Menu
Back to Journals » Clinical Interventions in Aging » Volume 14
Grip Strength: An Indispensable Biomarker For Older Adults
Authors Bohannon RW
Received 20 August 2019
Accepted for publication 13 September 2019
Published 1 October 2019 Volume 2019:14 Pages 1681—1691
DOI https://doi.org/10.2147/CIA.S194543
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Richard W Bohannon
Department of Physical Therapy, Campbell University, Lillington, NC, USA
Correspondence: Richard W Bohannon
Department of Physical Therapy, Campbell University, 4150 US 421 South, Lillington, NC 27546, USA
Tel +1 910-814-4098
Fax +1 910 814-4951
Email [email protected]
Abstract: Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
Keywords: biomarker, muscle strength, health outcomes, epidemiology, mortality, rehabilitation, aging
Introduction
Biomarkers are medical signs at the level of pathology, body function or structure, or activity/participation that provide an objective indication of medical status.1,2 Grip strength, a measure of body function, has been suggested as a biomarker of aging.3 As such, its value as an explanator of current status and predictor of future outcomes has been widely researched and reviewed.4,5 The purpose of this narrative review is to provide an up-to-date, thorough, and balanced synopsis of research addressing grip strength as a biomarker of current and future medical status.
Grip Strength As A Biomarker Of Current Status
Use of grip strength as a biomarker of current health status is most directly supported by research showing a cross-sectional association between grip strength and the strength of other muscle actions of both healthy individuals and adults with pathology.6–9 Based on this research and the practicality of hand-grip dynamometry, the measurement of grip strength has been widely adopted as a singular indicator of overall strength. This adoption notwithstanding, clinicians and scientists should be cautious in using grip strength as an indicator of overall strength as there is evidence that grip strength may not always be reflective of overall strength10 and may provide a better indication of overall strength if used in conjunction with a measure of lower limb strength.11
In any case, grip strength is related concurrently to measures other than the strength of different muscle actions. Chief among such measures are those of activities2 involving the upper limbs, of which the hands are a part. Research by Wang and Chen supports this declaration.12 They identified cutoffs for grip strength needed by older adults (18.5 kg for women, 28.5kg for men) to manage heavy tasks (eg, lifting or carrying 11kg objects). Giray and Akyϋz found that the grip strength of women with postmastectomy edema, had low to moderate but significant correlations (r= −0.32 and −0.51) with self-reported upper limb function as characterized by the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.13 A low but significant correlation (r= −0.32) between grip strength and DASH scores has also been reported for patients examined one month after cardiac surgery.14 Sunderland et al demonstrated high correlations between grip strength and performance on the Frenchay Arm Test (r= 0.91), Motor Club Assessment (r= 0.86), and Peg Test (r= 0.79) by patients with stroke.15
Although grip strength is not directly required for the performance of functional activities such as gait, it does distinguish between older adults on the basis of their mobility. Forrest et al noted significantly lower grip strengths among older Americans who reported physical limitations- including standing from a chair, walking, climbing steps, and “going out”.16 Zhang et al demonstrated a significant, albeit low (r= 0.36), relationship between grip strength and the distance walked during the 6 min walk test.17 Specific grip strength thresholds have been determined that identify older adults who are weak and likely to have walking limitations. In 6 studies identifying walking as slow (< 0.80m/s), grip strength thresholds for men ranged from 23.2kg to 39.0kg. For women they ranged from 15.9kg to 22.0kg.18–23 Sallinen found that thresholds of 37.0kg for men and 21.0kg for women identified older adults with difficulty walking 0.5km or climbing stairs.24
As the pull of muscles on bones has a trophic effect on the latter, it should not be surprising that muscle strength is related to bone mineral density. What is noteworthy is the consistent demonstration across cultures of a relationship between grip strength and bone mineral density/osteoporosis at different sites- not all involving bones attached to muscles involved in hand-grip (eg, calcaneus, spine and hip.25–33 Of note, strength is a better explanator of bone mineral density/osteoporosis than muscle mass.26,33
Potentially related to the concurrent association of grip strength with bone mineral density/osteoporosis is the relationship between grip strength and fractures. In a systematic review Denk et al found that all of 11 included studies confirmed a relationship between decreased hand grip strength and the incidence of hip fractures.34 Similarly, Kim et al found that hand grip strength along with bone mineral density was associated with an increased risk of fragility fractures.27 Of course a key cause of fractures is falls. Therefore, the demonstration of an association between grip strength and falls might also be expected. Yang et al reported such an association, specifically they noted a mean grip strength of 17.6 kg in a group that had recently fallen compared to 20.7 kg in a group that had not fallen.35 Van Ancum et al determined that lower grip strength was present among males (but not females) with pre-hospitalization falls.36
Grip strength has been studied as a potential biomarker of malnutrition among diverse patient groups - with varying results. Examining a sample of older Chinese inpatients tested at hospital admission, Zhang et al noted that those with lower grip strength had an increased risk of malnutrition measured using the Nutritional Risk Screening and Subjective Global Assessment.37 For the Nutritional Risk Screening the best cut-points were 27.5kg for men 65–74 years, 21.0kg for men 75–90 years, 17.0kg for women 65–74 years, and 14.6kg for women 75–90 years. For the Subjective Global Assessment, the optimal cut-points were 24.9kg for men 65–74 years, 20.8kg for men 75–90 years, 15.2kg for women 65–74 years, and 13.5kg for women 75–90 years. Among patients on maintenance hemodialysis, Silva et al found low but significant inverse correlations (rs= −0.38 [men] and −0.36 [women]) between grip strength and the Malnutrition–Inflammation Score.38 The correlation was present regardless of race, diabetic status, age, and gender. They calculated grip strength cut points of 28.3kg for men and 23.4kg for women. Ozorio et al classified patients with gastrointestinal cancer into 4 levels of cachexia.39 Patients with the greatest degree of cachexia (refractory) had the lowest grip strength. They reported the most discriminating grip strength cutoff for refractory cachexia was 19.3 kg for men and 14.7 kg for women. Byrnes et al, who studied older adults admitted to general surgical wards, concluded that grip strength was not “suitable for screening older inpatients for malnutrition”.40 Although finding a significant association between grip strength and nutritional status, McNicholl described grip strength as having “poor validity as a single nutrition indicator”.41 As more of the patients they tested completed a grip strength assessment (92%) than a 5 meter walking assessment (43%), they concluded that grip strength “is a more useful functional measure” than the 5 meter walk test.
Weakness is a commonly observed impairment in the lower limbs of Individuals with diabetes, with weakness being greater in the presence of neuropathy.42 Some research, however, also evinces limited grip strength in individuals with diabetes43–45 or prediabetes.46 That strength has also been shown in a few studies to be inversely related to measures of glucose control such as fasting glucose, HBA1c, and hyperglycemia43–45 and to systemic inflammation.43 Grip strength is also related to multimorbidity whether or not diabetes is a component of the morbidity load;47–50 as the number of comorbidities rises the grip strength diminishes.
Up to this point, relationships between grip strength and variables of a physical nature have been addressed. Considerable research, however, notes a covariance of grip strength with cognition, depression, and sleep as well. In a recent systematic review examining the relationship between grip strength and cognitive function in older adults, Kobayashi-Cuya et al reported that 6 of 7 studies documented significant relationships.51 Vancampfort et al recently reported that among middle-aged and older adults, weak grip strength was associated with increased odds of having mild cognitive impairment.52 Others have shown a correlation between grip strength and the Mini-Mental State Examination scores of geriatric inpatients,53 information processing speed and executive functioning of patients attending a memory clinic,54 Stroop Task and 6-item Cognitive Impairment Test scores of physically active adults,55 visual memory,and reaction time of patients with schizophrenia,56 and Animal Fluency Test and Digital Symbol Substitution Test scores of cancer survivors.57 A link between grip strength and depression has been demonstrated among residents of 6 low and middle income countries58 as well as Brazil59 and Korea.60 Using a cutpoint of less than 30kg for men and 20kg for women for weak grip, Ashdown-Franks et al found a prevalence of depression of 8.8% among adults classified as weak versus 3.8% among adults not classified as weak.58 Kyu-Man et al determined in a sample of older adults that the correlation between grip strength and depression was lower in older adults with a higher household income.61 Perhaps the high income of Australians explains why Gopinath et al did not find their grip strength to be associated with depression.62 Greater sleep impairment,63 lower sleep quality,64,65 and longer sleep duration66 have been shown to be related to lower handgrip strength.
Finally, grip strength has been shown to relate concurrently to quality of life, a variable not limited specifically to physical or mental domains. These relationships have been documented using generic measures of quality of life in patients with liver disease,67 and disease specific measures of quality of life in patients with cancer,68 chronic obstructive lung disease,69,70 or surgery for spinal stenosis.71
Grip Strength As A Biomarker Of Future Outcomes
Grip strength is a predictor of numerous future outcomes. Mortality is probably the most widely studied outcome, with studies published as far back as the 1980s72 and at least 3 meta-analyses supporting the association of weak grip strength with all-cause mortality in the general population. In one of these meta-analyses Rijk et al summarized 22 articles addressing mortality. Their pooled hazard ratio for mortality for categorical variables was 1.79.73 In a more recent meta-analysis Wu et al consolidated the results of 40 studies addressing all-cause mortality.74 They calculated a pooled hazard ratio 1.16) per 5kg reduction in grip strength. In an even more recent meta-analysis García-Hermosa et al combined the results of 33 studies addressing all-cause mortality.75 They determined a pooled hazard ratio for a reduced risk of mortality for higher versus lower levels of grip strength to be 0.69. In addition to these meta-analyses, several recent large-scale studies have further reinforced the value of grip strength as a predictor of mortality in community-dwelling populations. These studies all involved over 1000 participants from each of several specific countries or regions: Japan;76 Russia;77 Denmark,77 the United Kingdom,77–79 Korea,80 Norway,81 the United States,82,83 the Netherlands,84 Switzerland,85 Western Europe,86 and Taiwan.87 In the last of these studies, “malnutrition synergistically increased the mortality risk” in keeping with low grip strength.87
Grip strength is also supported as a predictor of disease and disease-specific mortality- with much of the literature focused on cardiovascular disease and cancer. Wu et al, in a summary of 12 studies, determined that a 5kg decrease in grip strength was associated with an increased risk of cardiovascular disease (overall hazard ratio 5.98).74 Other studies not included in their review provide additional qualified support for measuring grip strength. Prasitsiriphon and Pothisiri found that grip strength was a significant predictor of cardiovascular mortality for men and women but that change in grip strength was not.86 Yates et al determined that grip strength was associated with cardiovascular mortality but only in men (hazard ratio: 1.38).88 Gubelman et al noted a significant association of low grip strength and cardiovascular events, but the difference was annulled after accounting for baseline cardiovascular risk.85 Whitney and Peterson, who measured absolute grip strength as well as grip strength normalized against body mass and body mass index, found only the latter 2 measures to covary with cerebrovascular events.82 Perhaps most telling in regard to the relationship of grip strength and cardiovascular mortality, however, are the findings reported by Leong et al89. They determined that grip strength was a more powerful predictor of cardiovascular mortality (hazard ratio 1.17) than systolic blood pressure. They also found grip strength to be associated with all-cause mortality (hazard ratio 1.16), myocardial infarction (hazard ratio 1.07), and stroke (hazard ratio 1.09).
In regard to cancer mortality, the value of grip strength as a predictive biomarker is uncertain. Based on a meta-analysis of 7 studies, Garcia-Hermoso et al calculated a hazard ratio of 0.97 and suggested that a “higher level of muscular strength is not statistically associate with a lower risk of cancer mortality“.90 Wu et al came to a similar conclusion following a meta-analysis of 10 studies (hazard ratio 1.10).74 In a more recently published study of more than 500,000 adults not included in these meta analyses, Celis-Morales et al found an association between lower grip strength and cancer mortality (all cause, colorectal, lung, and breast).91 Their findings did not extend to prostate cancer. For individuals who already have cancer, there is inconsistent evidence that low grip strength is a predictor of mortality. For older patients with cancer Pamoukdjian et al and Versteeg et al both showed that higher grip strength was associated with prolonged survival.92,93 Chen et al demonstrated a significant difference (p=0.016) in the 6 month mortality of patients with grip strength < 25kg versus normal grip strength who underwent esophagectomy for esophageal cancer.94 Puts et al, on the other hand, did not find a significant relationship between grip strength and mortality in patients with cancer.95 Unlike Versteeg et al, however, Puts et al did find an association between grip strength and treatment toxicity.
In addition to examining grip strength as a potential predictor of cardiovascular and cancer mortality, investigators have also shown the value of grip strength as a predictor of mortality in other pathologies. These pathologies include, but are not limited to, rheumatoid arthritis in women (relative risk 3.0),96 type 2 diabetes in men (hazard ratio 0.90),97 pneumonia (odds ratio 0.97),98 renal disease (1.76 and 1.81),99 and chronic obstructive pulmonary disease (hazard ratio 1.80).100 For patients with chronic obstructive pulmonary disease Mohamed-Hussein et al noted a significant difference in mean grip strength between patients admitted to the intensive care who died (5.7kg) compared to those who survived (14.5kg).101
As grip strength explains function cross-sectionally, it also predicts future function and changes in function over time. Over 10 years ago Bohannon published a systematic review in which he included the results of 9 studies investigating the value of grip strength as a predictor of future function.4 The studies included samples of healthy nondisabled, disabled, and diseased middle-aged and older adults whose function was measured a median 10 days to 25 years after their baseline grip strength. For the cohort followed a median 10 days, the grip strength of both sides was significantly less for patients who declined functionally during hospitalization.102 For the cohort followed 25 years, individuals with the lowest baseline grip strength were significantly more likely to walk at ≤0.4m/s (odds ratio 2.77), be unable to rise from a chair (odds ratio 2.73), lifting 4.5kg (odds ratio 1.94), doing heavy housework (odds ratio 1.69), dressing (odds ratio 2.43), and bathing (odds ratio 2.06), but not walking 0.8km (odds ratio 1.25), walking up 10 steps (odds ratio 1.28), eating (odds ratio 2.33), or toileting (odds ratio 1.96).103 More recent studies have confirmed the value of grip strength as a predictor of function. Dodds et al found the grip strength of a British cohort measured in “mid-life” to predict their mobility and/or personal care disability in early old age (odds ratio 1.84).104 The value of grip strength as a predictor was roughly equivalent to that of sit-to-stand speed and unipedal stance time (eyes closed) and added to the predictive power provided by chronic conditions and behavioral risk factors. McGrath et al determined that high baseline grip strength decreased the odds of developing disability in activities of daily living (odds ratio 0.95) and instrumental activities of daily living (odds ratio 0.92) among older Mexican Americans.105 For patients with specific problems grip strength was shown to be predictive of function as well. For example, Di Monaco et al documented that for women with hip-fractures, handgrip strength measured before rehabilitation was correlated weakly but significantly (p=0.001) with Barthel Index scores at the end of inpatient rehabilitation (rpartial =0.25) and at 6-month follow-up (rpartial =0.28).106 Hashimoto et al demonstrated that preoperative grip strength was significantly greater (p=0.001) among patients who used a step-over-step pattern rather than a step-to-step pattern to negotiate stairs one year post total knee arthroplasty.107 Incidentally, they also found preoperative grip strength to be better than preoperative knee extension strength for predicting the pattern used to negotiate stairs. Two studies have described the relationship between grip strength at hospital admission and functional decline. Garcia-Peña focused on functional decline between admission and discharge.108 In multivariable analysis they found that grip strength was related significantly to a 30-point decline in Barthel scores in men (odds ratio 0.87) but not in women (odds ratio 0.93). Olguín et al were concerned with functional decline over the 30 days after admission.109 They found grip strength to be significantly related (odds ratio 0.97, p =0.007) to functional decline as measured using the Karnofsky index. Grip strength was more predictive than age, nutritional status, or a cancer diagnosis of such a decline.
Although the cross-sectional relationship between grip strength and bone mineral density has been firmly supported by literature cited heretofore, there is little research showing a predictive relationship between grip strength and future bone mineral density or changes in bone mineral density over time. The one relevant article I found via a PubMed search reported a low but significant correlation (rs =0.25) between grip strength the annual percentage changes in bone mineral density of the femoral neck among a population-based cohort of women followed over 10 years.110 As have numerous cross-sectional studies, many longitudinal studies have addressed the value of grip strength as a predictor of incident fractures.111–115 Among healthy Saudi postmenopausal women, Rouzi et al found grip strength to be significantly lower for women who developed osteoporosis related fractures.111 The odds ratios associated with their experiencing a fragility fracture (2.56 or 2.24) were greater than the odds ratios associated with various bone mineral density measures (1.24 to 1.96). They suggested, consequently, that grip strength and other risk factors may be useful alternatives for identifying fracture risk where the measurement of bone mineral density is impracticable. Dixon et al expressed similar conclusions, noting that low grip strength is associated with an increased risk of incident vertebral fractures that cannot be explained by differences in lifestyle or body size.112 Rikkonen et al found grip strength to predict incident fractures (not corrected for bone mineral density) with hazard ratios of 2.0 and 1.3. Notably, both unipedal balance and squatting to the floor performance were more predictive of fractures and all 3 performance measures together were most predictive of fracture.113 Sirola et al followed women with normal bone mineral density at baseline for 15 years.114 While they found bone mineral density t-scores to be the best predictors of incident fractures, they determined that grip strength could be used as a “cost effective” supplemental predictor of fractures. As pointed out before the concurrence of fractures with falls renders the relationship between grip strength and falls important. Miller et al found that the risk of falling over a period of 1 year was low but significantly (p=0.034) greater among both men and women whose grip strength was below the 25th percentile of the older Australian population studied.115 Studying Swedish men, Cöster et al et al also found grip strength to predict incident falls (odds ratio 1.52 right, 1.64 left) but recurrent incident falls as well (odds ratio 1.57 right, 1.64 left).116 Notably, they reported that tests of sit-to-stand performance and walking time were also predictive of falls and recurrent falls (odds ratios 1.54 to 2.00). Van Ancum et al showed that grip strength was related to having at least 1 fall during the 3 months post hospital discharge. However, their finding was only validated with men (odds ratio 9.93).36 Luukinen et al noted that reduced grip strength was related significantly (p=0.05) to fall-related fractures in home-dwelling older adults but that knee extension strength was related as well.117
As the relationships between grip strength and cognitive and depressive status have been examined cross-sectionally, they have also been investigated over time. Two recent systematic reviews draw different conclusions from the predictive literature. In the first review, Kobayashi-Cuya et al concluded that while grip strength and cognition are associated longitudinally, it is not clear “which variable at baseline affects the other in the long-term.”51 In the second review, Zammit et al opined that while both grip strength and cognitive performance decline with age, evidence for an association between longitudinal rates of change in the variables is limited.118 Several original studies not included in the aforementioned reviews provide evidence supporting a predictive relationship between grip strength and cognitive decline. The studies include Japanese, Korean, and Italian populations, follow-up periods of 1 to 10 years, and cognitive tests as diverse as the Mini-Mental State Evaluation, Digit Symbol Substitution Test, Clock Drawing Test, and the Clinical Dementia Rating Scale.119–123
The final predictive value of grip strength addressed herein is that relative to hospitalization. Simmonds et al examined the association between grip strength and the combined rate of hospital admission/death over the following 10 years.124 For a large sample of both men and women, lower grip strength was associated with a significantly greater risk of any emergency admission/death (hazard ratios 1.08 and 1.21) and any > 7 days admission/death (hazard ratios 1.14 and 1.20). For women low grip strength was also associated with a significantly greater risk of any admission/death (hazard ratio 1.10) and any elective admission/death (hazard ratio 1.09). Cowthon et al, who followed a cohort of Americans over a mean 4.7 years, found that participants with the weakest grip strength had the highest risk of hospitalization.125 Notably, participants with the poorest knee extension strength, sit-to-stand times, and waking speed were also at a significant risk for hospitalization. In a large sample of Japanese individuals with type 2 diabetes, Hamasaki et al found hospitalization over a mean 2.4 years was associated significantly with grip strength (hazards ratio 0.96). The only variable they found to have a stronger relationship with hospitalization was HbA1c (hazards ratio 1.33).97
Not only are patients with weak grip strength more likely to be admitted to the hospital, they are more likely to experience complications while there. In a review referred to heretofore,4 weak grip strength was described as related to complications in patients undergoing surgery and in patients with cancer, hip fractures, and cirrhosis. In the study of patients with cirrhosis, grip strength was the only variable predicting a “significant increase in major complications.”126 More recent studies, not addressed in the review, have evinced a relationship between grip strength and complications/post-operative risk in patients undergoing surgery for abdominal cancer127 or elective cardiac surgery.128 A contemporary study of patients hospitalized for hip fractures showed their grip strength to be associated with a risk of pressure ulcers.129
The literature is inconsistent, but hospital and rehabilitation length of stay and readmission have been shown in several studies to correlate with grip strength. Specifically, significant relationships with length of stay have been reported with the stronger hand of older hospitalized patients,130 both hands of patients with stroke,131 the stronger hand of patients with pneumonia,132 the average of both hands of patients undergoing hip or knee arthroplasty,133 and handgrip strength normalized against body weight for patients undergoing implantation of a left ventricular assistive device.134 Hospital readmission is also related to grip strength. Regarding hospital readmissions, a study referred to earlier demonstrated a significant relationship between low preadmission grip strength and death or readmission within 30 days (odds ratio 1.13 to 1.30).124 Andeasen et al noted a significant relationship between low postadmission grip strength and death or readmission within 6 months.135 Allard et al, who measured grip strength at discharge from an acute care hospital, showed higher grip strength to be accompanied by a lower 30-day rate of readmission.136 Isaia et al found neither admission nor discharge grip strength to be predictors of readmission, but they were associated with mortality.137 Vecchiarino et al did not verify grip strength as a predictor of readmission in patients admitted to the hospital with pneumonia.132
Discussion And Conclusions
Several authors have recommended grip strength as a “useful indicator for overall health,”16 a vital sign4,5 and as a biomarker of health status.3,138,139 The purpose of this literature review was to provide an up-to-date, thorough and balanced synopsis of evidence for using grip strength as a biomarker of current and future health status. Based on the review it appears that there is adequate evidence to support the use of grip strength as an explanatory or predictive biomarker of specific outcomes such as generalized strength and function, bone mineral density, fractures, and falls, nutritional status, disease status and comorbidity load, cognition, depression, and sleep, hospital-related variables, and mortality. Based on this evidence and the promotion by others,140 the routine implementation of the measurement of grip strength can be recommended for older adults in the community and health-care settings.
This review has several limitations. Most notable, it was a narrative rather than a systematic review. As such, it is not as comprehensive as it might be, and the performance of a meta-analysis was not possible. This limitation noted, a PubMed search using the terms “hand AND grip AND strength” was used to help identify relevant literature and every effort was made to not limit the findings reported to those supportive of using grip strength as a biomarker. Another limitation is the lack of standardized testing across studies. Numerous different procedures, cut points for grip weakness and statistics were used in the reviewed investigations. The possible effects of these differences have led Roberts et al to argue for the use of a standardized approach to measurement in both clinical and epidemiological studies.141
The incredible amount of research on grip strength and outcomes notwithstanding, further research on the topic is warranted. Of interest may be topics such as the relative value of different grip strength measures (eg, absolute versus relative),142 alternative strength measures (eg, grip versus respiratory),143 and various combinations of measures (eg, grip strength and self-reported activity).53
Disclosure
The author reports no conflicts of interest in this work.
References
1. Strimbu K, Tavel JA. What are biomarkers. Curr Opin HIV AIDS. 2010;5(6):463–466. doi:10.1097/COH.0b013e32833ed177
2. WHO. International Classification of Functioning, Disability, and Health (ICF Short Version). World Health Organization: Geneva; 2001.
3. Sayer AA, Kirkwood TBL. Grip strength and mortality: a biomarker of ageing? Lancet. 2015;386(9990):226–227. doi:10.1016/S0140-6736(14)62349-7
4. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3–10.
5. Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opinion Clin Nutr. 2015;18(5):465–470.
6. Bohannon RW, Magasi SR, Bubela DJ, Wang Y-C, Gershon RC. Grip and knee extension muscle strength reflect a common construct among adults. Muscle Nerve. 2012;46(4):555–558. doi:10.1002/mus.23350
7. Bohannon RW. Are hand-grip and knee extension strength reflective of a common construct? Percept Mot Skills. 2012;114(2):514–518. doi:10.2466/03.26.PMS.114.2.514-518
8. Ekstrand E, Lexell J, Brogårdh C. Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. J Rehabil Med. 2015;47(80):706–713. doi:10.2340/16501977-1990
9. Takahashi J, Nishiyama T, Matsushima Y. Does grip strength on the unaffected side of patients with hemiparetic stroke reflect strength of other ipsilateral muscles? J Phys Ther Sci. 2017;29(1):64–66. doi:10.1589/jpts.29.64
10. Felicio DC, Pereira DS, Assumpção AM, et al. Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women. Geriatr Gerontol Int. 2014;14(1):185–189. doi:10.1111/ggi.12077
11. Sanderson WC, Scherbov S, Weber D, Bordone V. Combined measures of upper and lower body strength and subgroup differences in subsequent survival among the older population of England. J Aging Health. 2016;28(7):1178–1193. doi:10.1177/0898264316656515
12. Wang C-Y, Chen L-Y. Grip strength in older adults: test-retest reliability and cutoff for weakness of using the hands in heavy tasks. Arch Phys Med Rehabil. 2010;91(11):1747–1751. doi:10.1016/j.apmr.2010.07.225
13. Giray E, Akyϋz G. Assessment of family caregiver burden and its relationships between quality of life, arm disability, grip strength, and lymphedema symptoms in women with postmastectomy lymphedema: a prospective cross-sectional study. Eur J Breast Health. 2019;15(2):111–118. doi:10.5152/ejbh.2019.4385
14. Izawa KP, Kasahara Y, Hiraki K, Hirano Y, Watanabe S. Relation between the Disability of the Arm, Shouder and Hand score and muscle strength in post-cardiac surgery patients. Diseases. 2017;5(4):31. doi:10.3390/diseases5040031
15. Sunderland A, Tinson D, Bradley L, Langton Hewer R. Arm function after stroke. An evaluation of grip strength as a measure of recovery and prognostic indicator. J Neurol Neurosurg Psychiatr. 1989;52(11):1267–1272.
16. Forrest KYZ, Williams AM, Leeds MJ, Robare JF, Bechard TJ. Patterns and correlates of grip strength in older Americans. Curr Aging Sci. 2018;11(1):63–70. doi:10.2174/1874609810666171116164000
17. Zhang Q, Lu H, Pan S, Lin Y, Zhou K, Wang L. 6MWT performance and its correlations with VO2 and handgrip strength in home-dwelling mid-aged and older Chinese. Int J Environ Res Public Health. 2017;14(5):E473.
18. Alley DE, Shardell MD, Peters KW, et al. Grip strength cutpoints for the identification of clinically relevant weakness. J Gerontol. 2014;69(5):559–566. doi:10.1093/gerona/glu011
19. Bahat G, Tufan A, Tufan F, et al. Cut-off points to identify sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP). Clin Nutr. 2016;35(6):1557–1563. doi:10.1016/j.clnu.2016.02.002
20. Dong R, Guo Q, Wang J. Optimal cutoffs of grip strength for definition as weakness in the elderly. J Biosci Med. 2014;2(9):14–18.
21. De Souza Barbosa JF, Zepeda MUP, Béland F, Guralnik JM, Zunzunegul MV, Guerra RO. Clinically relevant weakness in diverse populations of older adults participating in the International Mobility in Aging Study. Age. 2016;38(1):25. doi:10.1007/s11357-016-9919-9
22. Duchowny KA, Peterson MD, Clarke PJ. Cut points for clinical muscle weakness among older Americans. Am J Prev Med. 2017;53(1):63–69. doi:10.1016/j.amepre.2016.12.022
23. DeSouza Vasconcelos KS, Domingues Dias JM, De Carvalho Bastone A, et al. Handgrip strength cutoff points to identify mobility limitation in community-dwelling older people and associated factors. J Nutr Health Aging. 2016;20(3):306–315. doi:10.1007/s12603-015-0584-y
24. Sallinen J, Stenholm S, Rantanen T, Heliövaara M, Sainio P, Koskinen S. Hand-grip strength cut-points to screen older persons at risk for mobility limitation. J Am Geriatr Soc. 2010;58(9):1721–1726. doi:10.1111/j.1532-5415.2010.03035.x
25. Kritz-Silverstein D, Barrett-Conner E. Grip strength and bone mineral density in older women. J Bone Miner Res. 1994;9(1):45–51. doi:10.1002/jbmr.5650090107
26. Tachiki T, Kouda K, Dongmaei N, et al. Muscle strength is associated with postmenopausal women: the Japanese-based osteoporosis. J Bone Joint Mineral Metab. 2019;37(1):53–59. doi:10.1007/s00774-017-0895-7
27. Kim SW, Lee HA, Cho E-H. Low handgrip strength is associated with low bone mineral density and fragility fractures in postmenopausal healthy Korean men. J Korean Med Sci. 2012;27(7):744–747. doi:10.3346/jkms.2012.27.7.744
28. Miyakoshi N, Kudo D, Hongo M, Kasukawa Y, Ishikawa Y, Shimada Y. Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers. Osteoporos Int. 2017;28(11):3153–3160. doi:10.1007/s00198-017-4184-z
29. McGrath RP, Kraemer WJ, Vincent BM, Hall OT, Peterson MD. Muscle strength is protective against osteoporosis in an ethnically diverse sample of adults. J Strength Cond Res. 2017;31(9):2586–2589. doi:10.1519/JSC.0000000000002080
30. Logan S, Thu WPP, Lay WK, Wang LY, Cauley JA, Yong EL. Chronic joint pain and handgrip strength correlates with osteoporosis in mid-life women: a Singaporean cohort. Osteoporos Int. 2017;28(9):2633–2643. doi:10.1007/s00198-017-4095-z
31. Nagai A, Tajika T, Yamamoto A, Okura C, Kanazawa S, Takagishi K. Relations between quantitative ultrasound assessment of calcaneous and grip and key pinch power in Japanese mountain village residents. J Orthop Surg. 2017;25(1):1–6.
32. Li YZ, Zhuang HF, Cai SQ, et al. Low grip strength is a string risk factor of osteoporosis in postmenopausal women. Orthop Surg. 2018;10(1):17–22. doi:10.1111/os.12360
33. Ma Y, Fu L, Jia L, et al. Muscle strength rather than muscle mass is associated with osteoporosis in older Chinese adults. J Formos Med Assoc. 2018;117(2):101–108. doi:10.1016/j.jfma.2017.03.004
34. Denk K, Lennon S, Gordon S, Jaarsma RL. The association between decreased hand grip strength and hip fracture in older people: a systematic review. Exp Gerontol. In press 2018.
35. Yang N-P, Hsu N-W, Lin C-H, et al. Relationship between muscle strength and fall episodes among the elderly: the Yilan study, Taiwan. BMC Geriatr. 2018;18(1):90.
36. Van Ancum JM, Pijnappels M, Jonkman NH, et al. Muscle mass and muscle strength are associated with pre- and post-hospitalization falls in older male in Taiwan: a longitudinal cohort study. BMC Geriatr. 2018;18(1):116. doi:10.1186/s12877-018-0812-5
37. Zhang XS, Liu YH, Zhang Y, et al. Handgrip strength as a predictor of nutritional status in Chinese elderly inpatients at hospital admission. Biomed Environ Sci. 2017;30(11):802–810. doi:10.3967/bes2017.108
38. Silva LF, Matos CM, Lopes CB, et al. Handgrip strength as a simple indicator of possible malnutrition and inflammation in men and women on maintenance hemodialysis. J Ren Nutr. 2011;21(3):235–245. doi:10.1053/j.jrn.2010.07.004
39. Ozorio GA, Barão K, Forones NM. Cachexia stage, patient generated subjective global assessment, phase angle, and handgrip strength in patients with gastrointestinal cancer. Nutr Cancer. 2017;69(5):772–779. doi:10.1080/01635581.2017.1321130
40. Byrnes A, Mudge A, Young A, Banks M, Bauer J. Use of grip strength in nutrition risk screening of older patients admitted to general surgical wards. Nutr Diet. 2018;75(5):520–526. doi:10.1111/1747-0080.12422
41. McNicholl T, Dubin JA, Curtis L, et al. Handgrip strength, but not 5-meter walk, adds value to a clinical nutrition assessment. Nutr Clin Pract. 2018;34(3):428–435. doi:10.1002/ncp.10198
42. Andersen H, Nielsen S, Mogensen CE, Jakobsen J. Muscle strength in type 2 diabetes. Diabetes. 2004;53(6):1543–1548. doi:10.2337/diabetes.53.6.1543
43. Lee M-R, Jung SM, Bang H, Kim HS, Kim YB. Association between muscle strength and type 2 diabetes mellitus in adults in Korea: data from Korea national health and nutrition examination survey (KNHANES) VI. Medicine. 2018;97(23):e10984. doi:10.1097/MD.0000000000010984
44. Bohannon RW, Smith J, Barnhard R. Grip strength in end stage renal disease. Percept Mot Skills. 1994;79(3Pt2):1523–1526. doi:10.2466/pms.1994.79.3f.1523
45. Peterson MD, Duchowny K, Meng Q, Wang Y, Chen X, Zhao Y. Low normalized grip strength is a biomarker for cardiometabolic disease and physical disabilities among US and Chinese adults. J Gerontol A Biol Sci Med Sci. 2017;72(11):1525–1531. doi:10.1093/gerona/glx031
46. Hu S, Gu Y, Zhang Q, et al. Relationship between grip strength and prediabetes in a large-scale adult population. Am J Prev Med. 2019;56(6):844–851. doi:10.1016/j.amepre.2019.01.013
47. Cheung C-L, Nguyen U-S DT, Au E, Tan CB, Kung AWC. Association of handgrip strength with chronic diseases and multimorbidity. Age. 2013;35(3):929–941. doi:10.1007/s11357-012-9385-y
48. Yorke AM, Curtis AB, Shoemaker M, Vangsnes E. The impact of multimorbidity on grip strength in adults age 50 and older: data from the health and retirement survey (HRS). Arch Gerontol Geriatr. 2017;72:164–168. doi:10.1016/j.archger.2017.05.011
49. Reeve TE, Ur R, Craven TE, et al. Grip strength measurement for frailty assessment in patients with vascular disease and associations with comorbidity, cardiac wrist, and sarcopenia. J Vasc Surg. 2018;67(5):1512–1520. doi:10.1016/j.jvs.2017.08.078
50. Volaklis KA, Halle M, Thorand B, et al. Handgrip strength is inversely and independently associated with multimorbidity among older women: results from the KORA-Age study. Eur J Intern Med. 2016;31:35–40. doi:10.1016/j.ejim.2016.04.001
51. Kobayashi-Cuya KE, Sakurai R, Suzuki H, Ogawa S, Takebayashi T, Fujiwara Y. Observational evidence of the association between handgrip strength, hand dexterity, and cognitive performance in community-dwelling older adults: a systematic review. J Epidemiol. 2018;28(9):373–381. doi:10.2188/jea.JE20170041
52. Vancampfort D, Stubbs B, Firth J, Smith L, Swinnen N, Koyanagi A. Associations between handgrip strength and mild cognitive impairment in middle-aged and older adults in six low-and middle-income countries. Int J Geriatr Psychiatry. 2019;34(4):609–616. doi:10.1002/gps.5061
53. Dudzińka-Griszek J, Szuster K, Szewieczek J. Grip strength as a frailty diagnostic component in geriatric inpatients. Clin Interventions Aging. 2017;12:1151–1157.
54. Hooghiemstra AM, Ramakers IHGB, Sistermans N, et al. Gait speed and grip strength reflect cognitive impairment and are modestly related to incident cognitive decline in memory clinic patients with subjective cognitive decline and mild cognitive impairment: findings from the 4C Study. J Gerontol A Biol Sci Med Sci. 2017;72(6):846–854. doi:10.1093/gerona/glx003
55. Ramnath U, Rauch L, Lambert EV, Kolbe-Alexander TL. The relationship between functional status, physical fitness and cognitive performance in physically active older adults: a pilot study. PLoS One. 2018;13(4):e0194918.
56. Firth J, Stubbs B, Vancampfort D, et al. Grip strength is associated with cognitive performance in schizophrenia and the general population: a UK Biobank Study of 476559 participants. Schizophr Bull. 2018;44(4):728–736. doi:10.1093/schbul/sby034
57. Yang L, Koyanagi A, Smith L, et al. Hand grip strength and cognitive function among elderly cancer survivors. PLoS One. 2018;13(6):e0197909. doi:10.1371/journal.pone.0197909
58. Ashdown-Franks G, Stubbs B, Koyanagi A, et al. Handgrip strength and depression among 34129 adults aged 50 years and older in six low- and middle-income countries. J Affect Disord. 2019;243:448–454. doi:10.1016/j.jad.2018.09.036
59. Szlejf C, Suemoto CK, Brunoni AR, et al. Depression is associated with sarcopenia due to low muscle strength: results from the ELSA-Brasil Study. J Am Med Dir Assoc. In press 2019.
60. Lee M-R, Jung SM, Bang H, Kim HS, Kim YB. The association between muscular strength and depression in Korean adults: a cross-sectional analysis of sixth Korea National Health and Nutrition Examination (KNHANES VI) 2014. BMC Public Health. 2018;18(1):1123.
61. Kyu-Man H, Jisoon C, Ho-Kyoung Y, et al. Relationships between hand-grip strength, socioeconomic status, and depressive symptoms in community-dwelling older adults. J Affect Disord. 2019;252:263–270. doi:10.1016/j.jad.2019.04.023
62. Gopinath B, Kifley A, Liew G, Mitchell P. Handgrip strength and its association with functional independence, depressive symptoms and quality of life in older adults. Maturitas. 2017;106:92–94. doi:10.1016/j.maturitas.2017.09.009
63. Pengpid S, Peltzer K. Hand grip strength and its sociodemographic and health correlates among older adult men and women (50 years and older) in Indonesia. Curr Gerontol Geriatr Res. 2018: 3266041.
64. Lee G, Baek S, Park H-W, Kang EK. Sleep quality and attention may correlate with hand grip strength: FARM Study. Ann Rehabil Med. 2018;42(6):822–832. doi:10.5535/arm.2018.42.6.822
65. Laredo-Aguilera JA, Carmona-Torres JM, Cobo AI, Garcia-Pinillos F, Latorre-Román PÁ. Handgrip strength is associated with psychological functioning, mood and sleep in women over 65 years. Int J Environ Res Public Health. 2019;16(5):E873.
66. Chen H-C, Hsu N-W, Chou P. The association between sleep duration ad hand grip strength in community-dwelling older adults: the Yilan Study, Taiwan. Sleep. 2017;40:4.
67. Nishikawa H, Enomoto H, Yoh K, et al. Health-related quality of life in chronic liver diseases. J Clin Med. 2018;7(12):E553.
68. Kilgour RD, Vigano A, Trutschnigg B, Llucar E, Borod M, Moralais JA. Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients. Support Care Cancer. 2013;21(12):3261–3270. doi:10.1007/s00520-013-1894-4
69. Kaymaz D, Candemir IC, Ergüu P, Demir N, Taşdemir F, Demir P. Relation between upper-limb muscle strength with exercise capacity, quality of life, and dyspnea in patients with severe chronic chronic obstructice pulmonary disease. Clin Respir J. 2018;12(3):1257–1263. doi:10.1111/crj.12659
70. Jeong M, Kang HK, Song P, et al. Hand grip strength in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulm Dis. 2017;12:2385–2390.
71. Shen F, Kim H-J, Lee N-K, et al. The influence of hand grip strength on surgical outcomes after surgery for degenerative lumbar spinal stenosis: a preliminary result. Spine J. 2018;18(11):2018–2025. doi:10.1016/j.spinee.2018.04.009
72. Milne JS, Maule MM. A longitudinal study of handgrip strength predicts incident dementia in older people. Age Ageing. 1984;13(1):42–48. doi:10.1093/ageing/13.1.42
73. Rijk JM, Roos PRKM, Deckx L, van Den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta-analysis. Geriatr Gerontol Int. 2016;16(1):5–20. doi:10.1111/ggi.12508
74. Wu Y, Wang W, Liu T, Zhang D. Association of grip strength with risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations: a meta-analysis of prospective cohort studies. J Am Med Direct Assoc. 2017;18(6):551e17–551.e35.
75. García-Hermoso A, Cavero-Redondo I, Ramírez-Vélez R, et al. Muscular strength as a predictor of all-cause mortality in an apparently healthy population: a systematic review and meta-analysis of data from approximately 2 million men and women. Arch Phys Med Rehabil. 2018;99(10):2100–2113e5. doi:10.1016/j.apmr.2018.01.008
76. Sasaki H, Kasagi F, Yamada M, Fujita S. Grip strength predicts cause-specific mortality in middle-aged and elderly persons. Am J Med. 2007;120(4):337–342. doi:10.1016/j.amjmed.2006.04.018
77. Oksuzyan A, Demakakos P, Shkolnikova M, et al. Handgrip strength and prognostic value for mortality in Moscow, Denmark, and England. PLoS One. 2017;12;9:e0182684.
78. Granic A, Davies K, Jagger C, Dods RM, Kirkwood TBL, Sayer AA. Initial level and rate of change in grip strength predict all-cause mortality in very old adults. Age Ageing. 2017;46:970–976. doi:10.1093/ageing/afx087
79. Kim Y, White T, Wijndaele K, et al. The combination of cardiorespiratory fitness and muscle strength, and mortality risk. Eur J Epidemiol. 2018;33(10):953–964. doi:10.1007/s10654-018-0384-x
80. Bae E-J, Park N-J, Sohn H-S, Kim Y-H. Handgrip strength and all cause mortality in middle-aged and older Koreans. Int J Environ Res Public Health. 2019;16(5):E740.
81. Karlsen T, Nauman J, Dalen H, Langhammer A, Wisløff U. The combined association of skeletal muscle strength and physical activity on mortality in older women: the HUNT2 study. Mayo Clin Proc. 2017;92(5):710–718. doi:10.1016/j.mayocp.2017.01.023
82. Whitney DG, Peterson MD. The association between differing grip strength measures and mortality and cerebrovascular event in older adults: National Health and Aging Trends study. Front Physiol. 2019;9:1871. doi:10.3389/fphys.2018.01916
83. Duchowny K. Do nationally representative cutpoints for clinical muscle weakness predict mortality? Results from 9 years of follow-up in the health and retirement study. J Gerontol A Biol Sci Med Sci. 2019;74(7):1070–1075. doi:10.1093/gerona/gly169
84. Eekhoff EMW, van Schoor NM, Biedermann JS, et al. Relative importance of four functional measures as predictors of 15-year mortality in older Dutch population. BMC Geriatr. 2019;19(1):92. doi:10.1186/s12877-019-1092-4
85. Gubelmann C, Vollenweider P, Marques-Vidal P. No association between grip strength and cardiovascular risk: the CoLaus population-based study. Int J Cardiol. 2017;236:478–482. doi:10.1016/j.ijcard.2017.01.110
86. Prasitsiriphon PW. Associations of grip strength and change in grip strength with all-cause and cardiovascular mortality in a European older population. Clin Med Insights Cardiol. 2018;12. doi:10.1177/1179546818771894
87. Wang Y-C, Liang C-K, Hsu Y-H, et al. Synergistic effect of low hand-grip strength and malnutrition on 4-year all-cause mortality in older males: a prospective longitudinal cohort study. Arch Gerontol Geriatr. 2019;83:217–222. doi:10.1016/j.archger.2019.05.007
88. Yates T, Zaccardi F, Dhalwani NN, et al. Association of walking pace and handgrip strength with all-cause mortality: a UK Biobank observational study. Eur Heart J. 2017;38(43):3232–3240. doi:10.1093/eurheartj/ehx449
89. Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings form the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266–273. doi:10.1016/S0140-6736(14)62000-6
90. Garcia-Hermoso R-VR, Ramírez‐Vélez R. Peterson MD, et al. Handgrip and knee extension strength as predictors of cancer mortality: a systematic review and meta-analysis. Scand J Med Sci Sports. 2018;28(8):1852–1858. doi:10.1111/sms.13206
91. Celis-Morales CA, Welsh P, Lyall DM, et al. Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants. BMJ. 2018;361:k1651.
92. Pamoukdjian F, Aparicio T, Zebachi S, Zelek L, Paillaud C-PF. Comparison of mobility indices for predicting early death in older patients with cancer: the Physical Frailty in Elderly Cancer Cohort Stusy. J Gerontol A Biol Sci Med Sci. In press 2019.
93. Versteeg KS, Blauwoff-Buskermolen S, Buffart LM, et al. Higher muscle strength is associated with prolonged survival in older patients with advanced cancer. Oncologist. 2018;23(5):580–585. doi:10.1634/theoncologist.2017-0193
94. Chen C-H, Y-Z H, Hung -T-T. Hand-grip strength is a simple and effective outcome predictor in esophageal cancer following esophagectomy with reconstruction: a prospective study. J Cardiothorac Surg. 2011;6:98. doi:10.1186/1749-8090-6-98
95. Puts MTE, Monette J, Girre V, et al. Are frailty markers useful for predicting treatment toxicity and mortality in older newly diagnosed cancer patients? Results from a prospective pilot study. Crit Rev Oncol Hematol. 2011;78(2):138–149. doi:10.1016/j.critrevonc.2010.04.003
96. Callahan LF, Pincus T, Huston JW, Brooks RH, Nance EP, Kaye JJ. Measures of activity and damage in rheumatoid arthritis: depiction of changes and prediction of mortality over 5 years. Arthritis Care Res. 1997;10:381–394.
97. Hamasaki H, Kawashima Y, Ktsuyama H, Sako A, Goto A, Yanai H. Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Sci Rep. 2017;7:7041.
98. Bohannon RW, Maljanian R, Ferullo J. Mortality and readmission of the elderly one year after hospitalization for pneumonia. Aging Clin Exp Res. 2004;161:
99. Xavier SP, Goes CR, Bufarah MNB, Balbi AL, Ponce D. Handgrip strength and weight predict long-term mortality in acute kidney injury patients. Clin Nutr ESPEN. 2017;17:86–91. doi:10.1016/j.clnesp.2016.09.006
100. Burtin C, Ter Riet G, Puhan MA, et al. Handgrip weakness and mortality risk in COPD: a multicenteranalysis. Thorax. 2016;71(1):86–87. doi:10.1136/thoraxjnl-2015-207451
101. Mohamed-Hussen AAR, Makhlouf HA, Delim ZI, Saleh WG. Association between hand grip strength with weaning and intensive care outcomes in COPD patients: a pilot study. Clin Respir J. 2018;12(10):2475–2479. doi:10.1111/crj.12921
102. Klein BEK, Klein R, Knudtson MD, Lee KE. Frailty, morbidity and survival. Arch Gerontol Geriatr. 2005;41(2):141–149. doi:10.1016/j.archger.2005.01.002
103. Rantanen T, Guralnik JM, Foley D, et al. Midlife hand grip strength as a predictor of old age disability. Jama. 1999;281(6):558–560. doi:10.1001/jama.281.6.558
104. Dodds RM, Kuh D, Sayer AA, Cooper R. Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from the British birth cohort study. Exp Gerontol. 2018;110:118–124.
105. McGrath R, Robinson-Lane SG, Peterson MD, Baily RR, Vincent BM. Muscle strength and functional limitations: preserving function in older Mexican Americans. J Am Med Dir Assoc. 2018;19(5):391–398. doi:10.1016/j.jamda.2017.12.011
106. Di Monaco M, Castiglioni C, De Toma E, Gardin L, Giordano S, Tappero R. Handgrip strength is an independent predictor of functional outcome in hip-fracture women. Medicine. 2015;94(6):e542. doi:10.1097/MD.0000000000000874
107. Hashimoto S, Hatayama K, Terauchi M, Saito K, Higuchi H, Chikuda H. Preoperative hand-grip strength can be a predictor of stair ascent and descent ability after total knee arthroplasty in female patients. J Orthop Sci. In press 2019.
108. Garcia-Peña C, Garcia Fabela LC, Gutiérrez-Robledo G-GJJ, Ve A-L, Mu P-Z. Handgrip strength predicts functional decline at discharge in hospitalized male elderly: a hospital cohort study. PLoS One. 2013;8(7):e69849.
109. Olguín T, Bunout D, De la Maza MP, Barrera G, Hirsch S. Admission handgrip strength predicts functional decline in hospitalized patients. Clin Nutr ESPEN. 2017;17:28–32. doi:10.1016/j.clnesp.2016.12.001
110. Finigan J, Greenfield DM, Blumsohn A, et al. Risk factors for vertebral and nonvertebral fracture over 10 years: a population-based study in women. J Bone Miner Res. 2008;23(1):75–85. doi:10.1359/jbmr.070814
111. Rouzi AA, Al-Sibiani SAA, Al-Senani NS, Radaddi RM, Ardawi M-S M. Independent predictors of all osteoporosis-related fractures 110healthy Saudi postmenopausal women: the CEOR study. Bone. 2012;50(3):713–722. doi:10.1016/j.bone.2011.11.024
112. Dixon WG, Lunt M, Pye SR, et al. Low grip strength is associated with bone mineral density and vertebral body fracture in women. Rheumatology. 2005;44(5):642–646. doi:10.1093/rheumatology/keh569
113. Rikkonen T, Poole K, Sirola J, Sund R, Honkanen R, Kröger H. Long-term effects of functional impairment on fracture risk and mortality in postmenopausal women. Osteoporos Int. 2018;29(9):2111–2120.
114. Sirola J, Rikkonen T, Tuppurainen M, Jurvelin JS, Alhava E, Kröger H. Grip strength may facilitate fracture prediction in perimenopausal women with normal BMD: a 15-year population-based study. Calcif Tissue Int. 2008;83(2):93–100. doi:10.1007/s00223-008-9155-0
115. Miller MD, Giles LC, Crotty M, Harrison JE, Andrews GR. A clinically relevant criterion for grip strength: relationship with falling in a sample of older adults. Nutr Diet. 2003;60:248–252.
116. Cöster ME, Karlsson M, Ohlsson S, et al. Physical function tests predict incident falls: a prospective study of 2969 men in the Swedish Osteoporotic Fractures in Men study. Scand J Public Health. In press 2019.
117. Luukinen H, Koski K, Laippala P. KiveläS-R. Factors predicting fractures during falling impacts among home-dwelling older adults. J Am Geriatr Soc. 1996;45(11):1302–1309.
118. Zammit AR, Robitaille A, Piccinin AM, Muniz-Terrera G, Hofer SM. Associations between aging-related changes in grip strength and cognitive function in older adults: a systematic review. J Gerontol A Biol Sci Med Sci. 2019;74(4):519–527. doi:10.1093/gerona/gly046
119. Viscogliosi G, Di Bernardo MG, Ettorre E, Chiriac IM. Handgrip strength predicts longitudinal changes in clock drawing test performance. An observational study in a sample of older non-demented adults. J Nutr Health Aging. 2017;21(5):593–596. doi:10.1007/s12603-016-0816-9
120. Kim J-H. Effect of grip strength on mental health. J Affect Disord. 2019;245:371–376. doi:10.1016/j.jad.2018.11.017
121. Kim KH, Park SY, Lee DR, Lee J. The relationship between handgrip strength and cognitive function in elderly Koreans over 8 years: a prospective population-based study using Korean Longitudinal Study of Ageing. Korean J Fam Med. 2019;40(1):9–15. doi:10.4082/kjfm.17.0074
122. Jeong S, Kim J. Prospective association of handgrip strength with risk of new-onset cognitive dysfunction in Korean adults: a 6-year national cohort study. Tohoku J Exp Med. 2018;244(2):83–91. doi:10.1620/tjem.244.83
123. Chou M-Y, Nishita Y, Nakagawa T, et al. Role of gait speed and grip strength in predicting 10-year cognitive decline among community-dwelling older people. BMC Geriatr. 2019;19(1):186. doi:10.1186/s12877-019-1199-7
124. Simmonds SJ, Syddall HE, Westbury LD, Dodds RM, Cooper C, Sayer AA. Grip strength among community-dwelling older people predicts hospital admission during the following decade. Age Ageing. 2015;44(6):954–959. doi:10.1093/ageing/afv146
125. Cawthon PM, Fox KM, Gandra SR, et al. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? J Am Geriatr Soc. 2009;57(8):1411–1419. doi:10.1111/j.1532-5415.2009.02366.x
126. Álvares-da-Silva MR. Reverbel da Silveira T. Comparison between handgrip strength, subjective global assessment, and prognostic nutritional index in predicting clinical outcome in cirrhotic outpatients. Nutrition. 2005;21(2):113–117. doi:10.1016/j.nut.2004.02.002
127. Karlsson E, Egenvall M, Farahnak P, et al. Better preoperative physical performance reduces the odds of complication severity and discharge to care facility after abdominal cancer resection in people over the age of 70- A prospective cohort study. Eur J Surg Oncol. 2018;44(11):1760–1767. doi:10.1016/j.ejso.2018.08.011
128. Perry IS, Grad L, Tk DS, Vieira SRR, Gc S. Handgrip strength in preoperative elective cardiac surgery patients and association with body composition and surgical risk. Nutr Clin Pract. Nutr Clin Pract. 2019;34(5):760–766.
129. Gonzalez EDL, Mendivil LLL, Garza DPS, Hermosillo HG, Chavez JHM, Corona RP. Low handgrip strength is associated with a higher incidence of pressure ulcers in hip fractured patients. Acta Orthop Belg. 2018;84(3):284–291.
130. Savino E, Sioulis F, Gurra M, et al. Potential prognostic value of handgrip strength in older hospitalized patients. J Frailty Aging. 2012;1(1):32–38. doi:10.14283/jfa.2012.6
131. McAniff CM. Bohannon. Validity of grip strength dynamometry in acute rehabilitation. J Phys Ther Sci. 2002;14(1):41–46. doi:10.1589/jpts.14.41
132. Vecchiarino P, Bohannon RW, Ferullo J. Short-term outcomes and their predictors of patients hospitalized with community-acquired pneumonia. Heart Lung. 2004;33(5):301–307.
133. Kumar AJS, Beresford-Cleary N, Kumar P, et al. Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty. Eur J Surg Traumatol. 2013;23(5):553–556.
134. Yost G, Bhat G. Relationship between handgrip strength and length of stay for left ventricular assist device implantation. Nutr Clin Pract. 2017;32(1):98–102. doi:10.1177/0884533616665926
135. Andreasen J, Aadahl M, Ee S, Eriksen HH, Lund H, Overad K. Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study. Arch Gerontol Geriatr. 2018;76:65–72. doi:10.1016/j.archger.2018.01.013
136. Allard JP, Keller H, Teterina AA, et al. Lower handgrip strength at discharge from acute care hospital is associated with 30-day readmission: a prospective cohort study. Clin Nutr. 2016;35(6):1535–1542. doi:10.1016/j.clnu.2016.04.008
137. Isaia G, Greppi F, Pastorino A, et al. Predictive effects of muscle strength after hospitalization in old patients. Aging Clin Exp Res. 2013;25(6):633–636.
138. Iconaru EI, Ciucurel MM, Georgescu L, Ciucurel C. Hand grip strength as a biomarker of aging from the persprctive of a Fibonacci mathematical modeling. BMC Geriatr. 2018;18:296.
139. Nacul LC, Mudie K, Kingdon CC, Clark TG, Lacerda EM. Hand grip strength as a clinical biomarker for ME/CFS and disease severity. Front Neurol. 2018;9:992.
140. Ibrahim K, May CR, Patel HP, Baxter M, Sayer AA, Roberts HC. Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment: identifying facilitators and barriers using a theory-led intervention. BMC Geriatr. 2018;18:79. doi:10.1186/s12877-018-0768-5
141. Roberts HC, Denison HJ, Martin HJ, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardized approach. Implementation of grip strength measurement in medicine for older people wards as part of routine. Age Ageing. 2011;40(4):423–429. doi:10.1093/ageing/afr051
142. Ho FKW, Celis-Morales CA, Petermann-Rocha F, et al. The association of grip strength with health outcomes does not differ if grip strength is used in absolute or relative terms: a prospective cohort study. Age Ageing. In press.
143. Bahat G, Tufan A, Ozkaya H, et al. Relation between hand grip strength, respiratory muscle strength and spirometricmeasures in male nursing home residents. Aging Male. 2014;17(3):136–140. doi:10.3109/13685538.2014.936001
© 2019 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.
By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.