Use of hand grip strength in nutrition risk screening of older patients admitted to general surgical wards

Byrnes, Angela; Mudge, Alison; Young, Adrienne; Banks, Merrilyn; Bauer, Judy

doi:10.1111/1747-0080.12422

Cited by 18 publications

(19 citation statements)

References 50 publications

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“…However, there is debate regarding the relationship between HGS and nutritional status. Some studies have advocated for the added value of HGS in nutritional assessment [33,34], while others, including the current study, provide evidence that HGS may be of limited use as a predictor of nutritional status [35][36][37]. A recent study showed that HGS and knee extension strength (KES) have moderate-to-low agreement, indicating that HGS should not be used to represent overall muscle strength [38].…”

Section: Discussionmentioning

confidence: 81%

Malnutrition is associated with dynamic physical performance

et al. 2019

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Background Malnutrition and poor physical performance are both conditions that increase in prevalence with age; however, their interrelation in a clinically relevant population has not been thoroughly studied. Aims This study aimed to determine the strength of the association between malnutrition and measures of both static and dynamic physical performance in a cohort of geriatric outpatients. Methods This cross-sectional study included 286 older adults (mean age 81.8, SD 7.2 years, and 40.6% male) who were referred to geriatric outpatient mobility clinics. The presence of malnutrition was determined using the Short Nutritional Assessment Questionnaire (SNAQ, cutoff ≥ 2 points). Measures of dynamic physical performance included timed up and go (TUG), 4-m walk test, and chair stand test (CST). Static performance encompassed balance tests and hand grip strength (HGS). Physical performance was standardized into sex-specific Z-scores. The association between malnutrition and each individual measure of physical performance was assessed using linear regression analysis. Results 19.9% of the cohort was identified as malnourished. Malnutrition was most strongly associated with CST and gait speed; less strong but significant associations were found between malnutrition and TUG. There was no significant association between malnutrition and HGS or balance. Discussion Physical performance was associated with malnutrition, specifically, dynamic rather than static measures. This may reflect muscle power being more impacted by nutritional status than muscle strength; however, this needs to be further addressed. Conclusions Malnutrition is associated with dynamic physical performance in geriatric outpatients, which should inform diagnosis and treatment/prevention strategies.

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Section: Discussionmentioning

confidence: 81%

Malnutrition is associated with dynamic physical performance

et al. 2019

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“…Using established HGS cutpoints, sensitivity (SE) and specificity (SP) were inadequate when compared with the SGA (Giulani et al: SE = 0.42, SP = 0.73; Sallinen et al male: SE = 0.88, SP = 0.25; Sallinen et al female: SE = 0.86, SP = 0.21; Alley et al male: SE = 0.59, SP = 0.63; Alley et al female: SE = 0.70, SP = 0.46) . This is consistent with a recent attempt to determine the validity of HGS when compared with the criterion of patient‐generated SGA in surgical patients; HGS also did not enhance the discriminatory value of the Malnutrition Screening Tool …”

Section: Discussionmentioning

confidence: 99%

“…The participants used in these analyses did not have dementia or delirium. Prior work suggests that mental capacity is required for completion of HGS, and approximately 10% of surgical patients are unable to do HGS due to this reason . Other limitations include the potential for interrater differences within and between sites when assessing HGS and 5m; interrater reliability analyses were not conducted due to geographic restrictions.…”

Section: Discussionmentioning

confidence: 99%

Handgrip Strength, but Not 5‐Meter Walk, Adds Value to a Clinical Nutrition Assessment

et al. 2018

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Background: Decreased physical functioning is associated with malnutrition and common in acute care patients; determining loss of function is often considered part of a comprehensive nutrition assessment. Handgrip strength (HGS) and 5-meter timed walk (5m) are functional measures used in a variety of settings. This analysis sought to determine which functional measure could be added to a hospital nutrition assessment, based on its feasibility and capacity to discriminate patient subgroups. Methods: Eligible medical patients (no delirium/dementia, admitted from community; n = 1250), recruited from 5 hospitals that participated in a previous multisite action research study, provided data on demographics, HGS, 5m, nutrition status, perceived disability, and other characteristics. Results: Significantly more patients (z = 17.39, P < .00001) were able to complete HGS than 5m (92% versus 43%, respectively). Median HGS was 28.0 kg for men and 14.7 kg for women. Of patients who completed the 5m, mean completion time was 8.98 seconds (median, 6.79 seconds, SD = 6.59). 5m and HGS scores were significantly worse with patientperceived disability (z = −9.56, t = 10.69, respectively; P < .0001; 95% confidence interval [CI], [7.33, 10.63]; [1.76, 3.18]). HGS was associated with nutrition status (t = 4.13, P < .001; 95% CI [2.02, 5.67]), although it showed poor validity as a single nutrition indicator. Conclusions: These data indicate that HGS is a more useful functional measure than 5m when added to a hospital nutrition assessment. Determination of HGS cutpoints to identify low strength in acute care patients will promote its use. (Nutr Clin Pract.

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“…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.…”

Section: Grip Strength As a Biomarker Of Current Statusmentioning

confidence: 99%

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

Bohannon

2019

CIA

524

382

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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.

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Use of hand grip strength in nutrition risk screening of older patients admitted to general surgical wards

Cited by 18 publications

References 50 publications

Malnutrition is associated with dynamic physical performance

Malnutrition is associated with dynamic physical performance

Handgrip Strength, but Not 5‐Meter Walk, Adds Value to a Clinical Nutrition Assessment

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

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