Hand grip strength as a screening tool for frailty in older patients with haematological malignancies.
OBJECTIVE
Frailty is a geriatric syndrome characterized by decreased physiological reserves and an age-related vulnerability to stressors with higher risk of adverse health outcomes. Comprehensive geriatric assessment (CGA) might detect frailty but is time-consuming, implying the need for initial frailty screening. Most frailty screening tools do not include functional measures. Hand grip strength (HGS) is a reliable surrogate for overall muscle strength and predicts functional decline, morbidity and mortality. No studies are available in cancer patients on HGS as screening tool for frailty. We aimed to assess whether HGS can be used as a screening tool to predict an abnormal CGA and therefore frailty.


METHODS
Single centre cohort study in 59 patients aged 70 years or more with a haematological malignancy. HGS was measured using a vigorimeter. A patient was considered frail if any of the CGA elements were impaired.


RESULTS
Mean HGS before start of therapy in women was 37.0 ± 14.3 kPa and in men 66.1 ± 13.1 kPa. An abnormal CGA was present in 52 subjects (88%). HGS was associated with concurrent abnormal CGA (p = 0.058 in women, p = 0.009 in men). AUC was 0.800 (SE = 0.130) in women and 0.847 (SE = 0.118) in men. Optimal HGS cut-off points for likelihood of abnormal CGA were ≤52 kPa in women and ≤80 kPa in men.


CONCLUSIONS
In older patients with haematological malignancies, impairment in muscle function is present at diagnosis. HGS seems a promising screening tool to identify patients with abnormal CGA.
a Department of Geriatrics , Ghent University Hospital , De Pintelaan 185, 9000 Gent , Belgium.
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A
Velghe
a Department of Geriatrics , Ghent University Hospital , De Pintelaan 185, 9000 Gent , Belgium.
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S
De Buyser
b Department of Haematology , Ghent University Hospital , De Pintelaan 185, 9000 Gent , Belgium.
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L
Noens
a Department of Geriatrics , Ghent University Hospital , De Pintelaan 185, 9000 Gent , Belgium.
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R
Demuynck
a Department of Geriatrics , Ghent University Hospital , De Pintelaan 185, 9000 Gent , Belgium.
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M
Petrovic
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D018737:Hand Strength / Q000502:physiology*; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D012372:ROC Curve
Comprehensive geriatric assessment; Frailty; Haematological malignancy; Hand grip strength; Screening tool