopathy (AAG) with extra-autonomic manifestations is a very rare and not well known. It is reported before to be associated with solid malignancy, we describe here first association with hematological malignancy which is primary myelofibrosis. We aim to add this to literature, and to increase the knowledge and awareness of both hematologists and neurologists about this association and possible other hematological malignancies may be reported in the future DisclosuresVerstovsek: Celgene: Consultancy, Research Funding; CTI BioPharma: Research Funding; Genentech: Research Funding; Promedior: Research Funding; PharmaEssentia: Research Funding; Ital Pharma: Research Funding; Protagonist Therapeutics: Research Funding; Roche: Research Funding; Gilead: Research Funding; Incyte Corporation: Consultancy, Research Funding; NS Pharma: Research Funding; Blueprint Medicines Corp: Research Funding; AstraZeneca: Research Funding; Novartis: Consultancy, Research Funding; Sierra Oncology: Consultancy, Research Funding; Constellation: Consultancy; Pragmatist: Consultancy.

Physio-Cognitive Decline Syndrome as the Phenotype and Treatment Target of Unhealthy Aging.

In this era of unprecedented longevity, healthy aging is an important public health priority. Avoiding or shortening the period of disability or dementia before death is critical to achieving the defining objectives of healthy aging, namely to develop and maintain functional capabilities that enable wellbeing in older age. The first step is to identify people who are at risk and then to implement effective primary interventions. Geriatricians have identified a distinct clinical phenotype of concurrent physical frailty and cognitive impairment, which predicts high risk of incident dementia and disability and is potentially reversible. Differing operational definitions for this phenotype include "cognitive frailty", "motoric cognitive risk syndrome" and the recently proposed "physio-cognitive decline syndrome (PCDS)". PCDS is defined as concurrent mobility impairment no disability (MIND: slow gait or/and weak handgrip) and cognitive impairment no dementia (CIND: ≥1.5 SD below the mean for age-, sex-, and education-matched norms in any cognitive domain but without dementia). By these criteria, PCDS has a prevalence of 10-15% among community-dwelling older persons without dementia or disability, who are at increased risk for incident disability (HR 3.9, 95% CI 3.0-5.1), incident dementia (HR 3.4, 95% CI 2.4-5.0) and all-cause mortality (HR 6.7, 95% CI 1.8-26.1). Moreover, PCDS is associated with characteristic neuroanatomic changes in the cerebellum and hippocampus, and their neurocircuitry, which are distinct from neuroimaging features in normal aging and common dementia syndromes. Basic research and longitudinal clinical studies also implicate a hypothetical muscle-brain axis in the pathoetiology of PCDS. Most important, community-dwelling elders with PCDS who participated in a multidomain intervention had significant improvements in global cognitive function, and especially in the subdomains of naming and concentration. Our proposed operational definition of PCDS successfully identifies an appreciable population of at-risk older people, establishes a distinct phenotype with an apparently unique pathoetiology, and is potentially reversible. We now need further studies to elucidate the pathophysiology of PCDS, to validate neuroimaging features and muscle-secreted microRNA biomarkers, and to evaluate the effectiveness of sustained multidomain interventions.

Longitudinal association of sarcopenia and mild cognitive impairment among older Mexican adults.

BackgroundRecent evidence from cross‐sectional and longitudinal studies supports the hypothesis that sarcopenia is associated with worsening cognitive function. However, primary evidence largely comes from high‐income countries, whereas in low‐ and middle‐income countries, this association has been underexplored. This study aimed to estimate the longitudinal association between sarcopenia and mild cognitive impairment in a sample of older Mexican adults.MethodsData come from the three waves of the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE) in Mexico (2009, 2014, 2017). Four hundred ninety‐six older adults, aged ≥50, were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Mild cognitive impairment was determined based on the recommendations of the National Institute on Aging‐Alzheimer's Association. Cognitive function was evaluated by a composite cognitive score of five different cognitive tests: immediate and delayed recall, forward and backward digit span and semantic verbal fluency. Three‐level mixed‐effects models (logistic and linear) were used to estimate the longitudinal associations between sarcopenia, mild cognitive impairment and cognitive function.ResultsThe prevalence of mild cognitive impairment (8.9%, 12.9%, 16.0%) and sarcopenia (10.5%, 20.7%, 23.3%) showed a significant temporal increase for Waves 1, 2 and 3 (P‐value < 0.01, respectively). The presence of sarcopenia was significantly associated with mild cognitive impairment (OR = 1.74; CI95% 1.02, 2.96; P = 0.04) and worse cognitive function (β = −0.57; CI95% ‐0.93, −0.21; P < 0.01). We observed significant associations between sarcopenia and immediate verbal recall (β = −0.14; CI95% −0.28, −0.01; P = 0.04), delayed verbal recall (β = −0.12; CI95% −0.23, −0.01; P = 0.03) and semantic verbal fluency (β = −0.17; CI95% −0.28, −0.05; P = 0.01). The prevalence of mild cognitive impairment increased at an annual rate of 0.8% for non‐sarcopenic older adults, but nearly 1.5% for sarcopenic adults.ConclusionsSignificant longitudinal associations were observed between sarcopenia, mild cognitive impairment and cognitive function among older Mexican adults. Public health strategies, including policy research and clinical interventions, must be implemented in low‐ and middle‐income countries in order to reduce or delay the onset of sarcopenia and thus improve population‐level cognitive health among older adults.

Sarcopenia and Mild Cognitive Impairment in Older Adults from Six Low- and Middle-Income Countries.

Little is known about the relationship between sarcopenia and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). This study aimed to investigate this association among community-dwelling adults aged≥65 years from six LMICs. Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. These data were obtained in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010. Participants were considered to have sarcopenia if they had low skeletal muscle mass (i.e., lower skeletal mass index) and a weak handgrip strength. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression analysis was conducted to assess associations. The final analytical sample consisted of 12,912 individuals aged≥65 years with preservation in functional abilities without stroke (mean [standard deviation] age 72.2 [10.8] years; 45.2% males). The overall prevalence of sarcopenia and MCI were 11.3% and 18.1%, respectively. After adjusting for potential confounders, there was a positive association between sarcopenia and MCI in all countries (i.e., odds ratio [OR] > 1) with the exception of South Africa, and the overall estimate was OR = 1.60 (95% confidence interval [CI] = 1.32-1.93) with a low level of between-country heterogeneity (I2 = 0.0%). There was a positive association between sarcopenia and MCI in this sample of older adults living in LMICs. Causality should be assessed in future longitudinal research, while the utility of sarcopenia as a marker of MCI should also be investigated.

Prevalence of sarcopenia in patients with gastroesophageal and lung malignancies undergoing surgical resection and its impact on immediate postoperative outcomes: A prospective observational study.

e18617 Background: The study evaluated the prevalence &amp; impact of sarcopenia in gastroesophageal cancer (GC) &amp; lung cancer (LC) patients undergoing resection. Methods: An observational prospective study was conducted in department of surgical oncology, AIIMS, New Delhi. All patients aged under 65 years with resectable GC &amp; LC were included. Skeletal muscle index (SMI) using cross-sectional CT images at the level of L3 &amp; Hand grip strength (dynamometer) were used to assess sarcopenia. Random benign patients with CT images were used as control group. Patients were categorized into sarcopenic and non-sarcopenic and outcome parameters were compared. Results: In the study population (n = 66), GC &amp; LC constituted 44 (66.67%) &amp; 22(33.33%) respectively. Mean age was 53.4 years. The prevalence of sarcopenia based on the combined method (CT imaging &amp; handgrip strength) was 57.58%, CT based sarcopenia was 33.34% &amp; handgrip strength-based sarcopenia was 43.93%. Mild and moderate sarcopenia was seen in 37.88% (n = 25) &amp; 19.7 % (n = 13) respectively. Among patients with GC, prevalence of sarcopenia was 59.09% by combined method, 36.36% and 43.18% by CT based method alone &amp; handgrip strength-based method alone respectively. Among LC prevalence of sarcopenia was 54.54% by combined method, 27.27% and 45.45% by CT based &amp; handgrip-based method. The concordance between CT muscle mass &amp; grip strength was 62.12%. Most female patients had weak handgrip strength despite having normal SMI. In control group (n = 44) mean age was 54.5 years, the prevalence of CT based sarcopenia was 34.09%. Weight loss history &amp; BMI correlated with the degree of sarcopenia. Out of 66 patients 13% (n = 9) patients were unresectable. Moderate sarcopenia group had more statistically significant (P -0.02) unresectable disease compared to mild and non-sarcopenic groups. In postoperative period, sarcopenic group (64.51% vs 38.36 %) had more grade 2 complications though statistically insignificant. There was no difference in hospital stay between the two groups. In patients with GC , postoperative respiratory complication occurred in 11.53% (n = 3) of sarcopenic patients and 5.5%(n = 1) of non-sarcopenic patients, anastomotic leak occurred in 7.69% (n = 2) of sarcopenic patients and 5.5% (n = 1) of nonsarcopenic patients. Conclusions: The prevalence of sarcopenia is higher in patients with gastroesophageal cancer compared to lung cancer. The important factors that affect the sarcopenia include age and body mass index and weight loss history. The study has showed a trend towards increased post-operative complications and increased unresectable cases in patients with mild to moderate sarcopenia. Further larger studies are required to validate if sarcopenia can be used as an adjunct to predict resectability and post-operative outcomes.

Weak Handgrip at Index Admission for Acute Exacerbation of COPD Predicts All-Cause 30-Day Readmission.

Rationale: Identifying patients hospitalized for acute exacerbations of COPD (AECOPD) who are at high risk for readmission is challenging. Traditional markers of disease severity such as pulmonary function have limited utility in predicting readmission. Handgrip strength, a component of the physical frailty phenotype, may be a simple tool to help predict readmission.Objective(s): To investigate if handgrip strength, a component of the physical frailty phenotype and surrogate for weakness, is a predictive biomarker of COPD readmission.Methods: This was a prospective, observational study of patients admitted to the inpatient general medicine unit at the University of Chicago Medicine, US. This study evaluated age, sex, ethnicity, degree of obstructive lung disease by spirometry (FEV1 percent predicted), and physical frailty phenotype (components include handgrip strength and walk speed). The primary outcome was all-cause hospital readmission within 30 days of discharge.Results: Of 381 eligible patients with AECOPD, 70 participants agreed to consent to participate in this study. Twelve participants (17%) were readmitted within 30 days of discharge. Weak grip at index hospitalization, defined as grip strength lower than previously established cut-points for sex and body mass index (BMI), was predictive of readmission (OR 11.2, 95% CI 1.3, 93.2, p = 0.03). Degree of airway obstruction (FEV1 percent predicted) did not predict readmission (OR 1.0, 95% CI 0.95, 1.1, p = 0.7). No non-frail patients were readmitted.Conclusions: At a single academic center weak grip strength was associated with increased 30-day readmission. Future studies should investigate whether geriatric measures can help risk-stratify patients for likelihood of readmission after admission for AECOPD.

Objectively measured far vision impairment and sarcopenia among adults aged ≥ 65years from six low- and middle-income countries.

There are currently no studies on visual impairment and sarcopenia. We investigated the cross-sectional association between objectively measured far vision impairment and sarcopenia in a nationally representative sample of older adults aged 65years and over from six low- and middle-income countries (LMICs). Cross-sectional, community-based data from the study on global ageing and adult health (SAGE) were analyzed. Far vision acuity was measured using the tumbling E LogMAR chart and classified as: no vision impairment (6/12 or better); mild vision impairment (6/18 or better but worse than 6/12); moderate vision impairment (6/60 or better but worse than 6/18); severe vision impairment (worse than 6/60). Sarcopenia was defined as having low skeletal muscle mass and either a slow gait speed or a weak handgrip strength. Associations were assessed with multivariable logistic regression. Fourteen thousand five hundred andeighty five individuals aged ≥ 65years were included in the analysis [mean (SD) age 72.6 (11.5) years; 54.1% females]. After adjustment for multiple potential confounders, compared to those with no vision impairment, the OR (95% CI) for sarcopenia in those with mild, moderate, and severe vision impairment were 1.10 (0.87-1.40), 1.69 (1.25-2.27), and 3.38 (1.69-6.77), respectively. The estimates for females and males were similar. The odds for sarcopenia increased with increasing severity of far vision impairment among older people in LMICs. The mere co-occurrence of these conditions is concerning, and it may be prudent to implement interventions to address/prevent sarcopenia in those with far vision impairment through the promotion of physical activity and appropriate nutrition.

Association between hand grip strength and stroke in China: a prospective cohort study.

Objectives: The association between weak hand grip strength (HGS) and stroke recovery has been studied; however, few studies focused on the association of HGS with stroke prevalence and incidence.Methods: A prospective cohort baseline study of a nationally representative sample in Chinese adults aged 45 years and older in 2011 was followed up in 2015. 8871 participants without stroke at baseline were followed. The associations of HGS and its changes with stroke prevalence and incidence were investigated using logistic regression models and Cox proportional hazards regression models.Results: Association of HGS and stroke prevalence was significant. HGS weakness significantly increased risk of stroke incidence, with 89.3% higher risk when compared to normal HGS. During 35,263 person-years of follow-up, 112 stroke patients occurred. The four-year incidence rate ratio of stroke for participants with a HGS weakness was 2.15, compared to normal HGS participants. HGS changes in weakness/weakness from 2011 to 2015(D-HGS) and normal/weakness D-HGS had higher risks of stroke incidence when compared with those who had normal/normal D-HGS.Conclusions: HGS weakness and decline of HGS were associated with stroke incidence for adults aged 45 years and older in China.

Analysis of Factors Influencing Hand Grip Strength and Acute Effect of Grip Strength Test on Blood Pressure in Young Adults

Introduction: Isometric Hand Grip (IHG) strength measurement is extensively used in many areas of medicine and sport science as a functional test of overall strength. By testing the IHG strength, maximum isometric strength of the hand and forearm muscles can be estimated. Weak hand grip strength is a key component of sarcopenia and is associated with subsequent disability and mortality. Aim: To evaluate the role of handedness, gender, ethnicity, Body Mass Index (BMI) on hand grip strength and to examine the acute effect of grip strength test on blood pressure in young adults. Materials and Methods: This cross-sectional study was done between November 2018-November 2019 on normal healthy participants (n=83; average age 20.24±0.21 years) representing various ethnicities. Participants’ demographic data was collected and their IHG strength was determined in both dominant and non dominant hand. Blood pressure was recorded before and after the IHG strength test. A correlation analysis was performed to determine the association between resting blood pressure/BMI with IHG strength. Results: A total of 83 subjects of different ethnicities and both male and female genders were included in the study. The IHG strength was not influenced by handedness in both the sexes. Amongst males, IHG strength was found to be slightly higher in the Arab population as compared to South-asian and Emirati. A lower IHG strength was observed in females compared to males in every ethnicity studied. Moderate positive correlation was found between IHG strength with BMI (dominant hand IHG strength vs BMI: r=0.34; p-value &lt;0.001, non dominant hand IHG strength vs BMI: r=0.35; p-value &lt;0.001) and with Systolic Blood Pressure (SBP) (r=0.55; p-value ≤0.0001) (SBP). Both the SBP and Diastolic Blood Pressures (DBP) were observed to be reduced after IHG strength test. Conclusion: Handedness did not influence IHG strength, but, ethnicity mildly and gender significantly influenced it. Blood pressure was reduced by IHG test. The IHG strength was positively correlated with BMI and SBP.

Weight underestimation and weight nonregulation behavior may be related to weak grip strength

The hypothesis of this study is that weight-related behaviors such as weight perception and weight control efforts may be related to health indicators such as grip strength as an indicator of muscle strength. This cross-sectional study aimed to prove this hypothesis by assessment of the associations of perceived weight status, weight misperceptions, and weight control efforts with grip strength. A questionnaire and measurements were used to assess the perceived weight status, weight control efforts, weight control methods, weight misperceptions, grip strength (sarcopenic vs normal), and confounding factors (measured body mass index, sociodemographic characteristics, concurrent chronic diseases, high sensitivity C-reactive protein, depressive mood, health-related quality of life, health behaviors, and protein intake) among 12,727 adults (men, 43.1%; 51.0 ± 16.6 years old) using the 2015 to 2017 Korea National Health and Nutrition Examination Survey. In fully adjusted models, the odds of sarcopenic grip strength tended to increase with thinner weight perceptions (P for trend <.001). Sarcopenic grip strength was inversely associated with accurate estimation or overestimation of weight (adjusted odds ratio [aOR] 0.64-0.68) and weight loss/maintenance efforts (aOR 0.68-0.73) compared with underestimation of weight and nonweight control efforts. These findings were consistent across sex and weight status, and were found among participants aged 60 years or older but not less than 60 years. In conclusion, this study supports the research hypothesis that the perception of one's own weight, the accuracy of the perceived weight, and the weight control efforts may be related to weak handgrip strength.

Determinants of Health-Related Quality of Life and Physical Performance-Based Components of Frailty in Patients Undergoing Hemodialysis

Health-related quality of life (HRQoL) measures capture the patient's experience of the burden of chronic disease and are strongly associated with adverse health-related outcomes across multiple populations. The SF-36 score is the most widely used HRQoL measure among patients with end-stage renal disease. Current understanding of determinants of the physical component summary (PCS) and the mental component summary (MCS) and their association with objectively measured physical performance and activity is limited. As an index of HRQoL, we prospectively examined the association of SF-36 and its component scores with physical function among 155 incident dialysis patients from the Hemodialysis Center. We investigated associations of HRQoL with the physical performance-based components of the frailty using multivariate linear and logistic regression after adjustment for confounders. Impaired physical performance was defined as having either slow usual gait speed or weak handgrip strength based on standardized and validated criteria derived from a large cohort study of older adults. The patients had a mean age of 65±11years, and 52.3% were male. After adjusting confounders, lower PCS was independently associated with decreased physical performance and reduced physical activity, but MCS was not associated. Among the PCS subscales, only physical functioning 10 (PF-10) was consistently associated with outcomes, and every 1 point increase in PF-10 score was associated with 4% lower odds of impaired physical performance (95% confidence interval 2-7, P=.01) after adjustment. SF-36, especially PF-10, is a valid surrogate that discriminates low physical performance and physical inactivity in the absence of formal physical function testing in patients on hemodialysis. The routine implementation of the PF-10 in clinical care has important clinical implications for medical management and therapeutic decision-making in patients undergoing hemodialysis.