Hand-grip strength cut points to screen older persons at risk for mobility limitation

Abstract

Objectives: To determine optimal hand-grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI).

Design: Cross-sectional analysis of data.

Setting: Data collected in the Finnish population-based Health 2000 Survey.

Participants: One thousand eighty-four men and 1,562 women aged 55 and older with complete data on anthropometry, hand-grip strength and self-reported mobility.

Measurements: Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand-grip strength cut points for likelihood of mobility limitation.

Results: The overall hand-grip strength cut points for likelihood of mobility limitation were 37 kg (sensitivity 62%; specificity 76%) for men and 21 kg (sensitivity 67%; specificity 73%) for women. The effect of the interaction between hand-grip strength and BMI on mobility limitation was significant in men (P=.02), but no such interaction was observed in women (P=.16). In men, the most-optimal cutoff points were 33 kg (sensitivity 73%; specificity 79%) for normal-weight men, 39 kg (sensitivity 67%; specificity 71%) for overweight men, and 40 kg (sensitivity 57%; specificity 68%) for obese men. In women, BMI-specific hand-grip strength cutoff values was not markedly more accurate than the overall cutoff value.

Conclusion: The hand-grip strength test is a useful tool to identify persons at risk of mobility limitation. In men, hand-grip strength cut points for mobility increased with BMI, whereas in women, only one hand-grip strength threshold was identified.

© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Figures

Figure 1

Receiver Operating Characteristics (ROC) curves for identifying mobility limitation according to different cut-points for hand-grip strength (kg) in men. Area under the curve (AUC) is indicated in the figure. The AUC is significantly different from 0.5, p

Figure 2

Receiver Operating Characteristics (ROC) curves for identifying mobility limitation according to different cut-points for hand-grip strength (kg) in women. Area under the curve (AUC) is indicated in the figure. The AUC is significantly different from 0.5, p