Grip strength as a frailty diagnostic component in geriatric inpatients

Abstract

Background: Frailty has emerged as a key medical syndrome predictive of comorbidity, disability, institutionalization and death. As a component of the five frailty phenotype diagnostic criteria, patient grip strength deserves attention as a simple and objective measure of the frailty syndrome. The aim of this study was to assess conditions that influence grip strength in geriatric inpatients.

Patients and methods: The study group consisted of 80 patients aged 78.6±7.0 years [Formula: see text], with 68.8% women, admitted to the Department of Geriatrics. A comprehensive geriatric assessment was complemented with assessment for the frailty phenotype as described by Fried et al for all patients in the study group. Functional assessment included Barthel Index of Activities of Daily Living (Barthel Index), Instrumental Activities of Daily Living Scale and Mini-Mental State Examination.

Results: Three or more frailty criteria were positive in 32 patients (40%), while 56 subjects (70%) fulfilled the frailty criterion of weakness (grip strength test). Multivariate linear regression analysis revealed that two independent measures showed positive association with grip strength - Mini-Mental State Examination score (β=0.239; P=0.001) and statin use (β=0.213; P=0.002) - and four independent measures were negatively associated with grip strength - female sex (β=-0.671; P<0.001), C-reactive protein (β=-0.253; P<0.001), prior myocardial infarction (β=-0.190; P=0.006) and use of an antidepressant (β=-0.163; P=0.018). Low physical activity was identified as the only independent qualitative frailty component associated with 2-year mortality in multivariate logistic regression analysis after adjustment for age and sex (odds ratio =6.000; 95% CI =1.357-26.536; P=0.018).

Conclusion: Cognitive function, somatic comorbidity and medical treatment affect grip strength as a measure of physical frailty in geriatric inpatients. Grip strength was not predictive of 2-year mortality in this group.

Keywords: antidepressant; cognitive function; frailty; mortality; physical activity; statin.