The Relationship Between Hand Grip Strength and Erectile Dysfunction

The association of frailty with postoperative delirium has not been fully investigated in patients undergoing cardiovascular surgery. Therefore, this study aimed to investigate whether preoperative hand grip strength is associated with postoperative delirium. This retrospective study included patients aged >65 years who had undergone elective cardiovascular surgery using cardiopulmonary bypass at a Japanese university hospital between April 2020 and February 2022. We defined low hand grip strength as hand grip values of <275 n and <177 n for men and women, respectively. Postoperative delirium was assessed using the confusion assessment method during patients’ intensive care unit stay. The odds ratio of low hand grip strength for postoperative delirium was estimated using multiple logistic analysis, which was adjusted for prominent clinical factors. Ninety-five patients with a median age of 74 years were included in the final analysis, and 31.5% of them had low hand grip strength. Postoperative delirium occurred in 37% of patients, and the odds ratio of low preoperative hand grip strength for postoperative delirium was 4.58 (95% confidence interval: 1.57–13.2). Thirty-seven patients experienced postoperative delirium after cardiovascular surgery using cardiopulmonary bypass, and low preoperative hand grip strength was positively associated with its occurrence.

Background and objectivesA correlation between low handgrip strength (HGS), HGS asymmetry, and low cognitive performance has been demonstrated. However, it remains unclear whether low HGS is associated with psychotic symptoms and whether HGS asymmetry is associated with cognitive and psychotic symptoms in hospitalized patients with schizophrenia. This study aimed to investigate the validity of HGS as a measure for assessing cognition and psychotic symptoms in hospitalized patients with stable schizophrenia.MethodsA total of 235 inpatients with stable schizophrenia were recruited between August 1, 2023, and August 31, 2023. The highest HGS values from three tests on the dominant hand were used to determine low HGS (male < 28 kg, female < 18 kg), and HGS asymmetry was identified when the non-dominant HGS/dominant HGS ratio was outside 0.9–1.1. Cognition and psychotic symptoms were assessed using the Chinese Montreal Cognitive Assessment (MoCA-C) and Positive and Negative Syndrome Scale (PANSS). Generalized linear model analyses examined the relationship between HGS and scale scores.ResultsCovariate-adjusted generalized linear models confirmed a strong association between low HGS alone and the MoCA-C score (OR = 0.819, 95% CI = 0.710‒0.945, p = 0.006) and PANSS score (OR = 1.113, 95% CI = 1.036‒1.239, p = 0.006). Similarly, the combination of low and asymmetric HGS was strongly associated with both MoCA-C (OR = 0.748, 95% CI = 0.653‒0.857, p<0.001) and PANSS scores (OR = 1.118, 95% CI = 1.032‒1.211, p = 0.006).ConclusionsThe results suggest that hospitalized patients with schizophrenia and low HGS, with or without asymmetry, are likely to have lower MoCA-C scores and higher PANSS scores. Screening stable schizophrenia patients with low HGS, with or without asymmetry, could be a valuable and straightforward approach to identifying those with lower cognition and severe psychotic symptoms.

BackgroundWidely adopted criteria suggest using either low handgrip strength or poor chair stand performance to identify probable sarcopenia. However, there are limited direct comparisons of these measures in relation to important clinical endpoints. We aimed to compare associations between these two measures of probable sarcopenia and all-cause mortality.MethodsAnalyses included 7838 community-dwelling participants (55% women) aged 40–84 years from the seventh survey of the Tromsø Study (2015–2016), with handgrip strength assessed using a Jamar + Digital Dynamometer and a five-repetition chair stand test (5-CST) also undertaken. We generated sex-specific T-scores and categorised these as “not low”, “low”, and “very low” handgrip strength or 5-CST performance. Cox Proportional Hazard regression models were used to investigate associations between these two categorised performance scores and time to death (up to November 2020 ascertained from the Norwegian Cause of Death registry), adjusted for potential confounders including lifestyle factors and specific diseases.ResultsA total of 233 deaths occurred (median follow-up 4.7 years) with 1- and 5-year mortality rates at 3.1 (95% confidence interval [CI] 2.1, 4.6) and 6.3 (95% CI 5.5, 7.2) per 1000 person-years, respectively. There was poor agreement between the handgrip strength and 5-CST categories for men (Cohen’s kappa [κ] = 0.19) or women (κ = 0.20). Fully adjusted models including handgrip strength and 5-CST performance mutually adjusted for each other, showed higher mortality rates among participants with low (hazard ratio [HR] 1.22, 95% CI 0.87, 1.71) and very low (HR 1.68, 95% CI 1.02, 2.75) handgrip strength compared with the not low category. Similar associations, although stronger, were seen for low (HR 1.88, 95% CI 1.38, 2.56) and very low (HR 2.64, 95% CI 1.73, 4.03) 5-CST performance compared with the not low category.ConclusionsWe found poor agreement between T-score categories for handgrip strength and 5-CST performance and independent associations with mortality. Our findings suggest that these tests identify different people at risk when case-finding probable sarcopenia. As discussions on an international consensus for sarcopenia definitions proceed, testing both handgrip strength and chair stand performance should be recommended rather than viewing these as interchangeable assessments.

Physical strength can be an important parameter to monitor for patients with diabetes mellitus type 2 (T2DM) to promote healthy lifestyle choices. Functional measurements can contribute to healthcare advice and possibly motivate more active lifestyles. The aim of the study was to investigate whether adding measurement and feedback concerning handgrip strength (HGS) to the parameters measured for patients with T2DM at annual check-ups leads to change in physical activity (PA) level, HGS, HbA1c or waist circumference. Methods Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires. Results Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels. Conclusions Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function. ClinicalTrials registration: NCT03693521

ObjectThis study aimed to analyze the association between low handgrip strength (HGS) and low back pain (LBP) according to physical activity (PA) in the general population aged over 50 years.MethodsNationwide health surveys and examinations were performed in a cross-sectional representative of the Korean general population (n = 7,550 in 2014, n = 7,380 in 2015). Chronic LBP status was determined by self-reported survey responses with respect to the occurrence of LBP for more than 30 days during the previous 3 months. Maximal HGS was determined as the maximal strength of the dominant hand, and low HGS was defined as measurement in the lower 20th percentile of HGS measurements for the general population. High PA was defined as muscle-strengthening exercise for at least 3 days within 1 week. Demographics, medical history, and other variables were used to analyze adjusted weighted logistic regression models with propensity score matching. After propensity score matching, 429 participants were included in each group.ResultsAnalysis was confined to those aged 50–89 years who responded to the chronic LBP survey and had no missing data on HGS. Low HGS and LBP showed significant association in the crude logistic regression model. In the multiple logistic regression model, after adjusting for confounding factors, low HGS was significantly associated with LBP in women with low PA (adjusted odds ratio [aOR]: 1.75, p = 0.047). In the logistic regression model after propensity score matching, low HGS was also significantly related to LBP in women with low PA (aOR: 3.12, p = 0.004).ConclusionsOur study showed the relationship between low HGS and LBP using a cross-sectional Korean population-based health survey. Low HGS in women aged over 50 years with low PA was significantly associated with the presence of LBP.

Corrigendum

This study aimed to examine the link between handgrip strength (HGS) asymmetry and mortality risk among older Chinese adults. These analyses were conducted using data from adults aged 60 years and older from the 2011-2013 waves of the China Health and Retirement Longitudinal Study, using baseline participant data collected in 2011. Proxy-reported information was used to assess the mortality outcomes of the participants over a 2-year follow-up. The highest recorded HGS values for each hand were used to compute the HGS asymmetry ratio (non-dominant HGS/dominant HGS) and HGS weakness (Male<26 kg, Female<16 kg). Covariate-adjusted Cox models were employed to gauge the relationship between abnormal HGS and mortality risk. Overall, 5083 adults were enrolled in this study, of whom 50.15% (2549/5083) were male. The proportions of low HGS alone, HGS asymmetry alone, and asymmetric and low HGS were 6.43%, 30.95%, and 9.22%, respectively, in males, and 4.81%, 35.87%, and 9.55%, respectively, in females. A total of 96 and 78 deaths were recorded for male (3.77%) and female (3.08%) participants, respectively, over the 2-year follow-up period. Significant differences in mortality were observed between the different HGS groups for both sexes. An adjusted Cox regression analysis model confirmed that only low HGS (P = 0.047, hazard ratio [HR] = 1.949, 95% confidence interval [95% CI]: 1.008-3.768) and low HGS with asymmetry (P = 0.007, HR = 2.152, 95% CI: 1.231-3.764) were significantly associated with mortality risk in older males. The results revealed that low HGS with or without asymmetry was associated with a higher risk of death over a 2-year follow-up interval in older Chinese males. Geriatr Gerontol Int 2023; 23: 692-699.

muscle wasting is associated with a detrimental outcome in older people. Muscle strength measurements could be useful as part of a clinical evaluation of oldest old patients to determine who are most at risk of accelerated decline in the near future. this study aimed to assess if handgrip strength predicts changes in functional, psychological and social health among oldest old. the Leiden 85-plus Study is a prospective population-based follow-up study. five-hundred fifty-five, all aged 85 years at baseline, participated in the study. handgrip strength was measured with a handgrip strength dynamometer. Functional, psychological and social health were assessed annually. Baseline data on chronic diseases were obtained from the treating physician, pharmacist, electrocardiogram and blood sample analysis. at age 85, lower handgrip strength was correlated with poorer scores in functional, psychological and social health domains (all, P < 0.001). Lower baseline handgrip strength predicted an accelerated decline in activities of daily living (ADL) and cognition (both, P <or= 0.001), but not in social health (P > 0.30). poor handgrip strength predicts accelerated dependency in ADL and cognitive decline in oldest old. Measuring handgrip strength could be a useful instrument in geriatric practice to identify those oldest old patients at risk for this accelerated decline.

Prognostic significance of skeletal muscle mass in patients with alcohol-related cirrhosis.

Introduction: Bone mineral density is crucial for assessing bone health and osteoporosis risk. Handgrip strength is a marker of muscle function. Studies suggest that individuals with higher handgrip strength tend to have higher bone mineral density, even after adjusting for age, Body Mass Index, and physical activity. Understanding the relation between handgrip strength and bone mineral density may aid the identification of low bone density. Objectives: To analyze the association between higher handgrip strength and bone mineral density quartiles, assessing sex differences and age, Body Mass Index and physical activity impact in a sample of adults. Methodology: Whole-body bone mineral density was derived by dual-energy x-ray absorptiometry. Handgrip strength was assessed with a GripWise dynamometer. Ordinal regression, stratified by sex, analysed the association between handgrip strength and bone mineral density quartiles, adjusted for age intervals, Body Mass Index and physical activity. Results include odds ratios and 95% confidence intervals (OR; 95%CI). ANOVA F-values and eta squared (η²) were reported. Results: 680 adults (18-85 years, mean age 41.3±16.2, 67.2% women) were included. In women, handgrip strength differed across bone mineral density quartiles (F=15.180, p&lt;0.001), with 9% variance (η²=0.094). Q1 had lower handgrip strength than other Qs, with no significant difference between Q2 and Q3. A 1 kgf increase in handgrip strength raised the odds of a higher bone mineral density Q by 9% (1.09; 1.05-1.14). Younger women (18-20 years) were more likely to be in higher bone mineral density Qs compared to those aged 51+ (4.04; 2.72-6.14). Physical inactivity decreased the likelihood of being in a higher bone mineral density Q (0.57; 0.34-0.94). In men, handgrip strength differed across Qs (F=12.635, p&lt;0.001), with15% variance (η²=0.152). Q1 also had lower handgrip strength. However, there were no significant differences between Q2 and Q3, nor between Q3 and Q4. A 1 kgf increase in handgrip strength raised the odds of being in a higher bone mineral density Q by 7% (1.07; 1.03-1.12). Men who were minimally active had 48% lower odds of being in higher bone mineral density Qs (0.52; 0.29-0.93). Discussion: Findings reinforce that muscle strength is associated with bone mineral density, though the relation appears stronger in men, where handgrip strength variance was higher across bone mineral density quartiles. Age was negatively associated with bone mineral density only in women, aligning with prior evidence about postmenopausal bone loss in females. Low physical activity was associated with lower bone mineral density in both sexes, confirming the contribution of physical activity to better bone health. Conclusions: Higher higher handgrip strength was associated with better bone mineral density in this sample, independently of age, Body Mass Index and physical activity. Age was associated with lower bone mineral density in women, while physical activity positively impacted bone mineral density in both sexes. These results highlight sex differences in bone health.

Radical esophagectomy remains the primary treatment option for resectable esophageal cancer. However, it sometimes induces postoperative complications due to its invasive nature. Recently, the impact of loss of muscle mass on postoperative complications and survival among cancer patients has been highlighted. This study aimed to identify the impact of low hand grip strength (HGS) on postoperative complications after esophagectomy. A total of 188 patients (male: 166, female: 22) who underwent radical esophagectomy with gastric tube reconstruction between 2008 and 2014 were included. The correlation between HGS and age was analyzed using Pearson's correlation coefficient. Due to the small patient numbers, only male patients were stratified into two groups according to age (<70years: non-elderly group, ≥70years: elderly group). Receiver operating characteristic curve analysis was performed for each group using postoperative complication occurrence as the endpoint to determine an optimal HGS cutoff value. Postoperative complications occurred in 60.9% of the elderly group and 47.4% of the non-elderly group. When the cutoff values were set at 30.5 and 37kg for the elderly and non-elderly group, respectively, low HGS was an independent predictive factor of postoperative complications on multivariate analysis only in the elderly group (p=0.008). In the elderly group, the incidence of postoperative pneumonia was 39.5% among patients with low HGS vs. 3.8% among patients with high HGS. Preoperative HGS is an independent predictive factor of postoperative complications, especially postoperative pneumonia, for elderly male patients with esophageal cancer treated with radical esophagectomy.

Malnutrition is prevalent among hospitalized older patients. Early identification is therefore essential to implementing appropriate therapeutic interventions. This study aimed to explore the correlation between handgrip strength (HGS) and nutritional status in hospitalized older adults. This observational cross-sectional study was conducted at King Abdulaziz University Hospital, where a consecutive cohort of older adult inpatients was enrolled for participation. Shortly after admission, HGS and nutritional status were assessed using a dynamometer and the most recent version of the Mini-Nutritional Assessment Short Form (MNA-SF) test, respectively. Key anthropometric and biochemical indicators were also collected. A total of 135 consecutive patients were evaluated. Among participants with low HGS, 18 (16.22%) were malnourished, 43 (38.74%) were at risk of malnutrition, and 50 (45.05%) had normal nutrition status. The participants with low HGS had low hemoglobin, low lymphocyte levels, high creatinine levels, high BUN levels, high CRP levels, high HbA1c levels, and high vitamin B12 levels. Multiple logistic regression analysis showed that age, hemoglobin, and HbA1C were independently associated with low HGS. Based on the cut-off values for the HGS by the European Working Group on Sarcopenia in Older People-2 (EWGSOP2), low HGS showed high sensitivity to detect "malnourished and at risk of malnutrition" as well as "malnourished alone;" however, the specificity was low to exclude "malnourished and at risk of malnutrition" as well as "malnutrition alone." Age over 75 years, low hemoglobin, and elevated HbA1C levels were independent risk factors for low HGS. While HGS was sensitive in detecting malnutrition or risk, its specificity was low. Therefore, HGS may not be adequate as a standalone tool to assess nutritional status in hospitalized older adults. Replication of this study using locally reliable and validated HGS cut-off values is warranted to confirm these findings.

Measuring handgrip strength is the initial step to diagnose sarcopenia. To investigate whether the serum creatinine (Cr)/cystatin C (CysC) ratio could serve as a case-finding tool for low handgrip strength, we conducted a diagnostic accuracy study. Adults (aged ≥ 40 years) with normal renal function were recruited. Trained nurses collected blood samples and conducted the anthropometric measurements and handgrip strength test. The serum concentrations of Cr, CysC, and other biomarkers were measured. We recruited 1098 men and 1241 women. The Cr/CysC ratio was significantly associated with AWGS-defined low handgrip strength among men and women. The areas under the receiver operating characteristic curves were 0.79 among men and 0.78 among women for using the Cr/CysC ratio to identify AWGS-defined low handgrip strength. We set the Cr/CysC ratio cut-off values at < 8.9 among men and < 8.0 among women. The corresponding sensitivity values were 64.9% among men and 63.1% among women, while the specificity values were 83.7% among men and 77.5% among women. In conclusion, the Cr/CysC ratio is positively and linearly associated with handgrip strength and may be helpful for screening low handgrip strength in Chinese middle-aged and older adults dwelling in communities.

BackgroundEpidemiological investigations on the association of handgrip status and asthma risk still remain understudied. This research aims to investigate the associations of handgrip strength (HGS), relative handgrip strength (RHGS), low HGS, and asthma risk, as well as the mediating role of nutritional status, using data from the Survey of Health, Ageing and Retirement in Europe (SHARE).MethodThis investigation included 27,185 participants for a cross-sectional study and 18,047 participants for a prospective cohort study from SHARE. Four machine learning models, the Shapley Additive Explanations (SHAP) model, restricted cubic spline (RCS), cumulative occurrence curve, logistic regression, and Cox regression were used to comprehensively evaluate the performance of handgrip status in predicting asthma risk. Finally, the mediation effect model was employed to evaluate the role of nutritional status in the relationship between grip strength and asthma risk.ResultThe cross-sectional investigation suggested that both HGS (OR: 0.98, 95% CI: 0.98–0.99) and RHGS (OR: 0.61, 95% CI: 0.51–0.73) were negatively linked to the risk of asthma, and low HGS was a risk factor for asthma (OR: 1.52, 95% CI: 1.24–1.87). And the prospective cohort investigation with a median follow-up time of 30 months further confirmed that both HGS (HR: 0.98, 95% CI: 0.97–1.00) and RHGS (HR: 0.52, 95% CI: 0.37–0.73) were negatively linked to the risk of asthma. Among the four machine learning models used to evaluate handgrip status and the risk of asthma, eXtreme Gradient Boosting (XGBoost) showed better predictive performance. The SHAP model based on XGBoost suggested that the top five crucial indicators for predicting asthma risk were RHGS, HGS, country, age, and chronic lung disease. Finally, the mediation effect model suggested that malnutrition partially mediated the relationship between low HGS and increased risk of asthma, with a mediation proportion of 2.71%.ConclusionThis investigation suggested that lower HGS and RHGS were linked to a higher risk of asthma, and handgrip status could be used as an independent marker of asthma risk in European populations. And malnutrition partially mediated the relationship between low HGS and asthma risk. Improving muscle strength could be a potential preventive strategy against asthma, with implications for public health and clinical practice.

Although several studies have examined the relationship between thyroid function and muscle strength, their population primarily derived from Asian areas, and their results were controversial. Thus, this study aimed to explore the association between thyroid function and handgrip strength (HGS) in the U.S. population. A total of 1,067 participants from NHANES were categorized into three different age groups including young (<45 years), middle (45~64 years), and old (≥65 years) age groups. Thyroid function was measured by the competitive binding immune-enzymatic assays, while HGS was examined by a trained evaluator using a dynamometer. The weighted multiple linear regression models were used to examine the association between thyroid function and handgrip strength. The restricted cubic splines were employed to explore the non-linear relationship between these two variables. All statistical analyses were performed using the SPSS version 20.0 and R software. After adjustment for potential covariates, FT3/FT4, but not TSH was positively associated with HGS in middle age group (β=0.091, t=2.428, P=0.016). The subgroup analysis by sex revealed that the positive association between FT3/FT4 and HGS was observed in the middle age group for both male and female participants (β=0.163, t=2.121, P=0.035; β=0.157, t=2.180, P=0.031). The RCS analysis showed a statistically significant non-linear association between FT3/FT4 and HGS in overall population (P for non-linear=0.026). After adjustment for covariates, men with low HGS had a significant lower FT3/FT4 than those without low HGS in old age group (P=0.013). There was a significant increase in TSH level for female participants with low HGS in old age group compared to those with normal HGS (P=0.048). This study demonstrated FT3/FT4, but not TSH, was positively associated with HGS in middle age group, and the different association was observed in men in middle age group when participants were stratified by sex. Future longitudinal cohort study should be conducted to reveal the causal relationship between thyroid function and muscle strength.