Prognostic value of physical function tests: hand grip strength and six-minute walking test in elderly hospitalized patients

Abstract

To discern if physical function test are better mortality predictors than muscle mass in elderly hospitalized patients, we analyzed the prognostic value of muscle mass malnutrition and compared it with physical muscle function tests, including the six-minute walking test (6MWT) and hand grip strength. We included the ankle brachial index (ABI) to assess arterial disease, related to muscle atrophy due to hypoperfusion. We also analyzed the relationship of ABI with malnutrition, physical function tests and survival. We studied 310 hospitalized patients older than 60 years. To assess nutritional status, we determined BMI, triceps skinfold and mid-arm muscle area; we performed a subjective nutritional assessment; and evaluated the degree of inflammatory stress. We assessed physical function by hand grip strength and 6MWT. We evaluated arterial disease by ABI. Forty-one patients died during hospitalization; 269 were discharged and followed for a mean 808 days, reaching a mortality of 49%. Muscle malnutrition was frequent and was related to mortality, but the best predictors were physical function tests: inability to perform the 6MWT and low handgrip strength. Function tests were closely related to each other and correlated with nutritional data. Reduced ABI was related to impaired nutritional status, physical function tests and mortality.

The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study

“…[9][10][11][12][13] Our finding of similar associations between grip strength and all-cause mortality across age groups is in line with the few previous reports which have been able to stratify analyses by age. 14-16 19 22 23 Our finding of an equally strong inverse association between grip strength and all-cause mortality in men and women is also consistent with findings in other studies.…”

“…9 Since the publication of this review, subsequent studies have continued to find that weaker grip strength is associated with increased all-cause mortality rates in a range of settings. [10][11][12][13] Most studies of grip strength in middle and old age have investigated associations with all-cause mortality, and studies that have examined causespecific mortality are not as numerous. [14][15][16][17][18][19] Furthermore, often such studies are only powered to investigate broad groups of causes of death such as cardiovascular disease (CVD) and cancer, and have not been able to look at additional causes such as ischaemic heart disease (IHD), respiratory diseases and external causes.…”

Prognostic value of physical function tests and muscle mass in elderly hospitalized patients. A prospective observational study

“…Life expectancy has increased in the past decades, and patients admitted to general medical wards are older and have greater comorbidity. Malnutrition with muscle loss, impaired physical function, disability and a high mortality rate are frequent among elderly patients . Consequently, two concepts have emerged: sarcopenia and frailty.…”

Hand Grip Strength in Pregnant and Non-Pregnant Females

“…A better performance on the HGS is associated with high functional index of nutritional status (9,10), reduced risk of a series of ill health outcomes (6)(7)(8)11) and decreased functional limitations (3)(4)(5)12), disability (13,14), and morbidity and mortality rates especially among older populations (15,16).…”

“…Hand Grip Strength (HGS) is reported as an indicator of the total body strength (1, 2), an objective test for physical capability (3), and a valid predictor of work capacity (4,5), degree of disease/injury, and rehabilitation outcomes (6)(7)(8). A better performance on the HGS is associated with high functional index of nutritional status (9,10), reduced risk of a series of ill health outcomes (6)(7)(8)11) and decreased functional limitations (3)(4)(5)12), disability (13,14), and morbidity and mortality rates especially among older populations (15,16).…”