Association between Hand Grip Strength and Risk of Malnutrition in Elderly at Out-Patient Clinic, Faculty of Medicine, Vajira Hospital

Main Article Content

Thanakorn Witsawaphaisan
Wilailuk Teepprasan

Abstract

Objectives: To study the optimal cut-off point of hand grip strength for evaluation risk of malnutrition, and factors associated with malnutrition in elderly out-patient clinic, Faculty of Medicine Vajira Hospital.


Methods: This research is cross-sectional study in volunteers aged 60 years and over, who came to family medicine out-patient clinic Vajira Hospital. The total number of volunteers were 243 patients, male 68 patients, female 175 patients. All volunteers have been taking history, screening for MNA and hand grip strength.


Results: Optimal cut-off point for hand grip strength in male patients is 28.75 kgF, which sensitivity 100%, specificity 44%. Optimal cut-off point for hand grip strength in female patients is 17.22 kgF, which sensitivity 66%, specificity 54%. In male, there were 3 factors associated with risk of malnutrition; over ages 80-89 years (p-value 0.030), psychiatric disease (p-value 0.004), right hand grip strength below 23.07 ± 4.48 (p-value 0.015). In female, there were 4 factors associated with risk of malnutrition; no education (p-value 0.025), cardiovascular disease (p value 0.042), low BMI < 18.5 (p value 0.003) and left hand grip strength below 15.88 ± 4.3 p value 0.027).


Conclusion: Optimal cut-off point for hand grip strength in male patients is 28.75 kgF. Optimal cut-off point for hand grip strength in female patients is 17.22 kgF. It can be use in screening for patients who are at risk of malnutrition.

Article Details

How to Cite
Witsawaphaisan, T., & Teepprasan, W. (2021). Association between Hand Grip Strength and Risk of Malnutrition in Elderly at Out-Patient Clinic, Faculty of Medicine, Vajira Hospital. Vajira Medical Journal : Journal of Urban Medicine, 65(4), 288–299. https://doi.org/10.14456/vmj.2021.28
Section
Original Articles

References

Wells JL, Dumbrell AC. Nutrition and aging: assessment and treatment of compromised nutritional status in frail elderly patients. Clinical interventions in aging 2006:1(1) 67-79.

Elsawy B, Higgins KE. The Geriatric assessment. Am Fam Physician 2011;83(1):48-56.

Panutat S, Chuto C, Nuntawan C, Pumsrisawat A, Pruksacheva T. Caring for the elderly with malnutrition. JRIHS 2017; 1(1): 1-15.

Rober E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutrition risk screening and assessment. J Clin Med 2019; 8: 1065-84.

Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the mini nutrition assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. The Journal of Nutrition, Health & Aging 2009; 13(9).

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN).ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22(4):415-21.

Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, et al. Overview of the MNA-Its history and challenges. J Nutr Health Aging 2006;10(6): 456-63; discussion 463-5.

Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature—What does it tell us? J Nutr Health Aging 2006;10(6):466-85; discussion 485-7.

Alvis BD, Hughes CG Physiology considerations in the geriatric patient. Anesthesiol Clin 2015;33(3):447-56. Doi:10.1016/j.anclin.2015.05.003.

Akbar F, Setiati S. Correlation between hand grip strength and nutritional status in elderly patients. J Phys Conf Ser 2018;1073(4): 1-8.

Zhang XS, Liu YH, Zhang Y, Xu Q, Yu XM, Yang XY, et al. Handgrip strength as a predictor of nutrional status in Chinese elderly inpatients at hospital admission. Biomed Environ Sci 2017;30(11):802-10.

Racic M, Pavlovic J, Ivkovic N. Handgrip strength cut-off values for the undernutrition Risk screening among elderly men and woman in Bosnia and Herzegovina. J Aging Res[Internet]. 2019 [cited 2020 Sep 10]: 1-10. Available from: https://www.hindawi.com/journals/jar/2019/5726073.

Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Jr AA, Orlandini A, et al. Prognostic value of grip strength: findings from the prospective Urban Rural Epidemiology(PURE) study. Lancet 2015;386(9990):266-73.

Lera L, Albala C, Leyton B, Marquez C, Angel B, Saguez R, et al. Reference values of hand grip dynamometry and the relationship between low strength and mortality in older Chileans. Clinical interventions in aging 2018;13:317-24.

Yu RC, Ju YJ, Yeon PK. Clinically relavant cut-off points for the diagnosis of sarcopenia in older Korean people. J Gerontol A Biol Sci Med Sci 2017;72(12):1724-31. doi:10.1093/Gerona/glx05.

Cawthon PM, Peters KW, Shatdell MD, McLean RR, Thuy-Tien LD, Kenny AM, et al. Cutpoints for low appendicular lean mass that identify older adults with clinically significant weakness. J Gerontol A Biol sci Med Sci 2014;69(5):567-75.doi.10.1093/gerona/glu023.

Dodds RM, Syddall HE, Cooper R, Kuh D, Cooper C, Sayer AA. Global variation in grip strength: a systematic review and meta analysis of normative data. Age and aging 2016;45(2): 209-16.

Zhang XS, Liu YH, Zhang Y, Xu Q, Yu XM, Yang XY, et al. Handgrip strength as a predictor of nutrition status in Chinese elderly inpatients at hospital admission. Biomed Environ Sci 2017;30 (11): 802-10.

Ong HL, Abdin E, Chua BY, Zhang Y, Seow E, Vaingankar JA, et al. Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors. BMC Geriatrics 2017; 17: 176-86.

Beller J, Miething A, Regidor E, Lostao L, Epping J, Geyer S. Trends in grip strength: Age, period, and cohort effects on grip strength in older adults in Germany, Sweden and Spain. SSM Popul Health 2019; 9: 1-9.

World Health Organization. Physical status: the used and interpretation of anthropometry. WHO Expert Committee Report. Geneva: World Health Organization; 1995.

Somboontanont W, Thiengtham S. Factors related to Activity of Daily Living among Community dwelling Older Adults with Low Muscle Strength. Songklanagarind J Nurs 2561;38(2): 110-23.

Beumer A, Lindau TR. Grip strength ratio: a grip strength measurement that correlates well with DASH score in different hand/wrist conditions. BMC Musculoskelet Disord 2014; 15: 336-40.

Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, et al. Overview of the MNA-Its history and challenges. J Nutr Health Aging 2006;10(6):456-63; discussion 463-5.

Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group on Sarcopenia: 2019 Consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020; 21(3): 300-7.

Riviati N, Setiati S, Laksmi PW, Abdullah M. Factors related with handgrip strength in elderly patients. Acta med. Indones 2017; 49(3): 215-9.

Churak P, Praditsorn P, Meenongwah J, Wimonpeerapattana W. Factors associated with nutritional status of elderly in Ubon Ratchathani, Thailand. APST 2018; 24(1): 1-11.

Donini LM, Scardella P, Piombo L, Neri B, Asprino R, Proietti AR, et al. Malnutrition in elderly: social and economic determinants. J Nutr Health Aging 2013; 17(1): 9-15.

Damioa R, Santos AS, Matijasecich A, Menezes PR. Factors associated with risk of malnutrition in the elderly in south-eastern Brazil. Rev Bras Epidemiol 2017; 20(4): 598-610.