title: Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care.
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.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Postal zone V0-P, PO Box 9600, 2300, RC, Leiden, The Netherlands.
authors.forename: On Ying A
authors.initials: OY
authors.lastname: Chan
authors.forename: Anne H
authors.initials: AH
authors.lastname: van Houwelingen
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Jeanet W
authors.initials: JW
authors.lastname: Blom
authors.forename: Wendy P J
authors.initials: WP
authors.lastname: den Elzen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005684:Gait / Q000502:physiology; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D052097:Quadriceps Muscle / Q000503:physiopathology*; D055948:Sarcopenia / Q000503:physiopathology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires