Handgrip strength cutoff points to identify mobility limitation in community-dwelling older people and associated factors

被引:62
作者
de Souza Vasconcelos K.S. [1 ]
Domingues Dias J.M. [1 ]
de Carvalho Bastone A. [1 ]
Alvarenga Vieira R. [1 ]
de Souza Andrade A.C. [1 ]
Rodrigues Perracini M. [1 ]
Oliveira Guerra R. [1 ]
Corrêa Dias R. [1 ]
机构
[1] Physical Therapy, Universidade Federal de Minas Gerais, Rua Engenheiro Hermenegildo Campos de Almeida, 260, ap 31, Jundiaí — SP, Brasil, Jundiaí, 13208640, São Paulo
关键词
gait speed; handgrip strength; mobility; older people; Sarcopenia;
D O I
10.1007/s12603-015-0584-y
中图分类号
学科分类号
摘要
Background: Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass and strength. The specific threshold of muscle weakness that leads to mobility limitations has not been identified. Objectives: To determine the best cutoff point of handgrip strength for identifying mobility limitation and to investigate the factors associated with muscle weakness and mobility limitation in community-dwelling older people. Design: Transversal study. Setting: Cities of Belo Horizonte, Barueri and Santa Cruz in Brazil. Participants: 1374 community-dwelling older people from the Frailty study in Brazilian older people (FIBRA Study). Measurements: Outcomes included muscle weakness determined according to gender-specific handgrip strength cutoff points generated by Receiver Operating Characteristic curves, mobility limitation defined as a gait speed = 0.8 m/s; and a combination of both muscle weakness and mobility limitation. Associated factors included socio-demographic variables, lifestyle, anthropometrics, health conditions, use of health services and disability. Results: The cutoff points of handgrip strength with the best balancing between sensitivity and specificity for mobility limitation were 25.8 kgf for men (sensitivity 69%, specificity 73%) and 17.4 kgf (sensitivity 60%, specificity 66%) for women. Age and disability in instrumental activities of daily living were associated with all outcomes. Women had greater odds of mobility limitation than men. Physical inactivity, body fat, diabetes, depression, sleeping disturbances, number of medications and occurrence of falls remained as significant associated factors in the final model. Conclusions: Handgrip strength can be a useful tool to identify mobility limitation in clinical practice. Interventions to prevent or minimize impacts of sarcopenia should stimulate physical activity and improvement of body composition in addition to the management of chronic diseases and disabilities. © 2016, Serdi and Springer-Verlag France.
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页码:306 / 315
页数:9
相关论文
共 41 条
[21]  
Dong H., Marcusson E., Wressle E., Unosson M., Obese very old women have low relative handgrip strength, poor physical function, and difficulties in daily living, J Nutr Health Aging, 19, pp. 20-25, (2015)
[22]  
Zoico E., Di Francesco V., Guralnik J., Mazzali G., Bortoloni A., Guariento S., Sergi G., Bosello O., Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women, Int J Obes Int Relat Metab Dis, 28, pp. 234-241, (2004)
[23]  
Davison K., Ford E., Cosgwell M., Dietz W., Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III, J Am Geriatr Soc, 50, (2002)
[24]  
Lebrun C.E., van der Schouw Y.T., de Jong F.H., Grobbee D.E., Lamberts S.W., Fat mass rather than muscle strength is the major determinant of physical function and disability in postmenopausal women younger than 75 years of age, Menopause, 13, pp. 474-481, (2006)
[25]  
Woo J., Leung J., Kwok T., BMI, Body composition, and physical functioning in older adults, Obesity, 15, pp. 1886-1894, (2007)
[26]  
Rolland Y., Lawers-Cancers V., Cristini C., Kan G., Janssen I., Morley J., Vellas B., Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l’OSteoporose) Study, Am J Clin Nutr, 89, pp. 1895-1900, (2009)
[27]  
Sallinen J., Stenholm S., Rantanen T., Heliovaara M., Sainio P., Koskinen S., Handgrip strength cut points to screen older persons at risk for mobility limitation, J Am Geriatr Soc, 58, pp. 1721-1726, (2010)
[28]  
Alley D., Shardel M.D., Peters K., McLean R., Dam T., Kenny A., Fragala M., Harris T., Kiel D., Guralnik J.M., Ferrucci L., Kritchevsky S.B., Studenski S., Vassileva M., Cawthon P., Grip strength cutpoints for the identification of clinically relevant weakness, J Gerontology: Medical Sciences, 69, pp. 559-566, (2014)
[29]  
Hardy R., Cooper R., Sayer A., Ben-Shlomo Y., Cooper C., Deary I., Demakakos P., Gallacher J., Martin R., McNeill G., Starr J., Steptoe A., Sydall H., Kuh D., Body mass index, muscle strength and physical performance in older adults from eight cohort studies: The HALCyon Programme, PLOsOne, 8, (2013)
[30]  
Mascie-Taylor C.G.N., Goto R., Human variation and body mass index: a review of the universality of BMI cut-offs, gender and urban-rural differences and secular changes. J Physiol Anthropol, 26, pp. 109-112, (2007)