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Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care

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Abstract

Sarcopenia is thought to play a major role in the functional impairment that occurs with old age. In clinical practice, sarcopenia is often determined by measuring handgrip strength. Here, we compared the lower limb quadriceps strength to the handgrip strength in their association with health outcomes in older adults in primary care. Our study population consisted of older adults (n = 764, 68.2 % women, median age 83) that participated in the Integrated Systemic Care for Older People (ISCOPE) study. Participants were visited at baseline to measure quadriceps strength and handgrip strength. Data on health outcomes were obtained at baseline and after 12 months (including life satisfaction, disability in daily living, GP contact-time and hospitalization). Quadriceps strength and handgrip strength showed a weak association (β = 0.42 [95 % CI 0.33–0.50]; R 2 = 0.17). Quadriceps strength and handgrip strength were independently associated with health outcomes at baseline, including quality of life, disability in daily living, GP contact-time, hospitalization, and gait speed. Combined weakness of the quadriceps and handgrip distinguished a most vulnerable subpopulation that presented with the poorest health outcomes. At follow-up, handgrip strength showed an association with quality of life (β = 0.05; P = 0.002) and disability in daily living (β = −0.5; P = 0.004). Quadriceps weakness did not further contribute to the prediction of the measured health outcomes. We conclude that quadriceps strength is only moderately associated with handgrip strength in an older population and that the combination of quadriceps strength and handgrip strength measurements may aid in the identification of older adults in primary care with the poorest health outcomes. In the prediction of poor health outcomes, quadriceps strength measurements do not show an added value to the handgrip strength.

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Acknowledgments

Author contributions

Guarantor: WPJ den Elzen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design

J Gussekloo, JW Blom, WPJ den Elzen.

Acquisition of data

OYA Chan, AH van Houwelingen, J Gussekloo, JW Blom, WPJ den Elzen.

Analysis and interpretation of data

OYA Chan, AH van Houwelingen, J Gussekloo, JW Blom, WPJ den Elzen.

Drafting of the manuscript

OYA Chan, WPJ den Elzen.

Critical revision of the manuscript for important intellectual content

OYA Chan, AH van Houwelingen, J Gussekloo, JW Blom, WPJ den Elzen.

Obtained funding

JW Blom and J Gussekloo.

Competing interests

None declared.

Funding

This study was funded by a grant from the Netherlands Organization for Health Research and Development (ZonMw; grant number 60-61900-98-126).

Role of the Sponsor

The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Ethical approval

The Medical Ethical Committee of Leiden University Medical Center approved the study in 2009.

Trial registration

Netherlands Trial Register: NTR1946.

Author information

Authors and Affiliations

  1. Department of Public Health and Primary Care, Leiden University Medical Center, Postal zone V0-P, PO Box 9600, 2300, RC, Leiden, The Netherlands

    On Ying A. Chan, Anne H. van Houwelingen, Jacobijn Gussekloo, Jeanet W. Blom & Wendy P.J. den Elzen

Authors
  1. On Ying A. Chan
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  2. Anne H. van Houwelingen
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  3. Jacobijn Gussekloo
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  4. Jeanet W. Blom
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  5. Wendy P.J. den Elzen
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Corresponding author

Correspondence to Wendy P.J. den Elzen.

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Chan, O.Y.A., van Houwelingen, A.H., Gussekloo, J. et al. Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care. AGE 36, 9714 (2014). https://doi.org/10.1007/s11357-014-9714-4

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  • DOI: https://doi.org/10.1007/s11357-014-9714-4

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