Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis

Abstract

Aim: The aim of the present study was to systematically review the literature on the predictive value of handgrip strength as a marker for vulnerability. Furthermore, we aimed to update a recent systematic review on the association between handgrip strength and mortality.

Methods: Literature searches using Cochrane, PubMed and Embase databases, and searching reference lists of included studies. Eligible studies were observational longitudinal studies presenting handgrip strength at baseline as an independent variable and its association with cognition, depression, mobility, functional status, hospitalization or mortality at follow up in a general population aged 60 years and older. With respect to mortality, we updated a recent systematic review.

Results: We included 34 articles. Most of them involved the association between handgrip strength and cognition (n = 9), functional status (n = 12), mobility (n = 6) or mortality (n = 22), and mainly found a positive relationship, meaning that higher handgrip strength at baseline is protective for declines in these outcome measures. Statistical pooling was carried out for functional status and mortality, with a pooled ratio for functional status of 1.78 (95% CI 1.28-2.48) for categorical variables (high vs low handgrip strength) and 0.95 (95% CI 0.92-0.99) for handgrip strength as a continuous variable. The pooled hazard ratio for mortality was 1.79 (95% CI 1.26-2.55) for categorical variables and 0.96 (95% CI 0.93-0.98) for continuous variables.

Conclusions: Handgrip strength has a predictive validity for decline in cognition, mobility, functional status and mortality in older community-dwelling populations.

Keywords: aged; functional status; handgrip strength; mortality; review.