Physical functioning

Grip strength


In LASA161 (Anthropometry)

Contact: Marjolein Visser

Background
Grip strength is a measure for upper body functionality. Grip strength is known to be positively correlated with lower-extremity strength in older persons, with reported correlation coefficients between 0.47 and 0.51.1-2 Moreover, grip strength is a reliable (coefficient of variation 3-6% in older persons)  3-4 and portable muscle strength test that is very applicable in large epidemiological studies and in clinical practice. Low grip strength is a strong determinant of functional limitations later in life  5, mobility
disability 6
, poor functional performance  7, and premature death.8-9

Measurement instruments in LASA
In LASA grip strength is measured each wave during the medical interview starting from wave C (LASAC161) using a grip strength dynamometer (Takei TKK 5001, Takei Scientific Instruments Co. Ltd., Tokyo, Japan). Measurements were made in duplicate for both hands. Respondents were asked to perform two maximum grip strength trials with each hand, in standing position with their arms along their body. Grip strength was recorded to the nearest 1 kg. Upward of wave 3B, grip strength was measured using a JAMAR 5030J1 Hydraulic Hand Dynamometer. Respondents were instructed to perform two maximum grip strength trials with each hand, in seated position with the back straight and elbow bended in a 90° angle. Both dynamometers were adjusted for hand size.

Questionnaires
LASAC161 / LASAD161 / LASAE161 / LAS2B161 / LASAF161 / LASAG161 / LASAH161 / LAS3B161 / LASMB161 (in preparation) / LASAI161 (part of Anthropology in medical interview, in Dutch)

Variable information
LASAC161 / LASAD161 / LASAE161 / LAS2B161 / LASAF161 / LASAG161 / LASAH161 / LAS3B161 / LASMB161 (in preparation) / LASAI161
(pdf)

Availability of information per wave 1

 

B

C

D

E

 
2B*

F

G

H

 

3B*

 MB*

I

Grip Strength (hand)

 Me

Me 

Me

Me

Me 

Me 

Me 

Me 

Me**

Me 

 1 More information about the LASA data collection waves is available here.

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort (Under Construction)

** Only right hand measurement was done

Me=data collected in medical interview

Previous use in LASA
No standardized way of using grip strength data is available from the literature. Within LASA the data have been used in different ways:

  • The maximum strength out of two attempts of the dominant hand; 7
  • The sum of the mean strength of the left and right hand;  10
  • The average of the highest score of the left and right hand. 11

Schaap et al. showed that (including data from the Health Aging and Body Composition (Health ABC) Study, low levels of total testosterone and free testosterone were neither associated with 3-year decline in physical performance nor with 3-year decline in muscle strength  12. They also showed that higher levels of IL-6 and CRP (inflammatory markers) increase the risk of grip strength loss, whereas higher levels of ACT decrease the risk of muscle strength loss in older men and women  11, and that low levels of sex hormones were associated with impaired mobility and low muscle strength in men, but not in women  13. Furrer et al.  14 concluded that in men, higher handgrip strength and physical performance are related to higher bone quality and reduced fracture risk, whereas in women, a moderate to high level of physical activity is associated with reduced fracture risk. Research of Gardner et al.  15 showed that there was little evidence of associations between a larger diurnal drop and balance or grip strength. Swart et al. 16 suggested that in men, higher homocysteine levels were associated with lower grip strength.

 

References

  1. Avlund K, Schroll M, Davidsen M, Løvborg B, Rantanen T. Maximal isometric muscle strength and functional ability in daily activities among 75-year-old men and women. Scand J Med Sci Sports 1994;4:32-40.
  2. Viitasalo JT, Era P, Leskinen AL, Heikkinen E. Muscular strength profiles and anthropometry in random samples of men aged 31-35, 51-55 and 71-75 years. Ergonomics 1985;28:1563-74.
  3. Greig CA, Young A, Skelton DA, Pippet E, Butler FM, Mahmud SM. Exercise studies with elderly volunteers. Age Ageing 1994;23(3):185-9.
  4. Kallman DA, Plato CC, Tobin JD. The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. J Gerontol 1990;45(3):M82-8.
  5. Rantanen T, Guralnik JM, Foley D, Masaki K, Leveille S, Curb JD, White L. Midlife hand grip strength as a predictor of old age disability. JAMA 1999;281(6):558-60.
  6. Marsh AP, Rejeski WJ, Espeland MA, Miller ME, Church TS, Fielding RA, Gill TM, Guralnik JM, Newman AB, Pahor M, et al. Muscle strength and BMI as predictors of major mobility disability in the Lifestyle Interventions and Independence for Elders pilot (LIFE-P). J Gerontol A Biol Sci Med Sci 2011;66(12):1376-83.
  7. Visser M, Deeg DJ, Lips P, Harris TB, Bouter LM. Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women. J Am Geriatr Soc 2000;48(4):381-6.
  8. Legrand D, Vaes B, Mathei C, Adriaensen W, Van Pottelbergh G, Degryse JM. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. J Am Geriatr Soc 2014;62(6):1030-8.
  9. Cooper R, Kuh D, Hardy R, Mortality Review G, Falcon, Teams HAS. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 2010;341:c4467.
  10. Tromp E. Risk assessment of falls and fractures in the elderly. Thesis, 2000.
  11. Schaap LA, Pluijm SM, Deeg DJ, Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med 2006;119(6):526 e9-17.
  12. Schaap LA, Pluijm SM, Deeg DJ, Penninx BW, Nicklas BJ, Lips P, Harris TB, Newman AB, Kritchevsky SB, Cauley JA, et al. Low testosterone levels and decline in physical performance and muscle strength in older men: findings from two prospective cohort studies. Clin Endocrinol (Oxf) 2008;68(1):42-50.
  13. Schaap LA, Pluijm SM, Smit JH, van Schoor NM, Visser M, Gooren LJ, Lips P. The association of sex hormone levels with poor mobility, low muscle strength and incidence of falls among older men and women. Clin Endocrinol (Oxf) 2005;63(2):152-60.

  14. Furrer R, van Schoor NM, de Haan A, Lips P, de Jongh RT. Gender-specific associations between physical functioning, bone quality, and fracture risk in older people. Calcif Tissue Int 2014;94(5):522-30.
  15. Gardner MP, Lightman S, Sayer AA, Cooper C, Cooper R, Deeg D, Ebrahim S, Gallacher J, Kivimaki M, Kumari M, et al. Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages: an individual participant meta-analysis. Psychoneuroendocrinology 2013;38(1):40-9.

  16. Swart KM, van Schoor NM, Heymans MW, Schaap LA, den Heijer M, Lips P. Elevated homocysteine levels are associated with low muscle strength and functional limitations in older persons. J Nutr Health Aging 2013;17(6):578-84.