Handgrip strength weakness and asymmetry together are associated with cardiovascular outcomes in older outpatients: A prospective cohort study

Abstract

The evaluations of handgrip strength (HGS) weakness and asymmetry have implications for the comprehensive geriatric assessment. The aim of this study was to investigate the association of HGS weakness and asymmetry on cardiovascular outcomes in older outpatients.Methods: This was a prospective observational cohort study of 364 Geriatrics outpatients aged ≥60 years, in which all participants carried out HGS tests at baseline. Patients with HGS <28 kg for men and <18 kg for women were diagnosed as HGS weakness, and HGS ratio <0.90 or >1.10 were diagnosed as HGS asymmetry. Primary outcomes defined as the major adverse cardiovascular event and composite end-points were assessed during a 21month median follow-up.Results: Among 364 participants, 155 (42.6%) showed HGS weakness, and 160 (44.0%) showed HGS asymmetry. HGS weakness was associated with major adverse cardiovascular events (HR 2.76, 95% CI 1.22-6.27) and composite end-points (HR 2.84, 95% CI 1.40-5.77). However, no significant correlation between HGS asymmetry and cardiovascular outcomes was observed. Compared with the normal and symmetric HGS group, older adults with HGS weakness and asymmetry together had a higher risk of major adverse cardiovascular events (HR 5.23,) and composite end-points (HR 4.00, 95% CI 1.56-10.28).Conclusions: HGS weakness and asymmetry together might increase the risk of cardiovascular outcomes in older outpatients. HGS asymmetry offers complementary information to HGS weakness when making a comprehensive assessment of HGS.

Risk factors associated with weak and asymmetric handgrip strength in older Chinese adults

“…Moreover, in the current study, we found that 15.91% (Method A) and 20.65% (Method B) of individuals presented with comorbid forms of HGS weakness and HGS asymmetry, which differs slightly from previous studies. For example, a previous analysis that enrolled 330 community‐dwelling adults aged 55 and over reported that 12.1% of them exhibited weak and asymmetric HGS (K. K. Chen, Ho, & Chau, 2022), and another study that included 7395 older South Koreans reported a 10.22% incidence of this comorbid condition (Baek et al, 2022), while a study of 364 geriatrics outpatients aged ≥60 years reported the proportion was 21.43% (Lin et al, 2022). The slight differences between these results, apart from age, may be due to variations in factors such as the incidence of chronic disease incidence, geographical location, nutritional conditions, or lifestyle factors between the studies, together with the criteria used for determining HGS weakness and asymmetry.…”

“…Chen, Ho, & Chau, 2022). The presence of both HGS weakness and HGS asymmetry in older adults usually signifies more advanced muscle dysfunction relative to either of these conditions in isolation, exacerbating the risk of adverse health outcomes during aging (L. Klawitter, Vincent, et al, 2022;Lin et al, 2022;McGrath, Cawthon, et al, 2020;McGrath, Tomkinson, et al, 2020;McGrath, Vincent, et al, 2021). Therefore, it is important to pay close attention to instances of comorbid HGS weakness and HGS asymmetry in older populations.…”

“…Both weak HGS and asymmetric HGS alone have been reported to be associated with poor future health outcomes among older adults, including limitations in the specific activities of daily living (Mahoney et al, 2022), elevated risks of falls and fractures (Dowling et al, 2023; Go et al, 2021), all‐cause mortality (Li et al, 2018), and the incidence of neurological and psychiatric disorders (Z. Chen, Ho, & Chau, 2022). The presence of both HGS weakness and HGS asymmetry in older adults usually signifies more advanced muscle dysfunction relative to either of these conditions in isolation, exacerbating the risk of adverse health outcomes during aging (L. Klawitter, Vincent, et al, 2022; Lin et al, 2022; McGrath, Cawthon, et al, 2020; McGrath, Tomkinson, et al, 2020; McGrath, Vincent, et al, 2021). Therefore, it is important to pay close attention to instances of comorbid HGS weakness and HGS asymmetry in older populations.…”

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

“…Scientific physical activity has been shown to improve human health and muscle strength levels (36,39,40), but sedentary time has a range of adverse physiological effects on muscle strength independent of physical activity (41-43). Previous studies have confirmed that hypertension (44,45), hyperlipidemia (46)(47)(48) Smoking conditions are divided into three categories: never (smoked less than 100 cigarettes in life), former (smoked more than 100 cigarettes in life and smoke not at all now), now (smoked moth than 100 cigarettes in life and smoke some days or every day).…”

Low handgrip strength with or without asymmetry is associated with elevated all‐cause mortality risk in older Chinese males

“…Several studies have suggested that HGS asymmetry is a potent biomarker of impaired muscular function. 6,7 A widespread aging-related complication among adults throughout the world, 6,8,9 HGS has been linked to an increased incidence of geriatric hip fracture 10 and a variety of other negative health outcomes, including a range of psychiatric and neurological conditions, 9,11,12 chronic morbidity, 13,14 fall risk, 15,16 reduced ability to complete tasks required for basic self-care tasks, 6 and multi-morbidity. 17 Previous studies have sought to clarify how HGS asymmetry relates to all-cause mortality rates in older adults.…”