Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans

Abstract Introduction Handgrip strength (HGS) is increasingly used to estimate overall muscle strength. Association between low HGS and cognitive decline has been well documented. Recently, McGrath’s team elucidated a new dimension of HGS asymmetry with important implications on physical and cognitive limitations. It is unclear if these effects can be generalised. The Asian working group for sarcopenia (AWGS) has called for ‘special considerations’ due to ‘anthropometric and cultural or lifestyle-related differences’6. Hence, we aim to investigate if HGS asymmetry is associated with cognition in Asians. Methodology We defined sarcopenia by AWGS consensus: HGS <28 kg for men; <18 kg for women. Asymmetry was HGS >10% stronger on either hand; relative HGS was HGS adjusted for BMI. Low cognitive function was defined as MMSE<26. We compared weakness alone, any HGS asymmetry or relative HGS alone and combination of weakness and HGS asymmetry or relative HGS asymmetry. Each model was adjusted for demographic characteristics, hand dominance, obesity, frailty, physical activity, depression and perceived health status. Results 738 Asian subjects participated. Mean age 70.8 ± 0.2 years, 45.1% males, 82.5% Chinese. More than 50% have multimorbidity. 5.4% were frail. Mean BMI 24.4 ± 0.1 kg/m2. Mean HGS 22.6 ± 0.3. 93 (12.7%) had symmetrical HGS and not weak, 59 (7.8%) asymmetrical and not weak, 321 (43.6%) symmetrical and weak, 265 (35.9%) asymmetrical and weak. Mean MMSE scores for weakness alone, asymmetry alone and combined weakness and asymmetry are 26.6 ± 0.1, 26.8 ± 0.2 and 26.5 ± 0.2 respectively. HGS asymmetry alone was not associated with better cognitive function OR 0.66 (95%CI: 0.30–1.44). Combined asymmetry and weakness was non-significantly linked to worse cognition OR 2.14 (95%CI: 0.79–5.82). We found relative HGS to be protective for cognitive decline, OR 0.31 (95%CI: 0.12–0.78, p = 0.012). Conclusion Our study highlights the impact of ethnicity in sarcopenia research. Our population shows association of relative HGS with cognition. Further longitudinal studies are needed.

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Handgrip Strength Asymmetry and Weakness May Accelerate Time to Mortality in Aging Americans

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.04.030 ◽

2020 ◽

Vol 21 (12) ◽

pp. 2003-2007.e1 ◽

Cited By ~ 3

Author(s):

Ryan McGrath ◽

Grant R. Tomkinson ◽

Dain P. LaRoche ◽

Brenda M. Vincent ◽

Colin W. Bond ◽

...

Keyword(s):

Handgrip Strength ◽

Strength Asymmetry

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Associations of Handgrip Strength and Handgrip Strength Asymmetry with Depression in the Elderly in South Korea: A Cross-sectional Study

Journal of Preventive Medicine and Public Health ◽

10.3961/jpmph.20.315 ◽

2020 ◽

Author(s):

Kyungduk Hurh ◽

Eun-Cheol Park ◽

Yoon Sik Park ◽

Gyu Ri Kim ◽

Sung-In Jang

Keyword(s):

South Korea ◽

Handgrip Strength ◽

The Elderly ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Strength Asymmetry

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Handgrip strength asymmetry is associated with future falls in older Americans

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01757-z ◽

2020 ◽

Author(s):

Ryan McGrath ◽

Brian C. Clark ◽

Matteo Cesari ◽

Carol Johnson ◽

Donald A. Jurivich

Keyword(s):

Handgrip Strength ◽

Older Americans ◽

Strength Asymmetry

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Association between handgrip strength asymmetry and falls in elderly Koreans: A nationwide population-based cross-sectional study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2021.104470 ◽

2021 ◽

pp. 104470

Author(s):

Young Joo Go ◽

Duk Chul Lee ◽

Hye Jun Lee

Keyword(s):

Handgrip Strength ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Strength Asymmetry ◽

Elderly Koreans ◽

Falls In Elderly

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Handgrip Strength Asymmetry Is Associated With Functional Disability In Older Americans

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000761628.89906.3b ◽

2021 ◽

Vol 53 (8S) ◽

pp. 221-221

Author(s):

Ryan McGrath ◽

Lukus Klawitter ◽

Donald Jurivich ◽

Brenda Vincent ◽

Grant Tomkinson ◽

...

Keyword(s):

Functional Disability ◽

Handgrip Strength ◽

Older Americans ◽

Strength Asymmetry

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Handgrip Strength Asymmetry and Weakness Are Differentially Associated with Functional Limitations in Older Americans

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093231 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3231 ◽

Cited By ~ 1

Author(s):

Kyle Collins ◽

Nathaniel Johnson ◽

Lukus Klawitter ◽

Roman Waldera ◽

Sherri Stastny ◽

...

Keyword(s):

Functional Disability ◽

Handgrip Strength ◽

Functional Limitations ◽

Health Conditions ◽

Older Americans ◽

Health And Nutrition ◽

Age Related ◽

Strength Capacity ◽

Strength Asymmetry ◽

Nationally Representative

Background: Handgrip strength (HGS) is a convent measure of strength capacity and associated with several age-related health conditions such as functional disability. Asymmetric strength between limbs has been linked to diminished function. Therefore, both HGS asymmetry and weakness could be associated with functional disability. We examined the associations of HGS asymmetry and weakness on functional limitations in a nationally representative sample of older Americans. Methods: Data were analyzed from 2689 adults ≥ 60 years who participated in the 2011–2012 and 2013–2014 waves of the National Health and Nutrition Examination Survey. Weakness was defined as HGS < 26 kg for men and < 16 kg for women. Asymmetry was determined from the ratio of the dominant and non-dominant HGS. Those with HGS ratio 0.9–1.1 were considered as having HGS symmetry, and those outside this range had asymmetry. Results: Compared to those with symmetric HGS and were not weak, those with weakness alone, and both weakness and HGS asymmetry had 2.47 (95% confidence interval [CI]: 1.14–5.35) and 3.93 (CI: 1.18–13.07) greater odds for functional limitations, respectively. However, HGS asymmetry alone was not associated with functional limitations (odds ratio: 0.80; CI: 0.62–1.03). Conclusion: The use of HGS asymmetry in protocols could improve the prognostic value of handgrip dynamometers.

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Handgrip Strength Asymmetry and Weakness Together Are Associated With Functional Disability in Aging Americans

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa100 ◽

2020 ◽

Cited By ~ 2

Author(s):

Ryan McGrath ◽

Brenda M Vincent ◽

Donald A Jurivich ◽

Kyle J Hackney ◽

Grant R Tomkinson ◽

...

Keyword(s):

Generalized Estimating Equations ◽

Daily Living ◽

Functional Disability ◽

Handgrip Strength ◽

National Sample ◽

Dominant Hand ◽

Predictive Utility ◽

Strength Asymmetry ◽

Adl Disability ◽

Retirement Study

Abstract Background Evaluating handgrip strength (HGS) asymmetry may help to improve the prognostic value of HGS. This study sought to determine the associations of HGS asymmetry and weakness on future activities of daily living (ADL) disability in a national sample of aging Americans. Methods The analytic sample included 18,468 Americans aged ≥50 years from the 2006–2016 waves of the Health and Retirement Study. A handgrip dynamometer measured HGS. Those with HGS >10% stronger on either hand were considered as having any HGS asymmetry. Individuals with HGS >10% stronger on their dominant hand were considered as having dominant HGS asymmetry, while those with HGS >10% stronger on their nondominant hand were classified as having nondominant HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered weak. ADLs were self-reported. Generalized estimating equations were used for analyses. Results Relative to those with symmetric HGS and no weakness, each HGS asymmetry and weakness group had increased odds for future ADL disability: 1.11 (95% confidence interval [CI]: 1.02–1.20) for any HGS asymmetry alone, 1.42 (CI: 1.16–1.74) for weakness alone, and 1.81 (CI: 1.52–2.16) for both any HGS asymmetry and weakness. Most weakness and HGS asymmetry dominance groups had increased odds for future ADL disability: 1.30 (CI: 1.13–1.50) for nondominant HGS asymmetry alone, 1.42 (CI: 1.16–1.74) for weakness alone, 1.72 (CI: 1.29–2.29) for both weakness and nondominant HGS asymmetry, and 1.86 (CI: 1.52–2.28) for both weakness and dominant HGS asymmetry. Conclusions HGS asymmetry and weakness together may increase the predictive utility of handgrip dynamometers.

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Handgrip Strength Asymmetry Is Associated With Limitations in Individual Basic Self-Care Tasks

Journal of Applied Gerontology ◽

10.1177/0733464820982409 ◽

2020 ◽

pp. 073346482098240

Author(s):

Sean J. Mahoney ◽

Kyle J. Hackney ◽

Donald A. Jurivich ◽

Lindsey J. Dahl ◽

Carol Johnson ◽

...

Keyword(s):

Confidence Interval ◽

Activities Of Daily Living ◽

Daily Living ◽

Handgrip Strength ◽

Self Care ◽

Health And Retirement Study ◽

Dominant Hand ◽

Strength Asymmetry ◽

Retirement Study

This investigation sought to determine the associations between handgrip strength (HGS) asymmetries and limitations in individual activities of daily living (ADL). The analytic sample included 18,468 participants from the 2006 to 2016 waves of the Health and Retirement Study. Those with HGS >10% stronger on either hand had any HGS asymmetry. Individuals with HGS >10% stronger on their dominant or non-dominant hand had dominant or non-dominant HGS asymmetry, respectively. ADL abilities were self-reported. Those with any HGS asymmetry had 1.21 (95% confidence interval [CI] = [1.01–1.46]) greater odds for a toileting limitation and 1.25 (CI = [1.03–1.52]) greater odds for a transferring limitation. Individuals with dominant HGS asymmetry had 1.24 (CI = [1.01–1.53]) greater odds for a transferring limitation. Those with non-dominant HGS asymmetry had 1.39 (CI = [1.01–1.93]) and 1.44 (CI = [1.05–1.96]) greater odds for a bathing and toileting limitation, respectively. HGS asymmetries could help to identify future limitations in specific ADLs.

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