Weak Handgrip Strength Research Articles

Dietary advanced glycation end-products (dAGEs) intake and its relation to sarcopenia and frailty - The Rotterdam Study.

Studies on mice have shown a relationship between dietary intake of advanced glycation end-products (dAGEs) and deterioration of musculoskeletal health, but human studies are absent. We investigated the relationship between dietary intake of carboxymethyllysine (dCML) - an AGE prototype - and risk of sarcopenia at baseline and after 5years of follow-up and a single evaluation of physical frailty in participants from the population-based Rotterdam Study. Appendicular lean mass (ALM) was obtained using insight dual-energy X-ray absorptiometry and hand grip strength (HGS) using a hydraulic hand dynamometer. Subjects with both low ALM and weak HGS were classified as having sarcopenia. Frailty (yes/no) was defined by presence of ≥3 and pre-frailty by presence of 1 or 2 components namely, exhaustion, weakness, slowness, weight loss or low physical activity. dCML was calculated using a food frequency questionnaire and dAGE databases. Logistic regression analysis was used to evaluate the odds of physical frailty and prevalent sarcopenia at baseline and follow-up and incident sarcopenia. 2782 participants with an age 66.4±9.9years and dCML intake 3.3±1.3mg/day, had data on sarcopenia at both time points. Of whom 84 had sarcopenia at baseline and 73 developed sarcopenia at follow-up. We observed an association of one SD increase in dCML intake with prevalent sarcopenia at baseline [odds ratio, OR=1.27 (1.01-1.59)] and no association of dCML with incident sarcopenia at 5-year follow-up [OR=1.12 (0.86-1.44)]. For frailty we analyzed 3577 participants, of whom 1972 were pre-frail and 158 were frail. We observed no association of dCML with either pre-frailty [OR=0.99 (0.91-1.07)] or frailty [OR=1.01 (0.83-1.22)] when non-frail subjects were used as reference. Our results show an association of dAGEs with sarcopenia cross-sectionally but not longitudinally where inconclusive findings are observed possibly due to a very low incidence of sarcopenia. There was no association with frailty cross-sectionally.

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<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.

Relative Handgrip Strength Mediates the Relationship between Hemoglobin and Health-Related Quality of Life in Older Korean Adults.

Little is known regarding how anemia and handgrip strength influence the health-related quality of life (HRQoL) of older populations. This population-based study aimed to examine whether handgrip strength mediates the association between anemia and HRQoL in a representative sample of 6892 Korean adults aged ≥ 65 years (3753 females). HRQoL was assessed with the EuroQol-5 dimension. Anemia was defined according to World Health Organization (WHO) criteria, and handgrip strength was measured with a digital hand dynamometer. Individuals with anemia were at increased risk for a lower HRQoL (odds ratio, OR = 1.285, p = 0.002) even after adjustment for age, sex, body mass index, income, marital status, education, physical activity, and multimorbidity compared with individuals without anemia (OR = 1). Individuals with weak handgrip strength were also at increased risk for a lower HRQoL (OR = 1.429, p < 0.001) even after adjustment for all the covariates compared with individuals with normal handgrip strength (OR = 1). Mediation analysis with a bootstrapping procedure showed that relative handgrip strength mediated the relationship between hemoglobin and HRQoL (95% confidence interval, CI 0.0192 to 0.0289) even after adjustment for all covariates, with 42.0% of the total effect of hemoglobin on HRQoL explained. The current findings suggest that the impact of anemia on HRQoL is partially mediated by weak handgrip strength, implying the clinical importance of having or maintaining adequate hemoglobin and handgrip strength via healthy lifestyle choices to maintain a high HRQoL later in life.

Gait speed, handgrip strength, and cognitive impairment among older women - A multistate analysis.

Cognitive impairment imposes substantial psychological, emotional, and economic burdens on affected individuals, families and society. A better understanding of potentially modifiable risk factors that may be used in the prevention of cognitive impairment is therefore a high priority in aging research. This study included 9268 community-dwelling women aged 65years or older from the Study of Osteoporotic Fractures launched between 1986 and 1988 in the US. Participants were followed for 20years. Modified Mini-Mental State Examination (m-MMSE) was administered up to 6 times. Six updated measurements of gait speed and handgrip strength at the same visit time when m-MMSE was administered were used. The m-MMSE score was used to define cognitive impairment states (normal, mild, and severe impairment). A multi-state model (MSM) was used to estimate the transitions between different states of cognitive function. Faster gait speed (one unit increase of meter/s) was associated with lower risk of transition from cognitively normal status to mild cognitive impairment (HR=0.50, 95% CI: 0.37-0.67), and from mild impairment to severe impairment (HR=0.52, 95% CI: 0.37-0.72). Higher gait speed was associated with increased risk of cognitive transition from severe impairment to mild impairment (HR=2.56 95% CI: 0.97-6.77), although the result did not reach statistical significance. Similarly, we observed greater handgrip strength (per kg increase) was associated with lower risk of transition of cognitive status from normal to mild impairment (HR=0.96 95% CI: 0.95-0.97), and from mild to severe impairment (HR=0.98, 95% CI: 0.96-0.99). Greater handgrip strength was associated with increased risk of cognitive transition from severe to mild cognitive impairment (HR=1.05, 95% CI: 1.01-1.09). In addition, we also observed that both faster gait speed and greater handgrip strength were associated with lower risk of transitions from normal or mild cognitive impairment status to death. Our results confirmed that screening for slow gait speed or weak handgrip strength may be useful for identifying older adults at risk for cognitive decline when they are still cognitively normal or only mildly impaired. Exercise programs to improve gait speed and muscle strength may delay or prevent transitions into cognitive impairment in older adults.

The Associations between Upper and Lower Body Muscle Strength and Diabetes among Midlife Women.

We hypothesized that a combined index of upper and lower body muscle strength would be more strongly associated with diabetes than either measure alone. Women recruited into the Integrated Women’s Health Program had their handgrip strength (HGS) measured using a dynamometer and underwent a timed 5-repetition chair stand (RCS) test. HGS < 18 kg and RCS performance ≥ 12 s assessed upper and lower body strength, respectively, both individually and combined in a muscle strength index (MSI). Diabetes was defined as physician-diagnosed, use of anti-diabetic medication, or fasting blood glucose ≥ 7.0 mmol/L. Binary logistic regression examined the associations between muscle strength and diabetes. Of 1170 midlife women, 12.1% had diabetes. A low HGS was independently associated with diabetes (aOR: 1.59, 95% CI: 1.03, 2.44). Prolonged RCS was also associated with diabetes (aOR: 1.59, 95% CI: 1.09, 2.30), but this was not independent of visceral adiposity and muscle mass. A poor MSI had higher odds of diabetes (aOR: 2.37, 95% CI: 1.40, 4.03), independent of age, ethnicity, education level, menopausal status, smoking, alcohol consumption, physical activity, height, visceral adiposity, and muscle mass. The combination of both upper and lower body muscle strength into a composite MSI was more strongly associated with diabetes than either weak HGS or prolonged RCS alone in midlife women.

Factors Determining the Occurrence of Frailty Syndrome in Hospitalized Older Patients.

Frailty syndrome (FS) is a condition characterized by a decline in reserves, observed with aging. The most important consequences of the frailty syndrome include disability, hospitalization, fractures, institutionalization, and early mortality. The aim of this study was to identify the most important risk factors for FS in a group of older hospitalized patients in Poland. A total of one hundred and forty-one (78 women, 63 men) elderly patients from the Departments of Internal Medicine of the Medical University of Lodz (Poland) were recruited for this study. Frailty Instrument of the Survey of Health, Aging and Retirement in Europe (SHARE-FI), handgrip strength (HGS), depressive symptoms using the Geriatric Depression Scale (GDS), and functional ability (FA) using the Instrumental Activities of Daily Living (IADL) were assessed. According to SHARE-FI score, participants were divided into control group, frail, and pre-frail patients. Out of all 141 tested patients, FS was confirmed in 55 patients, and pre-frailty was observed in 52 patients. The occurrence of FS in the group of studied patients was related to age (p < 0.001), widowhood (p < 0.001), comorbidities (p < 0.001), heart diseases (p = 0.04), more medications taken (p < 0.001), lower FA (p < 0.001), weaker HGS, and depression (p < 0.001). The strongest positive correlations were between Share-FI score and the number of diseases (rS = 0.31), GDS (rS = 0.32), while negative correlations with IADL (rS = −0.47) and HGS (rS = −0.35). The study shows that FS is associated with age, comorbidities, number of medications taken, and widowhood. The present study has also demonstrated that FA, depression, and especially HGS are essential determinants of FS of elderly hospitalized people.

S1037 Prevalence and Predictors of Nutritional Deficiencies and Quality of Life in Patients With Ulcerative Colitis

Introduction: To study the prevalence and predictors of nutritional deficiencies and poor quality of life (QOL) in patients with Ulcerative colitis (UC). Methods: It was a cross-sectional prospective study where all the patients visiting gastroenterology services over a year diagnosed as UC were evaluated for macronutrient and micronutrient deficiency after informed consent. Patients with significant comorbid conditions were excluded. Cases were defined as patients with UC and controls were healthy relatives of the cases. We used short inflammatory bowel disease questionnaire (SIBDQ) score < 50 as poor QOL. Results: 126 patients of UC and 57 healthy controls were analysed. The cases and controls were well matched in their demographic and social characteristics. Patients with UC as compared to controls had increased prevalence of being underweight (27.8% v/s 3.50%), low mid-arm-circumference (45.23% v/s 12.28%), weak handgrip strength (66.66% v/s 45.61%) and weak lower limb strength (80.15% v/s 42.10%).They showed higher protein deficiency (30.95% v/s 3.50%), albumin-deficiency (25.39% v/s 0%) and cholesterol-deficiency (62.69% v/s 28.07%). Micronutrient deficiency was also significantly more prevalent in patients: calcium-deficiency (44.44% v/s 5.26%) and phosphate-deficiency (20.63% v/s 1.75%). UC patients had high prevalence of other micronutrient deficiencies – Iron-deficiency (87.3%), Folate-deficiency (15.9%), Vitamin B12 deficiency (10.3%) and vitamin D-deficiency(< 11 ng/ml) (19.8%). Serum albumin and iron deficiency emerged as independent predictors of serum calcium-deficiency with OR of 6.8 and 13.4 respectively. Serum folate-deficiency emerged as independent predictor of magnesium-deficiency with OR of 3.93. Serum calcium emerged as independent predictor of serum iron-deficiency with OR of 11.56. Serum albumin-deficiency emerged as independent predictor of vitamin D-deficiency with OR of 4.43. 85 (67.46%) of patients had poor quality of life by SIBDQ questionnaire. Vitamin D (r=0.275), and albumin levels (r=0.399) positively correlated with QOL. Vitamin D-insufficiency (< 32 ng/ml) and histologically active disease by Robarts histological score >3 emerged as independent predictors of poor QOL with OR of 6.0 and 4.0 respectively. Conclusion: Micro and macro-nutrient deficiencies are more prevalent in patients with UC than healthy controls. Albumin levels correlated well with micronutrient deficiencies and QOL. Vitamin D-insufficiency and histologically active disease predict the poor QOL.

Association between sarcopenia and quality of life among adults aged ≥ 65years from low- and middle-income countries.

Sarcopenia has been associated with a lower quality of life (QoL). However, studies on this association from low- and middle-income countries (LMICs) are scarce. To examine the association between sarcopenia and QoL, in a large nationally representative sample of older adults from six LMICs. Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Non-severe sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength but no slow gait speed, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. QoL was assessed with the 8-item WHO QoL instrument (range 0-100) with higher scores representing better QoL. Multivariable linear regression analysis was conducted. Data on 14,585 people aged ≥ 65years were analyzed [mean (SD) age 72.6 (11.5) years; 55.0% female]. After adjustment for potential confounders, compared to no sarcopenia, severe sarcopenia was associated with a significant -3.37 points [95% CI -5.56, -1.18] lower QoL score. Non-severe sarcopenia was not significantly associated with lower QoL. The association between sarcopenia and QoL observed in our study may be explained by factors such as functional impairment and disability related with sarcopenia. In this large representative sample of older adults from multiple LMICs, compared to no sarcopenia, only severe sarcopenia was associated with a significantly lower QoL score. Interventions to prevent or manage sarcopenia among older adults in LMICs may contribute to better QoL in this population.

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

IntroductionSarcopenia is an important clinical syndrome in older people living with HIV (PLWH). With a change to the Asia sarcopenia definition in 2019, we aimed to determine whether health outcomes were associated with different definitions of sarcopenia among Asian PLWH.MethodsWe performed a prospective cross‐sectional study enrolling PLWH aged ≥35 years from January 2018 to November 2021. We defined sarcopenia by the Asia Working Group of Sarcopenia (AWGS) criteria in 2014 and 2019. AWGS‐2014 included low muscle mass plus weak handgrip strength and/or slow gait speed. AWGS‐2019 included low muscle mass plus low muscle strength or physical performance, while the presence of all defines severe sarcopenia. We measured appendicular skeletal muscle mass using dual‐energy X‐ray absorptiometry, handgrip strength, usual gait speed, five‐time chair stand test and Short Physical Performance Battery. Correlations between each sarcopenia definition and health‐related quality of life (using EQ‐5D‐5L and SF‐36) and functional disability were determined.ResultsOne hundred and fifty Asian PLWH were enrolled, 132 (88%) were male, mean age was 60±10 years, duration of HIV diagnosis was 13 (IQR 8–18) years and current CD4 count was 574 (IQR 362–762) cells/mm3, 67 (45%) had multimorbidity, 64 (43%) had polypharmacy. Prevalence of sarcopenia by AWGS‐2014, AWGS‐2019 and severe sarcopenia was 17.3%, 27.3% and 18.0%, respectively. Age, education and polypharmacy were associated with sarcopenia. Sarcopenia (AWGS‐2014) and severe sarcopenia were associated with mobility, physical functioning and physical component score (SF‐36). All three criteria were associated with impaired instrumental activities of daily living (IADL). After age and sex adjustment, sarcopenia (AWGS‐2014) (adjusted odds ratio/aOR 5.4, 95% confidence interval/CI 2.0–15.1) and severe sarcopenia (aOR 5.1, 95% CI 1.9–14.0) were associated with mobility and physical component score (SF‐36) (β coefficients –5.3342, p = 0.022 and –5.412, p = 0.019). Sarcopenia (AWGS 2014) (aOR 5.2, 95% CI 1.7–16.2), sarcopenia (AWGS‐2019) (aOR 4.5, 95% CI 1.5–13.1) and severe sarcopenia (aOR 3.5, 95% CI 1.1–10.9) were associated with impaired IADL in fully adjusted models.ConclusionsIn a sample of Asian PLWH, 17.3%, 27.3% and 18.0% had sarcopenia as defined by AWGS‐2014, AWGS‐2019 and severe sarcopenia, respectively. Sarcopenia by AWGS‐2014 and severe sarcopenia correlated with parameters of poor health outcomes, while sarcopenia by AWGS‐2019 correlated with functional disability.

Relationship between handgrip strength and self-reported functional difficulties among older Indian adults: The role of self-rated health.

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

Relationship between handgrip strength, depression and cognitive functioning among older adults: Evidence from longitudinal ageing study in India

Handgrip strength (HGS) is a frequent and general indicator of muscle strength and it may affect several aspects of mental health among older people. This study explored the association of HGS with depression and cognitive impairment among community-dwelling older adults in resource-constrained setting of India. Data were drawn from the Longitudinal Ageing Study in India (LASI), and the analysis was conducted on 27,707 older adults aged 60years and above. Outcome measures included depression (assessed by the Short Form Composite International Diagnostic Interview (CIDI-SF) and the Center for Epidemiological Studies-Depression (CES-D) scales) and cognitive impairment. Descriptive statistics and mean scores of HGS were reported and multivariable linear regression analyses were conducted to test the research hypotheses of the study. Mean score of HGS was 24.33 (SD: 7.22) for males and 15.94 (SD: 5.14) for females. Mean age was 68.86 (SD: 7.19) and 68.40 (SD: 7.31) years among males and females respectively. Older participants who had weak HGS were significantly more likely to be depressed in CIDI-SF scale (B: 0.06, CI: 0.01-0.13) and CES-D scale (B: 0.02, CI: 0.01-0.03) in comparison to those who had strong HGS after adjusting for a large number of confounders. Older participants who had weak HGS were significantly more likely (B: 0.92, CI: 0.76-1.07) to have cognitive impairment compared to those who had strong HGS. The findings highlight the independent association of HGS with major depression, depressive symptoms and cognitive impairment that have implications on promoting resistance-training programs among aged population.

Role of handgrip strength testing in pre-anaesthetic check-up: A prospective cross-sectional study.

Frailty has been known to be associated with postoperative adverse events and longer hospital length of stay (LOS). Hand grip strength (HGS) is one of the parameters of measuring frailty. The aim of the study was to correlate preoperative handgrip strength and 30-day outcome of patients undergoing major abdominal surgery. It also aimed to evaluate the role of the standard preoperative variables like metabolic equivalents, revised cardiac risk index (RCRI), serum albumin, and serum creatinine along with their association with HGS testing in determining the postoperative outcome in surgical patients. This prospective observational study included 149 American Society of Anesthesiologists class III/IV patients presenting for major abdominal surgery. A mean of three measurements of dominant HGS using Camry hand dynamometer was measured. The patients were divided into groups: weak, normal, and strong depending on grip strength. Patients were followed for 30 days and postoperative outcome in terms of ventilatory support, admission to intensive care unit, cardiac complications, in-hospital mortality, and LOS were recorded. Observational data obtained were reported as mean value and analyzed using Student's t-test or Wilcoxon/Mann-Whitney Rank test. Associations between RCRI, serum albumin, and LOS with HGS were evaluated using logistic regression. The hospital LOS was significantly longer in patients with weak HGS (15.11 ± 11.03 days versus 10 ± 5.71 days, P = 0.001). Patients with weak HGS had significantly lower mean serum albumin levels compared to normal HGS (P = 0.0001) and a statistically significant RCRI score (P = 0.013). HGS can be used as a preoperative test in predicting hospital LOS after major surgery.

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.

Profile of Cachexia Parameters and Dietary Intakes in Advanced Stage of Nasopharyngeal Cancer Patients: Study inThree Hospitals in Semarang, Central Java, Indonesia

Background: Nasopharyngeal cancer (NPC) patients have high risk of cachexia. It is important to notice cachexia parameters in the beginning of their treatment in order to predict and anticipate unexpected outcomes. This study aimed to describe the profile of advanced stage NPC patient receiving first chemotherapy, especially in cachexia parameters and dietary intakes. Methods: A cross-sectional study was conducted involving advanced stage of NPC patients who would receive their first chemotherapy aged 20-70 years. Subjects with distant metastatic, acute infection, history of past chemotherapy or radiotherapy, were excluded. Parameters of cachexia being studied were inflammation markers (NLR and CRP level), anorexia and fatigue scores, body composition (fat and muscle mass) and hand grip strength (HGS), meanwhile dietary intakes were energy and protein. Frequency distribution, descriptive statistic, and Pearson correlation test were used in data analyses. Results: Forty-three subjects were participated. Average age was48.1±9.8 years old and 63% were males. NLR and CRP level were high, i.e.4.8±5.0 and 13.3±20.6 mg/dL, respectively. Anorexia and fatigue scores were 32.4±9 and 35.9±11.8, respectively, with 70% subjects were anorexic and 30% subjects experienced severe fatigue. Less than 20% were malnourished but 35% subjects had central obesity and 37% subjects classified to have very high fat mass. Most subjects had low muscle mass (77%) and classified to have weak HGS (77%). Energy and protein intakes were 26.7±8.9 kcal/kgBW/d and 1±0.4 g/kg BW/d respectively. Some variables had strong correlation (r≥0.80), i.e. BMI with visceral fat (r=0.94), fat with muscle mass (r=-0.89), energy with protein intakes (r=0.80), and moderate correlation (r=0.60–0.79) between anorexia and fatigue scores. Conclusions: Advanced stage of NPC patients receiving first chemotherapy had high inflammation status, anorexia and fatigue. Many subjects had low muscle mass and weak HGS. BMI with visceral fat, fat with muscle mass, energy with protein intake, were strongly correlated. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 302-310

Hand grip strength and depression among rural older South Africans.

The study aimed to assess the relationship between hand grip strength (HGS) and depressive symptoms among ageing women and men in a longitudinal study in rural South Africa. We analyzed longitudinal data from two consecutive population-based surveys in Agincourt, South Africa, 2014/2015-2018/2019. Results indicate that in all, 835 adults of 3268 participants without depression in Wave 1 (25.0 percent) had incident depression in Wave 2, and 184 adults of 3866 participants who had depression in Wave 1 (4.8 percent) screened positive for depression at both Wave 1 and 2 (persistent depression). The prevalence of weak HGS was 51.5 percent at baseline. In the fully adjusted model, weak HGS increased the odds of incident depressive symptoms between both sexes (AOR: 1.24, 95 percent CI: 1.04-1.47) among women (AOR: 1.33, 95 percent CI: 1.05-1.68), but not among men. No models among both sexes, among men and women, showed an increased odds of weak HGS with persistent depressive symptoms. Weak HGS was independently associated with the incident, but not persistent depressive symptoms between the two sexes and between women but not between men.

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.

Relation between Handgrip Strength and Quality of Life in Patients with Arthritis in Korea: The Korea National Health and Nutrition Examination Survey, 2015-2018.

Background and Objectives: This study aimed to investigate the relationship between handgrip strength (HGS) and quality of life (QOL) in patients diagnosed with osteoarthritis (OA) or rheumatoid arthritis (RA). Materials and Methods: We enrolled 13,966 from the Korea National Health and Nutrition Examination Survey from 2015 to 2018. All participants underwent the health-related QOL assessment using the European Quality of Life Scale-Five dimensions (EQ-5D) and measured the HGS. The weak HGS was defined as the lowest quartile. We investigated the difference in QOL between patients with arthritis and the healthy control group and evaluated the correlation between weak HGS and QOL in arthritis patients. Results: Those diagnosed with OA or RA had significantly lower QOL than healthy controls. The weak HGS was significantly correlated with lower QOL in arthritis patients. Among OA patients, those with weak HGS revealed significantly higher odds ratios for impairment in all dimensions of EQ-5D. RA patients with weak HGS had significantly higher odds ratios for impairment in dimensions of mobility, self-care, usual activity, and pain/discomfort than those with normal HGS. Conclusions: These results suggest that weak HGS is significantly associated with decreased QOL in patients with arthritis.