Abstract
Objectives
Dynapenia, low muscle strength, is predictive for negative health outcomes and is
usually expressed as handgrip strength (HGS). Whether HGS can be a proxy for overall
muscle strength and whether this depends on age and health status is controversial.
This study assessed the agreement between HGS and knee extension strength (KES) in
populations differing in age and health status.
Design
Data were retrieved from 5 cohorts.
Setting and Participants
Community, geriatric outpatient clinics, and a hospital. Five cohorts (960 individuals,
49.8% male) encompassing healthy young and older individuals, geriatric outpatients,
and older individuals post hip fracture were included.
Measures
HGS and KES were measured according to the protocol of each cohort. Pearson correlation
was performed to analyze the association between HGS and KES, stratified by sex. HGS
and KES were standardized into sex-specific z scores. The agreement between standardized
HGS and standardized KES at population level and individual level were assessed by
intraclass correlation coefficients (ICC) and Bland-Altman analysis.
Results
Pearson correlation coefficients were low in healthy young (male: 0.36 to 0.45, female:
0.45) and healthy older individuals (male: 0.35 to 0.37, female: 0.44), and moderate
in geriatric outpatients (male and female: 0.54) and older individuals post hip fracture
(male: 0.44, female: 0.57) (P < .05, except for male older individuals post hip fracture [P = .07]). Intraclass correlation coefficient values were poor to moderate in all populations
(ie, healthy young individuals [0.41, 0.45], healthy older individuals [0.37, 0.41,
0.44], geriatric outpatients [0.54], and older individuals post hip fracture [0.54]).
Bland-Altman analysis showed that within the same population of age and health status,
agreement between HGS and KES varied on individual level.
Conclusions
At both population and individual level, HGS and KES showed a low to moderate agreement
independently of age and health status. HGS alone should not be assumed a proxy for
overall muscle strength.
Keywords
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Article info
Publication history
Published online: June 20, 2018
Footnotes
This study was supported by the seventh framework program MYOAGE (HEALTH-2007-2.4.5-10), the United Kingdom Medical Research Council (MR/K025252/1) as part of the Lifelong Health and Wellbeing initiative, the Dutch Technology Foundation STW, and The Ministry of Education and Culture, Kela-The Social Insurance Institution of Finland, Juho Vainio Foundation. This study has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 675003. http://www.birmingham.ac.uk/panini
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
