Abstract
Objectives
To determine the sex-specific associations of handgrip strength (HGS) and asymmetry
with incident multimorbidity and examine whether these relationships differ by sex.
Design
Prospective cohort study.
Setting and Participants
Secondary analyses of data from the English Longitudinal Study of Ageing (ELSA, waves
2-8). The analytic sample included 3977 participants (51.4% female) aged ≥50 years
who had data for HGS on both hands and were living without multimorbidity at baseline.
Measures
HGS was assessed with a handheld dynamometer. Individuals in the lowest tertile of
sex-specific age-adjusted HGS were defined as having low HGS. The largest HGS readings
from the nondominant and dominant hand were used to calculate HGS ratio [nondominant
HGS (kg)/dominant HGS (kg)]. Those with HGS ratio <0.90 or >1.10 had any HGS asymmetry.
Further, those with HGS ratio <0.90 had dominant HGS asymmetry, whereas those with
HGS ratio >1.10 had nondominant HGS asymmetry. Multimorbidity was defined as the coexistence
of ≥2 chronic diseases. Cox proportional hazards regression models were conducted
for analyses.
Results
Low HGS was associated with multimorbidity among older men [hazard ratio (HR) 1.20,
95% confidence interval (CI) 1.03-1.40] and women (HR 1.19, 95% CI 1.03-1.38). No
significant effect modification by sex was observed (P-interaction = .71). HGS asymmetry increased the risk of multimorbidity in women only
(HR 1.23, 95% CI 1.07-1.41). The relationship between HGS asymmetry and multimorbidity
risk differed by sex (P-interaction = .01). Similarly, both dominant HGS asymmetry (HR 1.21, 95% CI 1.05-1.40)
and nondominant HGS asymmetry (HR 1.32, 95% CI 1.03-1.68) were related to incident
multimorbidity in women only. There was a significant interaction between dominant
HGS asymmetry and sex (P-interaction = .02).
Conclusions and Implications
Examining HGS asymmetry in HGS test protocols can provide novel insights for the predictive
power of HGS in the accumulation of diseases, particularly in women.
Keywords
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Article info
Publication history
Published online: August 10, 2021
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
