Normative values of muscle strength across ages in a ‘real world’ population: results from the longevity check‐up 7+ project

Abstract

Background Low muscle strength is a powerful predictor of negative health-related events and a key component of sarcopenia. The lack of normative values for muscle strength across ages hampers the practical appraisal of this parameter. The aim of the present study was to produce normative values for upper and lower extremity muscle strength across a wide spectrum of ages, in a large sample of community-dwellers recruited in the Longevity checkup (Lookup) 7+ project. Methods Lookup 7+ is an ongoing project that started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy with the aim of fostering the adoption of healthy lifestyles in the general population. Candidate participants are eligible for enrolment if they are 18+ years and provide written informed consent. Upper and lower extremity muscle strength is assessed by handgrip strength and five-repetition chair-stand [5 × sit-to-stand (STS)] tests, respectively. Cross-sectional centile and normative values for handgrip strength and 5 × STS tests from age 18 to 80+ years were generated for the two genders. Smoothed normative curves for the two tests were constructed for men and women using the lambda-mu-sigma method. Results From 1 June 2015 to 30 May 2019, 11 448 participants were enrolled. The mean age of participants was 55.6 years (standard deviation: 11.5 years; range: 18-98 years), and 6382 (56%) were women. Normative values for handgrip strength and the 5 × STS test, both absolute and normalized by body mass index, were obtained for men and women, stratified by age groups. Values of upper and lower extremity muscle strength across ages identified three periods in life: an increase to peak in young age and early adulthood (18-24 years), preservation through midlife (25-44 years), and a decline from midlife onwards (45+ years). Conclusions Our study established age-specific and gender-specific percentile reference values for handgrip strength and the 5 × STS test. The normative curves generated can be used to interpret the assessment of muscle strength in everyday practice for the early detection of individuals with or at risk of sarcopenia.

Grip strength performance from 9431 participants of the GenoFit study: normative data and associated factors

“…While many studies have examined grip performance within older European populations, there remains a paucity of grip strength data across the lifespan. To date, only two studies have provided primary data, in Swiss [ 32 ] and Italian [ 5 ] populations, while two recent pooled analysis studies have also provided life course data for British [ 29 ] and German [ 6 ] populations. When our results from each stage of adulthood (early = 18–39 years, middle = 40–59 years and late ≥ 60 years) were compared with those from other studies, our findings were either slightly lower (~ 6%) [ 6 , 32 ], slightly higher (~ 6%) [ 29 ], or notably higher (~ 14%) [ 5 ] than those of previous reports.…”

“…To date, only two studies have provided primary data, in Swiss [ 32 ] and Italian [ 5 ] populations, while two recent pooled analysis studies have also provided life course data for British [ 29 ] and German [ 6 ] populations. When our results from each stage of adulthood (early = 18–39 years, middle = 40–59 years and late ≥ 60 years) were compared with those from other studies, our findings were either slightly lower (~ 6%) [ 6 , 32 ], slightly higher (~ 6%) [ 29 ], or notably higher (~ 14%) [ 5 ] than those of previous reports. Importantly, however, small sample sizes [ 32 ] and heterogeneous gender distributions, sample sizes and grip strength determination protocols [ 29 ] limit the quality of data in some cases and make direct comparisons difficult.…”

“…In particular, low muscle strength has been identified as an independent risk factor for all-cause mortality, irrespective of muscle mass [ 3 , 4 ]. While broadly stable during early adulthood (20–39 years), a progressive decline in muscle strength commences as early as at ~ 45 years of age and accelerates in later life [ 5 , 6 ]. Such rapid deterioration, coupled with the plethora of unfavourable correlates of low muscle strength [ 3 , 4 , 7 – 9 ], emphasises the importance of timely diagnostic and therapeutic protocols.…”

Association between vitamin D status and physical performance in COVID-19 survivors: Results from the Gemelli against COVID-19 post-acute care project

“…Upper extremity muscle strength was measured by handgrip strength testing using a North Coast hand-held hydraulic dynamometer (North Coast Medical, Inc, Morgan Hill, CA) ( Landi et al, 2020 ). The participant was seated on a chair with shoulder in a neutral position, the elbow near the trunk and flexed at 90°, and the wrist in a neutral position (thumbs up) ( Landi et al, 2020 ). After one familiarization trial, muscle strength was measured in both hands and the higher value (kg) was used for the analysis.…”

Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery

“…For example, this is the case of the Mini-Mental State Examination (MMSE) [ 22 ] or the Geriatric Depression Scale (GDS) [ 23 , 24 ]. In contrast, the functional performance has been detected by using the Handgrip strength test [ 25 , 26 ]: handgrip measurement is assessed on the dominant hand using a Jamar dynamometer adhering to the standardized protocol recommended by the American Society of Hand Therapists and the average value of the handgrip in the two genders is used to define the scores. Thus, a lower score than 30 kg for man and lower than 20 kg for women is considered weak [ 27 ].…”