Grip strength among community-dwelling older people predicts hospital admission during the following decade.
BACKGROUND
Lower grip strength on admission to hospital is known to be associated with longer stay, but the link between customary grip and risk of future admission is less clear.


OBJECTIVE
To compare grip strength with subsequent risk of hospital admission among community-dwelling older people in a U.K. setting.


METHODS
Cohort study with linked administrative data.


METHODS
Hertfordshire, U.K.


METHODS
A total of 2,997 community-dwelling men and women aged 59-73 years at baseline.


METHODS
The Hertfordshire Cohort Study (HCS) participants completed a baseline assessment between 1998 and 2004, during which grip strength was measured. Hospital Episode Statistics and mortality data to March 2010 were linked with the HCS database. Statistical models were used to investigate the association of grip strength with subsequent elective, emergency and long-stay hospitalisation and readmission.


RESULTS
There was a statistically significant negative association between grip strength and all classes of admission in women [unadjusted hazard ratio per standard deviation (SD) decrease in grip strength for: any admission/death 1.10 (95% CI: 1.06, 1.14), elective admission/death 1.09 (95% CI: 1.05, 1.13), emergency admission/death 1.21 (95% CI: 1.13, 1.31), long-stay admission/death 1.22 (95% CI: 1.13, 1.32) and unadjusted relative risk per SD decrease in grip strength for 30-day readmission/death 1.30 (95% CI: 1.19, 1.43)]. These associations remained significant after adjustment for potential confounding factors (age, height, weight for height, smoking, alcohol, social class). In men, unadjusted rates for emergency admission/death, long-stay admission/death and readmission/death were significantly associated with grip strength; associations that similarly withstood adjustment.


CONCLUSIONS
This study provides the first evidence that grip strength among community-dwelling men and women in the U.K. is associated with risk of hospital admission over the following decade.
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK.
Shirley J
SJ
Simmonds
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK.
Holly E
HE
Syddall
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK.
Leo D
LD
Westbury
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK.
Richard M
RM
Dodds
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK University of Southampton-National Institute for Health Research Southampton Biomedical Research Centre, Southampton, UK University of Oxford-National Institute for Health Research Musculoskeletal Biomedical Research Unit, Oxford, UK.
Cyrus
C
Cooper
Medical Research Council-Lifecourse Epidemiology Unit, Southampton, UK University of Southampton-National Institute for Health Research Southampton Biomedical Research Centre, Southampton, UK University of Southampton-Academic Geriatric Medicine, Southampton, UK National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care: Wessex, Southampton, UK.
Avan
A
Aihie Sayer
D000368:Aged; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
Hospital Episode Statistics; grip strength; hospital admission; hospitalisation; older people; readmission