Analysis of Grip Strength Thresholds for Stroke Management and Prevention in South Korean Older Adults

Abstract

Background/objectives: Muscle weakness in older adults is associated with cardiovascular disease and all-cause mortality. However, its association with stroke prevalence remains underexplored. This study aimed to analyze the absolute grip strength (AGS) and weight-adjusted relative grip strength (RGS) thresholds for stroke prediction in South Korean older adults and to assess their sex-specific predictive ability.

Methods: Data from 5185 older adults (2231 men; 2954 women) from the Korea National Health and Nutrition Examination Survey (KNHNES, 2014-2018) were analyzed using complex sampling methods. Receiver operating characteristic (ROC) curve analysis was performed to determine AGS and RGS thresholds and predictive performance, while multivariate logistic regression was used to adjust for confounders and to assess independent effects.

Results: In older men, both the AGS and RGS demonstrated significant predictive ability for stroke, with AUCs of 0.637 and 0.623, respectively. In women, the AGS (AUC: 0.608) and RGS (AUC: 0.615) were predictive; however, only the RGS was significant for stroke management (odds ratio (OR): 3.026; 95% confidence interval (CI), 1.541-5.943). In men, AGS (OR: 3.544, 95% CI, 2.094-5.998) and RGS (OR: 2.585, 95% CI, 1.529-4.369) were significant. The stroke prediction thresholds were AGS 28.55 kg and RGS 0.47 for men and RGS 0.36 for women.

Conclusions: The AGS and RGS provide practical indicators for stroke risk prediction based on sex-specific differences, highlighting their potential for public health and clinical applications. Future studies should investigate the stroke type, severity, and additional functional fitness indices.

Keywords: KNHNES; absolute grip strength; older adults; relative grip strength; stroke.