A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness

IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Clinical nutrition Pub Date : 2024-09-06 DOI:10.1016/j.clnu.2024.09.010
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Abstract

Objectives

Handgrip strength (HGS) is accepted as a predictor of overall health status and a biomarker of aging, besides negative health outcomes and mortality. While differences in HGS between the dominant and non-dominant hands are expected, substantial discrepancies may signal impaired muscle function. This study aims to investigate whether handgrip asymmetry can serve as a reliable indicator of frailty in a diverse population of older adults.

Design

Cross-sectional study.

Setting and participants

A total of 512 patients aged 65 years and older who were admitted to the geriatric medicine outpatient clinic of a university hospital were enrolled in the study.

Methods

The Clinical Frailty Scale (CFS) was used to assess the overall level of frailty of the study population. The highest recorded HGS values from the non-dominant and dominant hand were used to calculate the HGS ratio. Those with a HGS ratio of dominant and non-dominant hand <0.90 or >1.10 were defined as HGS asymmetry.

Results

Of the whole study group, 61.1% was female and the mean age was 73.2 ± 6.1 years. The ratio of the participants living with frailty was 57.6% (n = 219). The number of patients with HGS asymmetry was 264 (51.6%), and 48.4% (n = 248) of the study population had symmetric HGS. The normal and symmetric HGS was found in 40.2% of the non-frail group, whereas it was 23.7% in patients living with frailty. Furthermore, the ratio of low and asymmetric HGS was 16.3% in the non-frail group, and 35.0% in the patients living with frailty (p < 0.001). The presence of asymmetric and low HGS increased the risk of frailty three times independently of other confounding factors (OR:3.08; 95% CI:1.48–6.43; p = 0.003).

Conclusions and implications

Identifying HGS asymmetry along with low HGS as potential indicators of frailty may provide clinicians with a clear and quantifiable criterion for assessing older patients.

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老年人的牵手现象:老年门诊病人体弱的风险增加与手部握力不对称和无力有关
目的手握力(HGS)被认为是预测总体健康状况的指标,也是衰老的生物标志物,此外还能预测负面健康状况和死亡率。虽然惯用手和非惯用手之间的握力差异是意料之中的,但巨大的差异可能预示着肌肉功能受损。本研究旨在探讨手握不对称是否可作为不同老年人群虚弱程度的可靠指标。方法采用临床虚弱量表(CFS)评估研究人群的整体虚弱程度。用非惯用手和惯用手的最高 HGS 值计算 HGS 比率。结果 在整个研究组中,61.1% 为女性,平均年龄为 73.2 ± 6.1 岁。年老体弱者占 57.6%(219 人)。HGS不对称的患者人数为264人(51.6%),48.4%(n = 248)的研究人群HGS对称。在非体弱组中,40.2%的患者HGS正常且对称,而在体弱患者中,这一比例为23.7%。此外,在非体弱组中,HGS 偏低和不对称的比例为 16.3%,而在体弱患者中,这一比例为 35.0%(p <0.001)。结论和意义将 HGS 不对称和低 HGS 识别为虚弱的潜在指标,可为临床医生评估老年患者提供一个明确且可量化的标准。
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来源期刊
Clinical nutrition
Clinical nutrition 医学-营养学
CiteScore
14.10
自引率
6.30%
发文量
356
审稿时长
28 days
期刊介绍: Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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