%0 Journal Article %J The Journal of Strength and Conditioning Research %D 2022 %T Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans %A Klawitter, Lukus %A Brenda Vincent %A Choi, Bong-Jin %A Smith, Joseph %A Hammer, Kimberly D. %A Donald A Jurivich %A Lindsey J Dahl %A Ryan P McGrath %K Chronic disease %K Exercise %K Mass Screening %K Risk Factors %K sarcopenia %X Identifying strength asymmetries in physically deconditioned populations may help in screening and treating persons at risk for morbidities linked to muscle dysfunction. Our investigation sought to examine the associations between handgrip strength (HGS) asymmetry and weakness on accumulating morbidities in aging Americans. The analytic sample included 18,506 Americans aged ≥50 years from the 2006–2016 Health and Retirement Study. Handgrip strength was measured on each hand with a handgrip dynamometer, and persons with an imbalance in strength >10% between hands had HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered as weak. Subjects reported the presence of healthcare provider–diagnosed morbidities: hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, arthritis, and psychiatric problems. Covariate-adjusted ordinal generalized estimating equations analyzed the associations for each HGS asymmetry and weakness group on future accumulating morbidities. Of those included in our study, subjects at baseline were aged 65.0 ± 10.2 years, 9,570 (51.7%) had asymmetric HGS, and 996 (5.4%) were weak. Asymmetry alone and weakness alone were associated with 1.09 (95% confidence interval [CI]: 1.04–1.14) and 1.27 (CI: 1.11–1.45) greater odds for future accumulating morbidities, respectively. Having both HGS asymmetry and weakness was associated with 1.46 (CI: 1.29–1.65) greater odds for future accumulating morbidities. Handgrip-strength asymmetry, as another potential indicator of impaired muscle function, is associated with future morbidity status during aging. Exercise professionals and related practitioners should consider examining asymmetry and weakness with handgrip dynamometers as a simple and noninvasive screening method for helping to determine muscle dysfunction and future chronic disease risk. %B The Journal of Strength and Conditioning Research %V 36 %P 106-112 %G eng %N 1 %R 10.1519/JSC.0000000000004166 %0 Journal Article %J JOURNAL OF THE AMERICAN GERIATRICS SOCIETY %D 2020 %T Sarcopenia Definition & Outcomes Consortium Defined Low Grip Strength in Two Cross-Sectional, Population-Based Cohorts %A Patel, Sheena M. %A Kate A Duchowny %A Douglas P Kiel %A Correa-de-Araujo, Rosaly %A Fielding, Roger A. %A Travison, Thomas %A Magaziner, Jay %A Manini, Todd %A Xue, Qian-Li %A Anne B Newman %A Pencina, Karol M. %A Santanasto, Adam J. %A Bhasin, Shalender %A Peggy M Cawthon %K Gait %K muscle %K Physical performance %K sarcopenia %X BACKGROUND/OBJECTIVES The extent to which the prevalence of muscle weakness in the US population varies by different putative grip strength constructs developed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) has not been described. DESIGN Cross-sectional analysis. SETTING Two nationally representative cohorts-2010 and 2012 waves of the Health and Retirement Survey and round 1 (2011) of the National Health and Aging Trends Survey. PARTICIPANTS Adults aged 65 years and older (n = 12,984) were included in these analyses. MEASUREMENTS We analyzed three constructs of muscle weakness developed by the SDOC, and found to be associated with mobility disability for men and women, respectively: absolute grip strength (<35.5 kg and 20 kg); grip strength standardized to body mass index (<1.05 kg/kg/m(2) and 0.79 kg/kg/m(2)); and grip strength standardized to weight (<0.45 kg/kg and 0.337 kg/kg). We estimated the prevalence of muscle weakness defined by each of these constructs in the overall older US population, and by age, sex, race, and ethnicity. We also estimated the sensitivity and specificity of each of the grip strength constructs to discriminate slowness (gait speed <0.8 m/s) in these samples. RESULTS The prevalence of muscle weakness ranged from 23% to 61% for men and from 30% to 66% for women, depending on the construct used. There was substantial variation in the prevalence of muscle weakness by race and ethnicity. The sensitivity and specificity of these measures for discriminating slowness varied widely, ranging from 0.30 to 0.92 (sensitivity) and from 0.17 to 0.88 (specificity). CONCLUSIONS The prevalence of muscle weakness, defined by the putative SDOC grip strength constructs, depends on the construct of weakness used. %B JOURNAL OF THE AMERICAN GERIATRICS SOCIETY %V 68 %P 1438-1444 %8 JUL %G eng %N 7 %9 Article %R 10.1111/jgs.16419 %0 Journal Article %J Journal of the American Medical Directors Association %D 2019 %T The Longitudinal Associations of Handgrip Strength and Cognitive Function in Aging Americans %A Ryan P McGrath %A Brenda Vincent %A Kyle J Hackney %A Sheria G Robinson-Lane %A Brian Downer %A Brian C Clark %K Alzheimer's disease %K Dementia %K Geriatrics %K Muscle Strength %K Muscle Weakness %K sarcopenia %X Objectives Factors that are responsible for age-related neurologic deterioration of noncognitive and cognitive processes may have a shared cause. We sought to examine the temporal, directional associations of handgrip strength and cognitive function in a national sample of aging Americans. Design Longitudinal panel. Setting Enhanced interviews that included physical, biological, and psychosocial measures were completed in person. Core interviews were often conducted over the telephone. Participants The analytic sample included 14,775 Americans aged at least 50 years who participated in at least 2 waves of the 2006-2016 waves of the Health and Retirement Study. Measures Handgrip strength was measured with a hand-held dynamometer. Participants were considered cognitively intact, mildly impaired, or severely impaired according to the Telephone Interview of Cognitive Status questionnaire. Separate lagged general estimating equations analyzed the directional associations of handgrip strength and cognitive function. Results The overall time to follow-up was 2.1 ± 0.4 years. Every 5 kg higher handgrip strength was associated with 0.97 [95% confidence interval (CI) 0.93, 0.99] lower odds for both future cognitive impairment and worse cognitive impairment. Those who were not weak had 0.54 (CI 0.43, 0.69) lower odds for future cognitive impairment and 0.57 (CI 0.46, 0.72) lower odds for future worse cognitive impairment. Conversely, any (β = −1.09; CI –1.54, −0.64), mild (β = −0.85; CI –1.34, −0.36), and severe cognitive impairment (β = −2.34; CI –3.25, −1.42) predicted decreased handgrip strength. Further, the presence of any, mild, and severe cognitive impairment was associated with 1.82 (CI 1.48, 2.24), 1.65 (CI 1.31, 2.08), and 2.53 (CI 1.74, 3.67) greater odds for future weakness, respectively. Conclusions/Implications Strength capacity and cognitive function may parallel each other, whereby losses of functioning in 1 factor may forecast losses of functioning in the other. Handgrip strength could be used for assessing cognitive status in aging Americans and strength capacity should be monitored in those with cognitive impairment. %B Journal of the American Medical Directors Association %G eng %U http://www.sciencedirect.com/science/article/pii/S1525861019306498 %R https://doi.org/10.1016/j.jamda.2019.08.032 %0 Journal Article %J Journal of the American Medical Directors Association %D 2019 %T Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis %A Ryan P McGrath %A Brenda Vincent %A Mark D Peterson %A Donald A Jurivich %A Lindsey J Dahl %A Kyle J Hackney %A Brian C Clark %K Aging %K Epidemiology %K Geriatrics %K Hand Strength %K Muscle Strength %K sarcopenia %X Objectives Quantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities. Design Longitudinal panel. Setting Detailed interviews that included physical measures were conducted in person, whereas core interviews were often performed over the telephone. Participants Data from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the Health and Retirement Study were analyzed. Measures A handgrip dynamometer was used to assess handgrip strength (HGS) in each participant. Men with HGS <26 kg were considered weak, ≥26 kg were considered not weak, and ≥32 kg were considered strong. Women with HGS <16 kg were classified as weak, ≥16 kg were classified as not-weak, and ≥20 kg were classified as strong. The National Death Index and postmortem interviews determined the date of death. The greedy matching algorithm was used to match cohorts. Results Of the 1077 weak and not-weak matched pairs, 401 weak (37.2%) and 296 not-weak (27.4%) older Americans died over an average 4.4 ± 2.5-year follow-up. There were 392 weak (37.0%) and 243 strong (22.9%) persons who died over a mean 4.5 ± 2.5-year follow-up from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95% confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality relative to persons in the not-weak and strong control cohorts, respectively. Conclusions and Implications Our findings may indicate a causal association between muscle weakness and mortality in older Americans. Health care providers should include measures of HGS as part of routine health assessments and discuss the health risks of muscle weakness with their patients. %B Journal of the American Medical Directors Association %G eng %U http://www.sciencedirect.com/science/article/pii/S152586101930756X %R https://doi.org/10.1016/j.jamda.2019.10.016 %0 Journal Article %J Eur J Clin Nutr %D 2016 %T Prevalence of weakness and its relationship with limitations based on the Foundations for the National Institutes for Health project: data from the Health and Retirement Study. %A John A. Batsis %A Cassandra M Germain %A Elizabeth Vasquez %A Bartels, S. J. %K Activities of Daily Living %K Aged %K Aging %K Cross-Sectional Studies %K Databases, Factual %K Female %K Humans %K Male %K Middle Aged %K Muscle Weakness %K National Institutes of Health (U.S.) %K Retirement %K sarcopenia %K Surveys and Questionnaires %K United States %X

BACKGROUND/OBJECTIVES: The objectives of this study were to determine the prevalence of muscle weakness using the two 2014 Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria and its relationship with physical limitations, basic activities of daily living (ADL) and instrumental ADL.

SUBJECTS/METHODS: We performed a cross-sectional analysis of community-dwelling adults from the Health and Retirement Study 2006-2008 and identified a subsample of 5092 adults aged ⩾60 years with grip strength (GS) data. Self-reported physical limitations, basic ADL and instrumental ADL were assessed. Criteria for GS (men<26 kg; women <16 kg) and GS adjusted for body mass index (GS/BMI; men <1.0; women <0.56) were applied to the sample. We determined the prevalence of muscle weakness in each sex. Multivariable logistic regression was used to calculate the association of physical limitations, basic ADL and instrument ADL with weakness definitions in each sex.

RESULTS: Mean age was 72.1 years (54.9% female). Mean GS was 38.3 and 22.9 kg and mean BMI was 29 kg/m, respectively, in men and women. Weakness prevalence using GS and GS:BMI definitions were 7.8 and 15.2 (P<0.001), respectively, in men and 11.4 and 13.3% (P=0.04) in women. Overall prevalence of physical limitations, basic ADL limitations and instrumental ADL limitations was 52.9, 28.1 and 35.9%, respectively. In those with weakness, prevalence of physical limitations, basic ADL and instrumental ADL was 78.5, 42.3 and 65.3%, respectively, using the GS definition, and 79.7, 40.7 and 58.8%, respectively, using the GS/BMI definition. GS and the GS/BMI definitions of weakness were strongly associated with physical limitations (odds ratio (OR) 2.19 (95% confidence interval (CI): (1.67-2.87)) and 2.52 (2.01-3.17)), basic ADL (OR 1.59 (1.22-2.07) and 1.66 (1.32-2.07)) and instrumental ADLs (OR 1.98 (1.28-2.54) and 1.78 (1.44-2.20)).

CONCLUSIONS: The new FNIH guidelines for weakness are associated with higher prevalence of physical limitations, basic ADL impairments and instrumental ADL impairments as compared with individuals without weakness.

%B Eur J Clin Nutr %V 70 %P 1168-1173 %8 2016 10 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/27245209 %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/27245209?dopt=Abstract %R 10.1038/ejcn.2016.90 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2012 %T The relationship between body weight, frailty, and the disablement process. %A Mary E Bowen %K Activities of Daily Living %K Aged %K Body Weight %K Cross-Sectional Studies %K Disability Evaluation %K Disabled Persons %K Female %K Frail Elderly %K Geriatric Assessment %K Health Behavior %K Health Surveys %K Humans %K Life Style %K Longitudinal Studies %K Male %K Middle Aged %K Overweight %K Physical Fitness %K Prospective Studies %K sarcopenia %K Socioeconomic factors %K Thinness %K United States %X

OBJECTIVES: To prospectively examine the relationship between body weight, frailty, and the disablement process.

METHOD: Longitudinal data from the Health and Retirement Study (1998-2006) were used to examine the relationship between being underweight, overweight, or obese (compared with normal weight) and the onset and progression of functional limitations and disabilities in instrumental activities of daily living (IADL) and activities of daily living (ADL) among a nationally representative sample of community-dwelling older adults (aged 50 and older) with characteristics of frailty (n= 11,491). Nonlinear multilevel models additionally adjusted for demographic characteristics and intra-individual changes in body weight, socioeconomic status, health behaviors, and health conditions over the course of 8 years.

RESULTS: Compared with their nonfrail normal weight counterparts, prefrail obese respondents have a 16% (p ≤ 0.001) reduction in the expected functional limitations rate and frail overweight and obese respondents have a 10% (p ≤ 0.01) and 36% (p ≤ 0.001) reduction in the expected functional limitations rate, respectively. In addition, frail obese respondents have a 27% (p ≤ 0.05) reduction in the expected ADL disability rate.

DISCUSSION: This study's findings suggest that underweight, overweight, and obese status differentially affect the risk for functional limitations and disabilities in IADL and ADL. Among prefrail and frail adults, some excess body weight in later life may be beneficial, reducing the rate of functional limitations and disability.

%B J Gerontol B Psychol Sci Soc Sci %I 67 %V 67 %P 618-26 %8 2012 Sep %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/22967933?dopt=Abstract %2 PMC in process %4 Weight/Frailty/Disability/Disability/Older people/Health behavior/Socioeconomic factors/activities Of Daily Living/ADL and IADL Impairments %$ 69624 %R 10.1093/geronb/gbs067