Handgrip strength asymmetry is associated with future falls in older Americans

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ORIGINAL ARTICLE

Handgrip strength asymmetry is associated with future falls in older Americans Ryan McGrath1 · Brian C. Clark2,3,4 · Matteo Cesari5,6 · Carol Johnson7 · Donald A. Jurivich7,8 Received: 3 September 2020 / Accepted: 9 November 2020 © Springer Nature Switzerland AG 2020

Abstract Background  Examining handgrip strength (HGS) asymmetry could extend the utility of handgrip dynamometers for screening future falls. Aims  We sought to determine the associations of HGS asymmetry on future falls in older Americans. Methods  The analytic sample included 10,446 adults aged at least 65 years from the 2006–2016 waves of the Health and Retirement Study. Falls were self-reported. A handgrip dynamometer measured HGS. The highest HGS on each hand was used for determining HGS asymmetry ratio: (non-dominant HGS/dominant HGS). Those with HGS asymmetry ratio  30.0%. Generalized estimating equations were used for the analyses. Results  Every 0.10 increase in HGS asymmetry ratio was associated with 1.26 (95% confidence interval (CI) 1.07–1.48) greater odds for future falls. Relative to those with HGS asymmetry 0.0-10.0%, participants with HGS asymmetry > 30.0% had 1.15 (CI 1.01–1.33) greater odds for future falls; however, the associations were not significant for those with HGS asymmetry 10.1–20.0% (odds ratio: 1.06; CI 0.98–1.14) and 20.1–30.0% (odds ratio: 1.10; CI 0.99–1.22). Compared to those with HGS asymmetry 0.0–10.0%, participants with HGS asymmetry > 10.0% and > 20.0% had 1.07 (CI 1.01–1.16) and 1.12 (CI 1.02–1.22) greater odds for future falls, respectively. Discussion  Asymmetric HGS, as a possible biomarker of impaired neuromuscular function, may help predict falls. Conclusions  We recommend that HGS asymmetry be considered in HGS protocols and fall risk assessments. Keywords  Aging · Functional laterality · Geriatrics · Geriatric assessment · Muscle strength dynamometer

Introduction

Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s4052​0-020-01757​-z) contains supplementary material, which is available to authorized users.

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Department of Geriatric Medicine, Ohio University, Athens, OH, USA

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Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milano, Italy

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Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA

Department of Clinical Sciences and Community Health, Università di Milano, Milano, Italy

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Department of Biomedical Sciences, Ohio University, Athens, OH, USA

Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA

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Sanford Health, Fargo, ND, USA

* Ryan McGrath [email protected] 1



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Falls are a leading cause of injury and disability in older adults [1]. Poor muscle strength is a risk factor for several age-related adverse health outcomes including falls [2]. Handgrip strength (HGS) is a convenient and reliable assessment of muscle strength that is largely driven

Department of Health, Nutrition, and Exercise Sciences, North Dakota State University,