Predictors Of Handgrip Strength And Its Relationship To Physical Performance In Older Irish Adults

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Background Handgrip strength declines with age and predicts poor physical performance and increased risk of falls and mortality. However, the strength of the relationship between handgrip strength and other physical measures is less well studied. We aimed to explore the predictors of handgrip strength in older Irish adults and its relationship to the Timed and Up and Go (TUG). Methods Study participants were from a longitudinal cohort of Irish adults aged >60 years; Trinity Ulster University Department of Agriculture (TUDA) study. Participants on current or long-term steroids, a history of stroke and with MMSE <24 were excluded. Handgrip strength was assessed with a dynamometer and defined as <27 kg for males and <16 kg for females. Abnormal performance in the TUG was defined as >12 seconds. Predictors of impaired handgrip were explored in multivariate logistic regression. Results There were 748 participants (68.9% female, mean age 70.2 years), of whom 33.4% had abnormal handgrip strength, which was more common in female’s vs males (39.4 vs 20.2%, p<0.001). Both abnormal handgrip strength and TUG was present in 13.6%. Normal handgrip strength had a negative predictive value of 76.0% for ruling out poor TUG, while abnormal handgrip had a positive predictive value of 62% for poor TUG. Predictors of impaired handgrip strength were older age (P<0.0001), female sex (p<0.0001), lower protein intake (P=0.024) and higher waist hip ratio (p=0.014). Conclusion Handgrip strength had a modest correlation with TUG A significant proportion had abnormal TUG but normal handgrip. Changes in lower limb muscle strength (affecting TUG) precede muscle loss in the upper limb. Higher protein intake predicted greater grip strength and supports the recommendation to maintain adequate intakes to prevent sarcopenia. Greater waist hip ratio is associated with reduced lean muscle mass which may explain the negative relationship we identified with handgrip strength.