Prognostic value of physical function tests: hand grip strength and six-minute walking test in elderly hospitalized patients

Abstract

To discern if physical function test are better mortality predictors than muscle mass in elderly hospitalized patients, we analyzed the prognostic value of muscle mass malnutrition and compared it with physical muscle function tests, including the six-minute walking test (6 MWT) and hand grip strength. We included the ankle brachial index (ABI) to assess arterial disease, related to muscle atrophy due to hypoperfusion. We also analyzed the relationship of ABI with malnutrition, physical function tests and survival. We studied 310 hospitalized patients older than 60 years. To assess nutritional status, we determined BMI, triceps skinfold and mid-arm muscle area; we performed a subjective nutritional assessment; and evaluated the degree of inflammatory stress. We assessed physical function by hand grip strength and 6 MWT. We evaluated arterial disease by ABI. Forty-one patients died during hospitalization; 269 were discharged and followed for a mean 808 days, reaching a mortality of 49%. Muscle malnutrition was frequent and was related to mortality, but the best predictors were physical function tests: inability to perform the 6 MWT and low handgrip strength. Function tests were closely related to each other and correlated with nutritional data. Reduced ABI was related to impaired nutritional status, physical function tests and mortality.