Hand grip strength as a nutritional assessment tool
Hand grip strength (HGS) is a new nutritional assessment parameter proposed by American Society for Parenteral and Enteral Nutrition (ASPEN) and the Academy of Nutrition and Dietetics (the Academy) for diagnosis of adult malnutrition related to acute illnesses, chronic diseases or starvation. Identification of ≥2 of the following conditions is considered to be malnourishment – weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, diminished HGS and inadequate energy intake. HGS is also a marker of sarcopenia, a condition defined by low muscle mass and low muscle strength or performance, as identified by the European Working Group on Sarcopenia in Older People. It has also been shown that lower HGS is associated with deficits in activities of daily living (ADL) and mobility. HGS is emerging as an important screening tool especially in the malnourished and aging population. This research evaluates the applicability of HGS as a nutrition screening tool in long-term care older adults. Data from a total of 129 participants age ≥60 years involved in an ongoing walking program in long-term care facilities in Saskatoon available for analysis at the time this work was undertaken. Participants were randomly assigned for an intervention period of 16 weeks to one of three study groups: 1) Usual Care Group, 2) Interpersonal Interaction Group, and 3) Walking Program Group. Activity of daily living, cognition and depression scores and hand grip strength were recorded at baseline and every eight weeks. Information on vitamin D intake status prior to study commencement was also collected. This study provides values of low grip strength similar to those defined for the risk of sarcopenia in frail older adults. Stronger baseline HGS was correlated with greater ADL independence in females (B=0.079, P=0.044). Greater ability to eat at baseline was also associated with stronger grip in females when cognition status was taken into consideration. Baseline ADL (B=-0.024) and HGS (B=1.004) were significant predictors of subsequent ADL and HGS, respectively, in males (P<0.01). Baseline HGS was associated with subsequent ADL and HGS in females, but such association was modified by other covariates. In summary, if grip strength is to be used as a nutritional screening tool in long-term care facilities, dietitians shall be cautious of other factors such as the residents’ cognitive status and age and use in conjunction with other nutrition assessment methods.
hand grip strength, older adults
Master of Science (M.Sc.)