A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness

Clin Nutr. 2024 Oct;43(10):2381-2387. doi: 10.1016/j.clnu.2024.09.010. Epub 2024 Sep 6.

Abstract

Objectives: Handgrip strength (HGS) is accepted as a predictor of overall health status and a biomarker of aging, besides negative health outcomes and mortality. While differences in HGS between the dominant and non-dominant hands are expected, substantial discrepancies may signal impaired muscle function. This study aims to investigate whether handgrip asymmetry can serve as a reliable indicator of frailty in a diverse population of older adults.

Design: Cross-sectional study.

Setting and participants: A total of 512 patients aged 65 years and older who were admitted to the geriatric medicine outpatient clinic of a university hospital were enrolled in the study.

Methods: The Clinical Frailty Scale (CFS) was used to assess the overall level of frailty of the study population. The highest recorded HGS values from the non-dominant and dominant hand were used to calculate the HGS ratio. Those with a HGS ratio of dominant and non-dominant hand <0.90 or >1.10 were defined as HGS asymmetry.

Results: Of the whole study group, 61.1% was female and the mean age was 73.2 ± 6.1 years. The ratio of the participants living with frailty was 57.6% (n = 219). The number of patients with HGS asymmetry was 264 (51.6%), and 48.4% (n = 248) of the study population had symmetric HGS. The normal and symmetric HGS was found in 40.2% of the non-frail group, whereas it was 23.7% in patients living with frailty. Furthermore, the ratio of low and asymmetric HGS was 16.3% in the non-frail group, and 35.0% in the patients living with frailty (p < 0.001). The presence of asymmetric and low HGS increased the risk of frailty three times independently of other confounding factors (OR:3.08; 95% CI:1.48-6.43; p = 0.003).

Conclusions and implications: Identifying HGS asymmetry along with low HGS as potential indicators of frailty may provide clinicians with a clear and quantifiable criterion for assessing older patients.

Keywords: Frailty; Handgrip asymmetry; Handgrip strength; Older adults.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Frail Elderly* / statistics & numerical data
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Frailty* / physiopathology
  • Geriatric Assessment* / methods
  • Geriatric Assessment* / statistics & numerical data
  • Hand / physiopathology
  • Hand Strength* / physiology
  • Humans
  • Male
  • Muscle Weakness* / physiopathology
  • Outpatients / statistics & numerical data
  • Risk Factors