Handgrip Strength Asymmetry and Weakness Together Are Associated With Functional Disability in Aging Americans

Abstract

Background Evaluating handgrip strength (HGS) asymmetry may help to improve the prognostic value of HGS. This study sought to determine the associations of HGS asymmetry and weakness on future activities of daily living (ADL) disability in a national sample of aging Americans. Methods The analytic sample included 18,468 Americans aged ≥50 years from the 2006–2016 waves of the Health and Retirement Study. A handgrip dynamometer measured HGS. Those with HGS >10% stronger on either hand were considered as having any HGS asymmetry. Individuals with HGS >10% stronger on their dominant hand were considered as having dominant HGS asymmetry, while those with HGS >10% stronger on their nondominant hand were classified as having nondominant HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered weak. ADLs were self-reported. Generalized estimating equations were used for analyses. Results Relative to those with symmetric HGS and no weakness, each HGS asymmetry and weakness group had increased odds for future ADL disability: 1.11 (95% confidence interval [CI]: 1.02–1.20) for any HGS asymmetry alone, 1.42 (CI: 1.16–1.74) for weakness alone, and 1.81 (CI: 1.52–2.16) for both any HGS asymmetry and weakness. Most weakness and HGS asymmetry dominance groups had increased odds for future ADL disability: 1.30 (CI: 1.13–1.50) for nondominant HGS asymmetry alone, 1.42 (CI: 1.16–1.74) for weakness alone, 1.72 (CI: 1.29–2.29) for both weakness and nondominant HGS asymmetry, and 1.86 (CI: 1.52–2.28) for both weakness and dominant HGS asymmetry. Conclusions HGS asymmetry and weakness together may increase the predictive utility of handgrip dynamometers.

Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study

“…Performing this simple test may help physicians assess both the mental health and physical status of elderly patients. The findings of this study are consistent with previous studies reporting that HGS asymmetry and weakness together are jointly associated with adverse health conditions in older populations [ 19 – 21 ]. Our results suggest that HGS asymmetry has potential as a new indicator of HGS in the elderly, although subsequent studies are needed to confirm its usefulness in clinical settings.…”

“…McGrath et al [ 19 ] found that HGS asymmetry was associated with functional limitations in older Americans in their cross-sectional study. Therefore, asymmetric HGS may represent an asymmetry in motor function, which leads to physical imbalance and functional limitations.…”

“…The cut-off value of low HGS followed the criteria recommended by the Asian Working Group of Sarcopenia [ 6 ]. It has been assumed that the grip strength of the dominant hand is approximately 10% greater than that of the non-dominant hand, which is referred to as the “10% rule” [ 19 – 21 , 25 ]. Therefore, symmetric HGS was defined as a calculated HGS ratio between 0.9 and 1.1; otherwise, HGS was defined as asymmetric.…”

“…However, Yu et al [ 18 ] suggested that the degree, not direction, of HGS asymmetry was related to depression in the elderly. Moreover, several studies have found that HGS asymmetry and weakness were jointly associated with functional impairment or lower cognitive function in the elderly [ 19 – 21 ]. To the best of our knowledge, no report has considered the effect of low HGS together with HGS asymmetry on depression in the Korean population.…”

Examining Additional Aspects of Muscle Function with a Digital Handgrip Dynamometer and Accelerometer in Older Adults: A Pilot Study

“…Incorporating other aspects of muscle function in HGS protocols such as digit grip strength, submaximal force control, fatigability, neuromuscular steadiness, and asymmetry will expand how muscle function is assessed, while also maintaining procedural ease and scalability. For example, HGS asymmetry and low maximal HGS together were associated with greater odds for functional disability than each measure alone [ 13 ], and HGS asymmetry is linked to early all-cause mortality [ 14 ]. As such, evaluating other aspects of muscle function outside of maximal strength may uncover deficits in muscle function that are not otherwise identified by maximal HGS.…”