Handgrip Strength and the Perceived Risk of Institutionalization, Hospitalization and Death

Abstract

Background: Handgrip strength assessment is a simple, quick and lowcost measure, and the presence of low values is predictive of adverse health outcomes such as institutionalization, hospitalization, and death. Weakness and frailty are two intrinsically linked concepts. The need to identify the older adults at risk, living in the community, has led to the development of multidimensional instruments for use in primary health care. The identification of predictors of adverse events is an added value for the referral, development, and planning of appropriate and prompt interventions. Aim: This study aimed to 1) explore the associations between the HGS and the different variables studied and 2) verify whether the HGS assessment is sufficiently robust to be systematically and routinely used in PHC to identify older people potentially at risk of adverse events over one year. Methods: 71 men and 103 women aged ≥65 years, community residents and primary health care users, were assessed on different anthropometric parameters, muscle strength and performance, and the perceived risk of institutionalization, hospitalization, and death at one year using the Community Risk Assessment Instrument. T-Test and Spearman correlation were used to identify the relations between variables. To identify the relationship between HGS and the presence or absence of concerns and the perceived risk of institutionalization, hospitalization, and death, an age-adjusted analysis of variance was performed. Results: Handgrip strength shows significant negative correlations with age, number of diseases, and muscle performance assessed by TUG for both genders. It presents a significant association with problems in Mental State for women (p=0.004), Medical State for men (p=0.025), and ADLs for both genders (Men p=0.001; Women p=0.037). General practitioner perceived risk shows a significant association with the risk of institutionalization (p=0.001) and hospitalization (p=0.004) in women. Conclusions: The associations found, lead us to suggest the use of handgrip strength measurement as a routine assessment in primary health care services, for preventively identifying people at risk of adverse events. Those assessed as 'weak', taking into account the HGS value, would be targeted for a more in-depth assessment and then referred to interventions designed to respond to the identified problems.