J Bone Metab.  2012 Nov;19(2):103-110. 10.11005/jbm.2012.19.2.103.

Evaluation of Factors Influencing Grip Strength in Elderly Koreans

• Lee JE
• Kim KW
• Paik NJ
• Jang HC
• Chang CB
• Baek GH
• Lee YH
• Gong HS

• KMID: 1975983
• DOI: http://doi.org/10.11005/jbm.2012.19.2.103

Abstract

OBJECTIVES
Grip strength has been used as a measure of function in various health-related conditions. Although grip strength is known to be affected by both physical and psychological factors, few studies have looked at those factors comprehensively in a population-based cohort regarding elderly Koreans. The aim of this study was to evaluate potential factors influencing grip strength in elderly Koreans.
METHODS
We evaluated dominant hand grip strengths in 143 men and 123 women older than 65 years who participated in a population-based cohort study, the Korean Longitudinal Study on Health and Aging (KLoSHA). Individuals who had a history of surgery for musculoskeletal disease or trauma in the upper extremity were excluded. Factors assessed for potential association with grip strength were; 1) demographics such as age and gender, 2) body constructs such as height, body mass index (BMI), and bone mineral density (BMD), 3) upper extremity functional status using disabilities of the arm, shoulder and hand (DASH) scores, and 4) mental health status using a depression scale and the short form-36 (SF36) mental health score. Multivariate analyses were performed in order to identify factors independently associated with grip strength.
RESULTS
Grip strengths of dominant hands in elderly Koreans were found to generally decrease with aging, and were significantly different between men and women, as expected. Multivariate analyses indicated that grip strength was independently associated with age, height and BMI in men (R2 = 21.3%), and age and height (R2 = 19.7%) in women. BMD, upper extremity functional status, or mental health status were not found to be associated with grip strength.
CONCLUSIONS
This study demonstrates that in elderly Koreans, grip strength is mainly influenced by age and height in both men and women, and additionally by BMI in men. BMD or self-reported physical or mental health status was not found to influence grip strength in elderly Koreans. This information may be helpful in future studies using grip strength as a measure of function in elderly Koreans.

Keyword

Factors; Grip strength; Influence; Koreans

MeSH Terms

Aged
Aging
Arm
Asian Continental Ancestry Group
Body Height
Bone Density
Cohort Studies
Demography
Depression
Female
Hand
Hand Strength
Humans
Longitudinal Studies
Male
Mental Health
Multivariate Analysis
Musculoskeletal Diseases
Shoulder
Upper Extremity

Reference

1. Rantanen T, Era P, Heikkinen E. Maximal isometric strength and mobility among 75-year-old men and women. Age Ageing. 1994. 23:132–137.

2. Jansen CW, Niebuhr BR, Coussirat DJ, et al. Hand force of men and women over 65 years of age as measured by maximum pinch and grip force. J Aging Phys Act. 2008. 16:24–41.

3. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008. 31:3–10.

4. Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, et al. The handgrip strength test as a measure of function in breast cancer survivors: relationship to cancer-related symptoms and physical and physiologic parameters. Am J Phys Med Rehabil. 2012. 91:774–782.

5. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010. 39:412–423.

6. Newman AB, Kupelian V, Visser M, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006. 61:72–77.

7. Hossain MG, Zyroul R, Pereira BP, et al. Multiple regression analysis of factors influencing dominant hand grip strength in an adult Malaysian population. J Hand Surg Eur Vol. 2012. 37:65–70.

8. Dong J, Li YJ, Lu XH, et al. Correlations of lean body mass with nutritional indicators and mortality in patients on peritoneal dialysis. Kidney Int. 2008. 73:334–340.

9. Günther CM, Bürger A, Rickert M, et al. Grip strength in healthy caucasian adults: reference values. J Hand Surg Am. 2008. 33:558–565.

10. Rantanen T, Guralnik JM, Leveille S, et al. Racial differences in muscle strength in disabled older women. J Gerontol A Biol Sci Med Sci. 1998. 53:B355–B361.

11. Rantanen T, Guralnik JM, Foley D, et al. Midlife hand grip strength as a predictor of old age disability. JAMA. 1999. 281:558–560.

12. Stenvinkel P, Barany P, Chung SH, et al. A comparative analysis of nutritional parameters as predictors of outcome in male and female ESRD patients. Nephrol Dial Transplant. 2002. 17:1266–1274.

13. Bohannon RW. Dynamometer measurements of hand-grip strength predict multiple outcomes. Percept Mot Skills. 2001. 93:323–328.

14. Bunout D, Barrera G, De La Maza T, et al. Lean and fat mass as determinants of muscle strength and insulin sensitivity in Chilean elderly subjects. J Nutr Health Aging. 2004. 8:374–378.

15. Roberts HC, Syddall HE, Cooper C, et al. Is grip strength associated with length of stay in hospitalised older patients admitted for rehabilitation? Findings from the Southampton grip strength study. Age Ageing. 2012. 41:641–646.

16. Visser M, Deeg DJ, Lips P. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003. 88:5766–5772.

17. Budziareck MB, Pureza Duarte RR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008. 27:357–362.

18. Gallagher D, Visser M, De Meersman RE, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol. 1997. 83:229–239.

19. Han SH, Nam KS, Ahn TK, et al. Analysis of grip and pinch strength in Korean people. J Korean Orthop Assoc. 2009. 44:219–225.

20. Mathiowetz V, Rennells C, Donahoe L. Effect of elbow position on grip and key pinch strength. J Hand Surg Am. 1985. 10:694–697.

21. Roh YH, Kim KW, Paik NJ, et al. How much are upper or lower extremity disabilities associated with general health status in the elderly? Clin Orthop Relat Res. 2012. 470:3246–3252.

22. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996. 29:602–608.

23. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004. 57:297–305.

24. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992. 30:473–483.

25. Beaton DE, Bombardier C, Hogg-Johnson SA. Measuring health in injured workers: a cross-sectional comparison of five generic health status instruments in workers with musculoskeletal injuries. Am J Ind Med. 1996. 29:618–631.

26. Marin RV, Pedrosa MA, Moreira-Pfrimer LD, et al. Association between lean mass and handgrip strength with bone mineral density in physically active postmenopausal women. J Clin Densitom. 2010. 13:96–101.

27. Gale CR, Martyn CN, Cooper C, et al. Grip strength, body composition, and mortality. Int J Epidemiol. 2007. 36:228–235.

28. Bot AG, Mulders MA, Fostvedt S, et al. Determinants of grip strength in healthy subjects compared to that in patients recovering from a distal radius fracture. J Hand Surg Am. 2012. 37:1874–1880.

29. Chandrasekaran B, Ghosh A, Prasad C, et al. Age and anthropometric traits predict handgrip strength in healthy normals. J Hand Microsurg. 2010. 2:58–61.

30. Rantanen T, Penninx BW, Masaki K, et al. Depressed mood and body mass index as predictors of muscle strength decline in old men. J Am Geriatr Soc. 2000. 48:613–617.

31. Silventoinen K, Magnusson PK, Tynelius P, et al. Heritability of body size and muscle strength in young adulthood: a study of one million Swedish men. Genet Epidemiol. 2008. 32:341–349.

32. Sternfeld B, Ngo L, Satariano WA, et al. Associations of body composition with physical performance and self-reported functional limitation in elderly men and women. Am J Epidemiol. 2002. 156:110–121.

33. Jang HC. Recent progression in sarcopenia and sarcopenic obesity. J Korean Geriatr Soc. 2011. 15:1–7.

34. Wallace BA, Cumming RG. Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Calcif Tissue Int. 2000. 67:10–18.

35. Albrand G, Munoz F, Sornay-Rendu E, et al. Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY study. Bone. 2003. 32:78–85.

36. Rikkonen T, Sirola J, Salovaara K, et al. Muscle strength and body composition are clinical indicators of osteoporosis. Calcif Tissue Int. 2012. 91:131–138.

37. Bayramoğlu M, Sözay S, Karataş M, et al. Relationships between muscle strength and bone mineral density of three body regions in sedentary postmenopausal women. Rheumatol Int. 2005. 25:513–517.

38. Shin HY, Kim SW, Kim JM, et al. Association of grip strength with dementia in a Korean older population. Int J Geriatr Psychiatry. 2012. 27:500–505.

39. Yoshimura N, Oka H, Muraki S, et al. Reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices for locomotive syndrome and associated disability: the second survey of the ROAD study. J Orthop Sci. 2011. 16:768–777.

40. Watson J, Ring D. Influence of psychological factors on grip strength. J Hand Surg Am. 2008. 33:1791–1795.

41. Koley S, Singh AP. An association of dominant hand grip strength with some anthropometric variables in Indian collegiate population. Anthropol Anz. 2009. 67:21–28.

42. Mateo Lázaro ML, Penacho Lázaro MA, Berisa Losantos F, et al. New tables on hand strength in the adult population from Teruel. Nutr Hosp. 2008. 23:35–40.

43. Mitsionis G, Pakos EE, Stafilas KS, et al. Normative data on hand grip strength in a Greek adult population. Int Orthop. 2009. 33:713–717.

44. Newman AB, Haggerty CL, Goodpaster B, et al. Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2003. 51:323–330.