Relationship Between Handgrip Strength and Framingham Risk Score in Older Adults in Bushehr, South Iran

Q: What are the key findings of this study?

Handgrip strength was not significantly associated with Framingham Risk Score after multivariable adjustment (total HGS adjusted β = -0.004, p = 0.785; relative HGS adjusted β = 0.185, p = 0.674).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease risk in older adults (n=2426). Intervention: Handgrip strength (total, relative, dominant, and nondominant). Primary outcome: Framingham Risk Score (FRS) (Adjusted β -0.004 (total HGS); Adjusted β 0.185 (relative HGS), 95% CI -0.381 to 0.288, p=0.785).

Q: What does this research mean for the field?

Handgrip strength is not independently associated with Framingham Risk Score in older adults after adjusting for demographic and clinical cardiovascular risk factors. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Anahita Ghasemi; Morteza Azari; Maryam Marzban; Mohammadreza Kalantarhormozi; Sadegh Darvishi

doi:10.1155/jare/7101568

January 1, 2026Journal of Aging ResearchOpen Access

Relationship Between Handgrip Strength and Framingham Risk Score in Older Adults in Bushehr, South Iran

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Key result

Handgrip strength is not associated with Framingham Risk Score after multivariable adjustment.

Adjusted β -0.004 (total HGS); Adjusted β 0.185 (relative HGS)
95% CI -0.381 to 0.288
P=0.785
n=2,426

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Why the study?

Previous studies showed that handgrip strength (HGS) predicts cardiovascular disease-related death, motivating an evaluation of the relationship between HGS and the Framingham Risk Score in older adults in Bushehr.

Is handgrip strength associated with 10-year cardiovascular disease risk as estimated by the Framingham Risk Score in community-dwelling older adults?

Key Points

To evaluate the relationship between different measures of handgrip strength and the Framingham Risk Score in older adults residing in Bushehr, Iran.
Analyzed 2426 participants aged ≥ 60 years who completed Phase II of the Bushehr Elderly Health Program after initial cluster sampling of 3000 individuals.
Measured total, relative, dominant, and nondominant handgrip strength using a DHD-1 dynamometer device.
Assessed cardiovascular disease risk using Framingham Risk Score categories (low, medium, high) and evaluated associations via unadjusted and adjusted linear regression models.
Mean hand strength differed across Framingham Risk Score groups, increasing from 17.21 ± 5.22 in low-risk to 18.33 ± 7.66 in medium-risk and 24.70 ± 9.45 in high-risk individuals (p < 0.001).
After adjusting for age, sex, BMI, lipid profile, blood pressure, and fasting blood sugar, associations lost statistical significance for total strength (β = −0.004, 95% CI −0.381 to 0.288, p = 0.785) and relative strength (β = 0.185, 95% CI −0.678 to 1.050, p = 0.674).

Study Design

Type

Cohort (n=2,426)

Multicenter

No

Structured PICO

Is handgrip strength associated with 10-year cardiovascular disease risk as estimated by the Framingham Risk Score in community-dwelling older adults?

P

Population

2,426 community-dwelling older adults (aged ≥60 years, 51.5% female, mean age 69.34 years in the baseline cohort of 3,000) in Bushehr, Iran, free of stroke, vascular, or neuromuscular disorders, evaluated in Phase II of the Bushehr Elderly Health Program.

E

Exposure

Handgrip strength (HGS) measurement (total/absolute, relative [sum of dominant and nondominant HGS divided by BMI], dominant, and nondominant) assessed using a calibrated DHD-1 dynamometer.

O

Outcome

Framingham Risk Score (FRS), analyzed as a continuous total score and categorized into low risk (<10%), medium risk (10%–20%), and high risk (>20%) 10-year cardiovascular disease risk.surrogate

Main Result

Effect estimate: Adjusted β -0.004 (total HGS); Adjusted β 0.185 (relative HGS) (95% CI -0.381 to 0.288)

p-value: p=0.785

In older Iranian adults, handgrip strength (whether total, relative, dominant, or nondominant) is not independently associated with the Framingham Risk Score after adjusting for conventional demographic and clinical risk factors.

Limitations

Did not evaluate the diagnostic accuracy of each HGS measure to identify which is clinically more accurate.
Population diversity (age heterogeneity, sex distribution, educational level, income status, and psychological status) was not fully accounted for in subgroup analyses.
Did not report detailed diagnostic measures such as variance inflation factors, limiting full assessment of multicollinearity.
Adjusted associations for variables also included in the FRS calculation, which reduces the ability to detect independent associations.
High proportion of participants in the high-risk group may have caused a ceiling effect for FRS, hindering its ability to detect associations with HGS.
Did not evaluate the diagnostic accuracy of each HGS measure to identify which is clinically more accurate
Considerable diversity in the study population (age heterogeneity, sex distribution, educational level, income status, and psychological status) was not included in subgroup analyses
Did not report detailed diagnostic measures such as variance inflation factors, limiting full assessment of multicollinearity
Adjusted associations for variables also included in the FRS, reducing the ability to detect independent associations
High proportion of participants in the high-risk group may have caused a ceiling effect for FRS, hindering its ability to detect associations with HGS

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Answers are grounded in this paper and cite their sources.

Implication

Handgrip strength adds no independent value beyond conventional factors in older adults; leaves open its utility for other outcomes or populations.

Abstract

Background Handgrip strength (HGS) indicates neuromuscular function, important in the elderly. Previous studies showed that HGS can be used as a predictor of cardiovascular disease (CVD)–related death. This study aimed to identify the relationship between HGS and the Framingham Risk Score (FRS) in the elderly referring to Bushehr Hospital in 2019. Methods In the Bushehr Elderly Health (BEH) Program, 3000 individuals aged ≥ 60 years who had lived in Bushehr for at least 1 year, had no plans to relocate within the following 2 years, and had stable physical and mental conditions were selected using a cluster sampling method. Of these, 2426 participants completed the second phase of the study. Demographics and FRS‐related information were recorded; CVD risk was assessed as low, medium, or high based on this score. Total, relative, dominant, and nondominant HGSs were measured using a DHD‐1 dynamometer device. Association of HGS with FRS was evaluated by regression analysis, performed with STATA MP 15. Results Of 2426 participants, 48.5% were men; majority were at high risk for CVD. Mean HGS differed significantly across the groups. It increased from low (17.21 ± 5.22) to medium (18.33 ± 7.66) and high (24.70 ± 9.45, p < 0.001). Unadjusted analysis showed a weak positive association for mean HGS, dominant HGS, and nondominant HGS ( β ≈ 0.3). Relative HGS was strongly associated with FRS ( β = 8.6). After adjustment, all HGS types lost their significance. Conclusions HGS and FRS were not associated in adjusted analysis of this study. This indicates a stronger role for demographic and clinical variables rather than absolute, relative, dominant, or nondominant HGS. Given the limitations of this study, further research is required before drawing definitive conclusions.

Discussion

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Cite This Study

Ghasemi et al. (2026) conducted a cohort in Cardiovascular disease risk in older adults (n=2,426). Handgrip strength (total, relative, dominant, and nondominant) was evaluated on Framingham Risk Score (FRS) (Adjusted β -0.004 (total HGS); Adjusted β 0.185 (relative HGS), 95% CI -0.381 to 0.288, p=0.785). Handgrip strength was not significantly associated with Framingham Risk Score after multivariable adjustment (total HGS adjusted β = -0.004, p = 0.785; relative HGS adjusted β = 0.185, p = 0.674).

synapsesocial.com/papers/6af46da27bb3da179b8501fe https://doi.org/10.1155/jare/7101568

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Relationship Between Handgrip Strength and Framingham Risk Score in Older Adults in Bushehr, South Iran

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Relationship Between Handgrip Strength and Framingham Risk Score in Older Adults in Bushehr, South Iran

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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