Hand-grip strength cut points to screen older persons at risk for mobility limitation

OBJECTIVES: To determine optimal hand‐grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI).

DESIGN: Cross‐sectional analysis of data.

SETTING: Data collected in the Finnish population‐based Health 2000 Survey.

PARTICIPANTS: One thousand eighty‐four men and 1,562 women aged 55 and older with complete data on anthropometry, hand‐grip strength and self‐reported mobility.

MEASUREMENTS: Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand‐grip strength cut points for likelihood of mobility limitation.

RESULTS: The overall hand‐grip strength cut points for likelihood of mobility limitation were 37 kg (sensitivity 62%; specificity 76%) for men and 21 kg (sensitivity 67%; specificity 73%) for women. The effect of the interaction between hand‐grip strength and BMI on mobility limitation was significant in men (P=.02), but no such interaction was observed in women (P=.16). In men, the most‐optimal cutoff points were 33 kg (sensitivity 73%; specificity 79%) for normal‐weight men, 39 kg (sensitivity 67%; specificity 71%) for overweight men, and 40 kg (sensitivity 57%; specificity 68%) for obese men. In women, BMI‐specific hand‐grip strength cutoff values was not markedly more accurate than the overall cutoff value.

CONCLUSION: The hand‐grip strength test is a useful tool to identify persons at risk of mobility limitation. In men, hand‐grip strength cut points for mobility increased with BMI, whereas in women, only one hand‐grip strength threshold was identified.