Abstract
Objectives
Absolute handgrip strength and adjusted by body mass index are useful to identify
age-related conditions. However, these values are not accurate for older adults with
extreme body size because of the nonlinear relationship between strength, height,
and body mass. The purpose of this study was to determine cut-off points for age-related
conditions of older adults using allometric coefficients to normalize grip strength
by body size.
Design
Cross-sectional study.
Setting and Participants
Data from 13,235 older adults of Study on Global Aging and Adult Health conducted
in 6 low- and middle-income countries were analyzed.
Methods
Country- and sex-specific allometric exponents for body-size variables (mass and height)
were computed with log-linear models. Partial correlation verified whether allometric
normalization removed the effect of body size on grip strength. Cut-off points were
established (<20th percentile) for low allometrically adjusted grip strength.
Results
Allometric exponents for normalization of grip strength were provided for body-size
variables, ranging from 0.19 to 2.45. Allometric normalization removed the effect
of body size on grip strength (r < 0.30). Overall, frequencies of low muscle strength
were overestimated with international criteria (absolute grip strength) compared with
the cut-off points proposed in this study.
Conclusions and Implications
The proposed allometric exponents normalized grip strength according to body-size
variables. These exponents improved the accuracy in identifying age-related conditions
in older adults with extreme body size. The variability between strength reveals the
need for developing specific cut-off points for low- and middle-income countries.
New cut-off points of low normalized grip strength with automatized applicability
were proposed for health care providers use in clinical practice.
Keywords
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Article info
Publication history
Published online: March 02, 2022
Footnotes
This work was supported by the CNPq – Conselho Nacional de Desenvolvimento Científico e Tecnológico [through PhD scholarship (142248/2018–5) to P.P.A.], CAPES – Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [finance Code 001 and through PhD scholarship (88887.593242/2020-00) to P.P.A. and 88887.371516/2019-00 to D.R.L.M.], and by National Funds by FCT - Portuguese Foundation for Science and Technology (CIAFEL: FCTUID/DTP/00617/2020 and ITR: LA/P/0064/2020). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
The authors declare no conflicts of interest.
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