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Avan Aihie Sayer - One of the best experts on this subject based on the ideXlab platform.
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mortality in the hertfordshire ageing study association with level and loss of hand Grip Strength in later life
Age and Ageing, 2017Co-Authors: Holly E. Syddall, Richard M Dodds, Elaine M Dennison, C. Cooper, Leo D Westbury, Avan Aihie SayerAbstract:Background Weak hand Grip Strength in later life is a risk factor for disability, morbidity and mortality and is central to definitions of sarcopenia and frailty. It is unclear whether rate of change in Grip Strength adds to level of Grip Strength as a risk factor for poor ageing outcomes. Methods Study participants were 292 community-dwelling men and women whose Grip Strength was measured during the 1994/5 (average age 67) and 2003/5 (average age 76) phases of the Hertfordshire Ageing Study, UK. Individual rate of change in Grip Strength was estimated using a residual change method. Mortality was followed-up to 2011 (42 men and 21 women died). Results Average Grip Strengths in 2003/5 were 38.4kg (standard deviation [SD] 8.1) and 23.7kg (SD 6.6) for men and women respectively. Average annualised rates of change in Grip Strength (2003/5 minus 1994/5) were modest owing to a healthy-participant effect (men: -0.12kg/year SD 0.71; women: 0.08kg/year SD 0.54) but varied widely. Mortality risk varied according to level and rate of change in Grip Strength (p=0.03); death rates per 100 person years of follow-up were 6.7 (95%CI 4.6,9.6) among participants who lost Grip over time and had low Grip in 2003/5, in contrast with 0.8 (95%CI 0.1,5.8) among participants whose Grip changed little over time and remained high in 2003/5. Conclusions Levels of Grip Strength in later life should be considered in conjunction with estimates of change in Grip Strength identified by repeat measurement over time. Normative data for longitudinal change in Grip Strength are required.
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Grip Strength decline and its determinants in the very old longitudinal findings from the newcastle 85 study
PLOS ONE, 2016Co-Authors: Antoneta Granic, Holly E. Syddall, Karen Davies, Carol Jagger, Thomas B L Kirkwood, Avan Aihie SayerAbstract:Background Low Grip Strength is a key component of sarcopenia and frailty and a powerful predictor of mortality, morbidity and disability. Despite increasing interest in understanding Grip Strength from a life course perspective, little is known about Grip Strength decline in the very old (aged 85+). We examined trajectories of Grip Strength in very old adults and identified the determinants. Methods Grip Strength (kg) was measured at four time points over 5 years in 319 men and 529 women participating in the Newcastle 85+ Study. Mixed models were used to establish trajectories of Grip Strength and associated factors in all participants, men and women separately, and in those with weak Grip Strength (≤27 kg in men, and ≤16 kg in women) at baseline and follow-ups. Results In the time-only model, men experienced linear annual decline in Grip Strength of −1.13 (0.8) kg (β (SE), P Conclusion Grip Strength decline in this cohort of very old adults followed linear (men) and curvilinear (women) trends. High levels of physical activity were protective in men and in those with overall weak Grip Strength. These findings have relevance to the design of interventions to improve muscle Strength in later life.
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global variation in Grip Strength a systematic review and meta analysis of normative data
Age and Ageing, 2016Co-Authors: Richard M Dodds, Rachel Cooper, Holly E. Syddall, C. Cooper, Avan Aihie SayerAbstract:Background: weak Grip Strength is a key component of sarcopenia and is associated with subsequent disability and mortality. We have recently established life course normative data for Grip Strength in Great Britain, but it is unclear whether the cut points we derived for weak Grip Strength are suitable for use in other settings. Our objective was to investigate differences in Grip Strength by world region using our data as a reference standard. Methods: we searched MEDLINE and EMBASE for reporting age- and gender-stratified normative data for Grip Strength. We extracted each item of normative data and converted it on to a Z-score scale relative to our British centiles. We performed meta-regression to pool the Z-scores and compare them by world region. Findings: our search returned 806 abstracts. Sixty papers met inclusion criteria and reported on 63 different samples. Seven UN regions were represented, although most samples (n = 44) were based in developed regions. We extracted 726 normative data items relating to 96,537 Grip Strength observations. Normative data from developed regions were broadly similar to our British centiles, with a pooled Z-score 0.12 SDs (95% CI: 0.07, 0.17) above the corresponding British centiles. By comparison, normative data from developing regions were clearly lower, with a pooled Z-score of −0.85 SDs (95% CI: −0.94, −0.76). Interpretation: our findings support the use of our British Grip Strength centiles and their associated cut points in consensus definitions for sarcopenia and frailty across developed regions, but highlight the need for different cut points in developing regions.
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Grip Strength among community dwelling older people predicts hospital admission during the following decade
Age and Ageing, 2015Co-Authors: S J Simmonds, Richard M Dodds, Holly E. Syddall, Cyrus Cooper, Leo D Westbury, Avan Aihie SayerAbstract: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 UK setting. Design: cohort study with linked administrative data. Setting: Hertfordshire, UK. Subjects: 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. Conclusion: this study provides the first evidence that Grip Strength among community-dwelling men and women in the UK is associated with risk of hospital admission over the following decade
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Grip Strength and its determinants among older people in different healthcare settings
Age and Ageing, 2014Co-Authors: Helen C Roberts, Holly E. Syddall, Avan Aihie Sayer, Cyrus Cooper, Jonathan Sparkes, Jan Ritchie, Joe Butchart, Alastair KerrAbstract:Background: low muscle Strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of Grip Strength of older people in rehabilitation or long-term care has been little explored. Objective: to describe Grip Strength of older people in rehabilitation and nursing home settings. Design: cross-sectional epidemiological study. Setting: three healthcare settings in one town. Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents. Methods: Grip Strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, MiniMental State Examination (MMSE), nutritional status and number of falls in the last year were recorded. Results: Grip Strength differed substantially between healthcare settings for both men and women (P< 0.0001). Nursing home residents had the lowest age-adjusted mean Grip Strength and community rehabilitation referrals the highest. Broadly higher Grip Strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in Grip Strength between settings remained significant. The Barthel score was the characteristic most strongly associated with Grip Strength. Conclusions: older people in rehabilitation and care home settings had lower Grip Strength than reported for those living at home. Furthermore Grip Strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether Grip Strength may help identify people at risk of adverse health outcomes within these settings.
Holly E. Syddall - One of the best experts on this subject based on the ideXlab platform.
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mortality in the hertfordshire ageing study association with level and loss of hand Grip Strength in later life
Age and Ageing, 2017Co-Authors: Holly E. Syddall, Richard M Dodds, Elaine M Dennison, C. Cooper, Leo D Westbury, Avan Aihie SayerAbstract:Background Weak hand Grip Strength in later life is a risk factor for disability, morbidity and mortality and is central to definitions of sarcopenia and frailty. It is unclear whether rate of change in Grip Strength adds to level of Grip Strength as a risk factor for poor ageing outcomes. Methods Study participants were 292 community-dwelling men and women whose Grip Strength was measured during the 1994/5 (average age 67) and 2003/5 (average age 76) phases of the Hertfordshire Ageing Study, UK. Individual rate of change in Grip Strength was estimated using a residual change method. Mortality was followed-up to 2011 (42 men and 21 women died). Results Average Grip Strengths in 2003/5 were 38.4kg (standard deviation [SD] 8.1) and 23.7kg (SD 6.6) for men and women respectively. Average annualised rates of change in Grip Strength (2003/5 minus 1994/5) were modest owing to a healthy-participant effect (men: -0.12kg/year SD 0.71; women: 0.08kg/year SD 0.54) but varied widely. Mortality risk varied according to level and rate of change in Grip Strength (p=0.03); death rates per 100 person years of follow-up were 6.7 (95%CI 4.6,9.6) among participants who lost Grip over time and had low Grip in 2003/5, in contrast with 0.8 (95%CI 0.1,5.8) among participants whose Grip changed little over time and remained high in 2003/5. Conclusions Levels of Grip Strength in later life should be considered in conjunction with estimates of change in Grip Strength identified by repeat measurement over time. Normative data for longitudinal change in Grip Strength are required.
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Grip Strength decline and its determinants in the very old longitudinal findings from the newcastle 85 study
PLOS ONE, 2016Co-Authors: Antoneta Granic, Holly E. Syddall, Karen Davies, Carol Jagger, Thomas B L Kirkwood, Avan Aihie SayerAbstract:Background Low Grip Strength is a key component of sarcopenia and frailty and a powerful predictor of mortality, morbidity and disability. Despite increasing interest in understanding Grip Strength from a life course perspective, little is known about Grip Strength decline in the very old (aged 85+). We examined trajectories of Grip Strength in very old adults and identified the determinants. Methods Grip Strength (kg) was measured at four time points over 5 years in 319 men and 529 women participating in the Newcastle 85+ Study. Mixed models were used to establish trajectories of Grip Strength and associated factors in all participants, men and women separately, and in those with weak Grip Strength (≤27 kg in men, and ≤16 kg in women) at baseline and follow-ups. Results In the time-only model, men experienced linear annual decline in Grip Strength of −1.13 (0.8) kg (β (SE), P Conclusion Grip Strength decline in this cohort of very old adults followed linear (men) and curvilinear (women) trends. High levels of physical activity were protective in men and in those with overall weak Grip Strength. These findings have relevance to the design of interventions to improve muscle Strength in later life.
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global variation in Grip Strength a systematic review and meta analysis of normative data
Age and Ageing, 2016Co-Authors: Richard M Dodds, Rachel Cooper, Holly E. Syddall, C. Cooper, Avan Aihie SayerAbstract:Background: weak Grip Strength is a key component of sarcopenia and is associated with subsequent disability and mortality. We have recently established life course normative data for Grip Strength in Great Britain, but it is unclear whether the cut points we derived for weak Grip Strength are suitable for use in other settings. Our objective was to investigate differences in Grip Strength by world region using our data as a reference standard. Methods: we searched MEDLINE and EMBASE for reporting age- and gender-stratified normative data for Grip Strength. We extracted each item of normative data and converted it on to a Z-score scale relative to our British centiles. We performed meta-regression to pool the Z-scores and compare them by world region. Findings: our search returned 806 abstracts. Sixty papers met inclusion criteria and reported on 63 different samples. Seven UN regions were represented, although most samples (n = 44) were based in developed regions. We extracted 726 normative data items relating to 96,537 Grip Strength observations. Normative data from developed regions were broadly similar to our British centiles, with a pooled Z-score 0.12 SDs (95% CI: 0.07, 0.17) above the corresponding British centiles. By comparison, normative data from developing regions were clearly lower, with a pooled Z-score of −0.85 SDs (95% CI: −0.94, −0.76). Interpretation: our findings support the use of our British Grip Strength centiles and their associated cut points in consensus definitions for sarcopenia and frailty across developed regions, but highlight the need for different cut points in developing regions.
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Grip Strength among community dwelling older people predicts hospital admission during the following decade
Age and Ageing, 2015Co-Authors: S J Simmonds, Richard M Dodds, Holly E. Syddall, Cyrus Cooper, Leo D Westbury, Avan Aihie SayerAbstract: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 UK setting. Design: cohort study with linked administrative data. Setting: Hertfordshire, UK. Subjects: 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. Conclusion: this study provides the first evidence that Grip Strength among community-dwelling men and women in the UK is associated with risk of hospital admission over the following decade
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Grip Strength across the life course normative data from twelve british studies
PLOS ONE, 2014Co-Authors: Richard M Dodds, Elaine M Dennison, Rachel Cooper, Holly E. Syddall, Catharine R Gale, Michaela Benzeval, Ian J Deary, H M Inskip, Carol JaggerAbstract:Introduction: Epidemiological studies have shown that weaker Grip Strength in later life is associated with disability, morbidity, and mortality. Grip Strength is a key component of the sarcopenia and frailty phenotypes and yet it is unclear how individual measurements should be interpreted. Our objective was to produce cross-sectional centile values for Grip Strength across the life course. A secondary objective was to examine the impact of different aspects of measurement protocol. Methods: We combined 60,803 observations from 49,964 participants (26,687 female) of 12 general population studies in Great Britain. We produced centile curves for ages 4 to 90 and investigated the prevalence of weak Grip, defined as Strength at least 2.5 SDs below the gender-specific peak mean. We carried out a series of sensitivity analyses to assess the impact of dynamometer type and measurement position (seated or standing). Results: Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. Males were on average stronger than females from adolescence onwards: males’ peak median Grip was 51 kg between ages 29 and 39, compared to 31 kg in females between ages 26 and 42. Weak Grip Strength, defined as Strength at least 2.5 SDs below the gender-specific peak mean, increased sharply with age, reaching a prevalence of 23% in males and 27% in females by age 80. Sensitivity analyses
Cyrus Cooper - One of the best experts on this subject based on the ideXlab platform.
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Grip Strength among community dwelling older people predicts hospital admission during the following decade
Age and Ageing, 2015Co-Authors: S J Simmonds, Richard M Dodds, Holly E. Syddall, Cyrus Cooper, Leo D Westbury, Avan Aihie SayerAbstract: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 UK setting. Design: cohort study with linked administrative data. Setting: Hertfordshire, UK. Subjects: 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. Conclusion: this study provides the first evidence that Grip Strength among community-dwelling men and women in the UK is associated with risk of hospital admission over the following decade
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Grip Strength and its determinants among older people in different healthcare settings
Age and Ageing, 2014Co-Authors: Helen C Roberts, Holly E. Syddall, Avan Aihie Sayer, Cyrus Cooper, Jonathan Sparkes, Jan Ritchie, Joe Butchart, Alastair KerrAbstract:Background: low muscle Strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of Grip Strength of older people in rehabilitation or long-term care has been little explored. Objective: to describe Grip Strength of older people in rehabilitation and nursing home settings. Design: cross-sectional epidemiological study. Setting: three healthcare settings in one town. Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents. Methods: Grip Strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, MiniMental State Examination (MMSE), nutritional status and number of falls in the last year were recorded. Results: Grip Strength differed substantially between healthcare settings for both men and women (P< 0.0001). Nursing home residents had the lowest age-adjusted mean Grip Strength and community rehabilitation referrals the highest. Broadly higher Grip Strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in Grip Strength between settings remained significant. The Barthel score was the characteristic most strongly associated with Grip Strength. Conclusions: older people in rehabilitation and care home settings had lower Grip Strength than reported for those living at home. Furthermore Grip Strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether Grip Strength may help identify people at risk of adverse health outcomes within these settings.
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is Grip Strength associated with length of stay in hospitalised older patients admitted for rehabilitation findings from the southampton Grip Strength study
Age and Ageing, 2012Co-Authors: Helen C Roberts, Holly E. Syddall, Cyrus Cooper, Avan Aihie SayerAbstract:Background: identification of patients at risk of prolonged hospital stay allows staff to target interventions, provide informed prognosis and manage healthcare resources. Admission Grip Strength is associated with discharge outcomes in acute hospital settings. Objective: to explore the relationship between Grip Strength and length of stay in older rehabilitation in-patients. Design: single-centre prospective cohort study. Setting: community hospital rehabilitation ward. Subjects: one hundred and ten patients aged 70 years and over. Methods: data on age, height, weight, body mass index (BMI), co-morbidities, medication, residence, Grip Strength, physical function, cognitive function, frailty, falls, discharge destination and length of stay were recorded. Results: higher Grip Strength was associated with reduced length of stay, characterised by an increased likelihood of discharge to usual residence among male rehabilitation in-patients (hazard ratio 1.09 (95% confidence interval 1.01, 1.17) per kilo increase in Grip Strength, P= 0.02) after adjustment for age and size. Conclusions: this is the first prospective study to show that stronger Grip Strength, particularly among male in-patients, is associated with a shorter length of stay in a rehabilitation ward. This is important because it demonstrates that Grip Strength can be discriminatory among frailer people. Further research into the clinical applications of Grip Strength measurement in rehabilitation settings is needed.
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is Grip Strength a good marker of physical performance among community dwelling older people
Journal of Nutrition Health & Aging, 2012Co-Authors: P J Stevens, Holly E. Syddall, Avan Aihie Sayer, Cyrus Cooper, H J Martin, Harnish P PatelAbstract:There is increasing interest in physical performance as it relates to both the current and future health of older people. It is often characterised using the Short Physical Performance Battery including assessment of gait speed, chair rises and standing balance. However this battery of tests may not be feasible in all clinical settings and simpler measures may be required. As muscle Strength is central to physical performance, we explored whether Grip Strength could be used as a marker of the Short Physical Performance Battery. To examine associations between Grip Strength and components of the Short Physical Performance Battery in older community dwelling men and women. Grip Strength measurement and the Short Physical Performance Battery were completed in 349 men and 280 women aged 63–73 years taking part in the Hertfordshire Cohort Study (HCS). Relationships between Grip Strength and physical performance (6m timed-up-and-go [TUG], 3m walk, chair rises and standing balance times) were analysed using linear and logistic regression, without and with adjustment for age, anthropometry, lifestyle factors and co-morbidities. Among men, a kilo increase in Grip Strength was associated with a 0.07s (second) decrease in 6m TUG, a 0.02s decrease in 3m walk time, and a 1% decrease in chair rises time (p<0.001 for all). Among women, a kilo increase in Grip Strength was associated with a 0.13s decrease in 6m TUG, a 0.03s decrease in 3m walk time, and a 1% decrease in chair rises time (p<0.001). Higher Grip Strength was associated with better balance among men (p=0.01) but not women (p=0.57). Adjustment for age, anthropometry, lifestyle and co-morbidities did not alter these results. Grip Strength is a good marker of physical performance in this age group and may be more feasible than completing a short physical performance battery in some clinical settings.
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a review of the measurement of Grip Strength in clinical and epidemiological studies towards a standardised approach
Age and Ageing, 2011Co-Authors: Helen C Roberts, Holly E. Syddall, Cyrus Cooper, H J Martin, Harnish P Patel, Hayley J Denison, Avan Aihie SayerAbstract:Background: the European Working Group on Sarcopenia in Older People has developed a clinical definition of sarcopenia based on low muscle mass and reduced muscle function (Strength or performance). Grip Strength is recommended as a good simple measure of muscle Strength when ‘measured in standard conditions’. However, standard conditions remain to be defined. Methods: a literature search was conducted to review articles describing the measurement of Grip Strength listed in Medline, Web of Science and Cochrane Library databases up to 31 December 2009. Results: there is wide variability in the choice of equipment and protocol for measuring Grip Strength. The Jamar hand dynamometer is the most widely used instrument with established test–retest, inter-rater and intra-rater reliability. However, there is considerable variation in how it is used and studies often provide insufficient information on the protocol followed making comparisons difficult. There is evidence that variation in approach can affect the values recorded. Furthermore, reported summary measures of Grip Strength vary widely including maximum or mean value, from one, two or three attempts, with either hand or the dominant hand alone. Conclusions: there is considerable variation in current methods of assessing Grip Strength which makes comparison between studies difficult. A standardised method would enable more consistent measurement of Grip Strength and better assessment of sarcopenia. Our approach is described.
Elaine M Dennison - One of the best experts on this subject based on the ideXlab platform.
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mortality in the hertfordshire ageing study association with level and loss of hand Grip Strength in later life
Age and Ageing, 2017Co-Authors: Holly E. Syddall, Richard M Dodds, Elaine M Dennison, C. Cooper, Leo D Westbury, Avan Aihie SayerAbstract:Background Weak hand Grip Strength in later life is a risk factor for disability, morbidity and mortality and is central to definitions of sarcopenia and frailty. It is unclear whether rate of change in Grip Strength adds to level of Grip Strength as a risk factor for poor ageing outcomes. Methods Study participants were 292 community-dwelling men and women whose Grip Strength was measured during the 1994/5 (average age 67) and 2003/5 (average age 76) phases of the Hertfordshire Ageing Study, UK. Individual rate of change in Grip Strength was estimated using a residual change method. Mortality was followed-up to 2011 (42 men and 21 women died). Results Average Grip Strengths in 2003/5 were 38.4kg (standard deviation [SD] 8.1) and 23.7kg (SD 6.6) for men and women respectively. Average annualised rates of change in Grip Strength (2003/5 minus 1994/5) were modest owing to a healthy-participant effect (men: -0.12kg/year SD 0.71; women: 0.08kg/year SD 0.54) but varied widely. Mortality risk varied according to level and rate of change in Grip Strength (p=0.03); death rates per 100 person years of follow-up were 6.7 (95%CI 4.6,9.6) among participants who lost Grip over time and had low Grip in 2003/5, in contrast with 0.8 (95%CI 0.1,5.8) among participants whose Grip changed little over time and remained high in 2003/5. Conclusions Levels of Grip Strength in later life should be considered in conjunction with estimates of change in Grip Strength identified by repeat measurement over time. Normative data for longitudinal change in Grip Strength are required.
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Grip Strength across the life course normative data from twelve british studies
PLOS ONE, 2014Co-Authors: Richard M Dodds, Elaine M Dennison, Rachel Cooper, Holly E. Syddall, Catharine R Gale, Michaela Benzeval, Ian J Deary, H M Inskip, Carol JaggerAbstract:Introduction: Epidemiological studies have shown that weaker Grip Strength in later life is associated with disability, morbidity, and mortality. Grip Strength is a key component of the sarcopenia and frailty phenotypes and yet it is unclear how individual measurements should be interpreted. Our objective was to produce cross-sectional centile values for Grip Strength across the life course. A secondary objective was to examine the impact of different aspects of measurement protocol. Methods: We combined 60,803 observations from 49,964 participants (26,687 female) of 12 general population studies in Great Britain. We produced centile curves for ages 4 to 90 and investigated the prevalence of weak Grip, defined as Strength at least 2.5 SDs below the gender-specific peak mean. We carried out a series of sensitivity analyses to assess the impact of dynamometer type and measurement position (seated or standing). Results: Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. Males were on average stronger than females from adolescence onwards: males’ peak median Grip was 51 kg between ages 29 and 39, compared to 31 kg in females between ages 26 and 42. Weak Grip Strength, defined as Strength at least 2.5 SDs below the gender-specific peak mean, increased sharply with age, reaching a prevalence of 23% in males and 27% in females by age 80. Sensitivity analyses
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Inflammation, telomere length, and Grip Strength: A 10-year longitudinal study
Calcified Tissue International, 2014Co-Authors: Daniel Baylis, Thomas Von Zglinicki, Diana Kuh, Georgia Ntani, David B Bartlett, Mark H Edwards, Elaine M Dennison, Carmen Martin-ruiz, Holly E. Syddall, Janet M LordAbstract:Telomere attrition has been associated with age-related diseases, although causality is unclear and controversial; low-grade systemic inflammation (inflam-maging) has also been implicated in age-related patho-genesis. Unpicking the relationship between aging, telomere length (TL), and inflammaging is hence essential to the understanding of aging and management of age-related diseases. This longitudinal study explored whether telomere attrition is a cause or consequence of aging and whether inflammaging explains some of the associations between TL and one marker of aging, Grip Strength. We studied 253 Hertfordshire Ageing Study participants at baseline and 10-year follow-up (mean age at baseline 67.1 years). Participants completed a health questionnaire and had blood samples collected for immune–endocrine and telomere analysis at both time points. Physical aging was characterized at follow-up using Grip Strength. Faster telomere attrition was associated with lower Grip Strength at follow-up (b = 0.98, p = 0.035). This association was completely attenuated when adjusted for inflammaging burden (p = 0.86) over the same period. Similarly, greater inflammaging burden was associated with lower Grip Strength at follow-up (e.g., interleukin [IL]-1b: b = -2.18, p = 0.001). However, these associations were maintained when adjusted for telomere attrition (IL-1b, p = 0.006). We present evidence that inflammaging may be driving telomere attrition and in part explains the associations that have previously been reported between TL and Grip Strength. Thus, biomarkers of physical aging, such as in-flammaging, may require greater exploration. Further work is now indicated.
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diet and its relationship with Grip Strength in community dwelling older men and women the hertfordshire cohort study
Journal of the American Geriatrics Society, 2008Co-Authors: S M Robinson, Elaine M Dennison, Holly E. Syddall, Cyrus Cooper, H J Martin, Karen A Jameson, Sue F Batelaan, Avan Aihie SayerAbstract:OBJECTIVES: To examine relationships between diet and Grip Strength in older men and women and to determine whether prenatal growth modifies these relationships. DESIGN: Cross-sectional and retrospective cohort study. SETTING: Hertfordshire, United Kingdom. PARTICIPANTS: Two thousand nine hundred eighty-three men and women aged 59 to 73 who were born and still living in Hertfordshire, United Kingdom. MEASUREMENTS: Weight at birth recorded in Health Visitor ledgers; current food and nutrient intake assessed using an administered food frequency questionnaire; and Grip Strength measured using a handheld dynamometer. RESULTS: Grip Strength was positively associated with height and weight at birth and inversely related to age (all P<.001). Of the dietary factors considered in relation to Grip Strength, the most important was fatty fish consumption. An increase in Grip Strength of 0.43 kg (95% confidence interval (CI)=0.13-0.74) in men (P=.005) and 0.48 kg (95% CI=0.24-0.72) in women (P<.001) was observed for each additional portion of fatty fish consumed per week. These relationships were independent of adult height, age, and birth weight, each of which had additive effects on Grip Strength. There was no evidence of interactive effects of weight at birth and adult diet on Grip Strength. CONCLUSION: These data suggest that fatty fish consumption can have an important influence on muscle function in older men and women. This raises the possibility that the antiinflammatory actions of omega-3 fatty acids may play a role in the prevention of sarcopenia.
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Grip Strength and the metabolic syndrome findings from the hertfordshire cohort study
QJM: An International Journal of Medicine, 2007Co-Authors: Avan Aihie Sayer, Elaine M Dennison, Holly E. Syddall, Cyrus Cooper, H J Martin, D I W Phillips, Christopher D ByrneAbstract:INTRODUCTION: Sarcopenia, the loss of muscle mass and Strength with age, is significantly associated with type 2 diabetes in older people. AIM: To determine whether there is a relationship between Grip Strength and features of the metabolic syndrome. DESIGN: Cross-sectional study. METHODS: Data were collected on Grip Strength, fasting glucose, triglycerides and HDL cholesterol, blood pressure, waist circumference and 2 h glucose after an oral glucose tolerance test, in a population-based sample of 2677 men and women aged 59-73 years. RESULTS: In men and women combined, a standard deviation (SD) decrease in Grip Strength was significantly associated with higher: fasting triglycerides (0.05 SD unit increase, 95%CI 0.02-0.09, p = 0.006); blood pressure (OR 1.13, 95%CI 1.04-1.24, p = 0.004); waist circumference (0.08 SD unit increase, 95%CI 0.06-0.10, p DISCUSSION: Our findings suggest that impaired Grip Strength is associated with the individual features, as well as with the overall summary definitions, of the metabolic syndrome. The potential for Grip Strength to be used in the clinical setting needs to be explored.
H J Martin - One of the best experts on this subject based on the ideXlab platform.
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is Grip Strength a good marker of physical performance among community dwelling older people
Journal of Nutrition Health & Aging, 2012Co-Authors: P J Stevens, Holly E. Syddall, Avan Aihie Sayer, Cyrus Cooper, H J Martin, Harnish P PatelAbstract:There is increasing interest in physical performance as it relates to both the current and future health of older people. It is often characterised using the Short Physical Performance Battery including assessment of gait speed, chair rises and standing balance. However this battery of tests may not be feasible in all clinical settings and simpler measures may be required. As muscle Strength is central to physical performance, we explored whether Grip Strength could be used as a marker of the Short Physical Performance Battery. To examine associations between Grip Strength and components of the Short Physical Performance Battery in older community dwelling men and women. Grip Strength measurement and the Short Physical Performance Battery were completed in 349 men and 280 women aged 63–73 years taking part in the Hertfordshire Cohort Study (HCS). Relationships between Grip Strength and physical performance (6m timed-up-and-go [TUG], 3m walk, chair rises and standing balance times) were analysed using linear and logistic regression, without and with adjustment for age, anthropometry, lifestyle factors and co-morbidities. Among men, a kilo increase in Grip Strength was associated with a 0.07s (second) decrease in 6m TUG, a 0.02s decrease in 3m walk time, and a 1% decrease in chair rises time (p<0.001 for all). Among women, a kilo increase in Grip Strength was associated with a 0.13s decrease in 6m TUG, a 0.03s decrease in 3m walk time, and a 1% decrease in chair rises time (p<0.001). Higher Grip Strength was associated with better balance among men (p=0.01) but not women (p=0.57). Adjustment for age, anthropometry, lifestyle and co-morbidities did not alter these results. Grip Strength is a good marker of physical performance in this age group and may be more feasible than completing a short physical performance battery in some clinical settings.
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a review of the measurement of Grip Strength in clinical and epidemiological studies towards a standardised approach
Age and Ageing, 2011Co-Authors: Helen C Roberts, Holly E. Syddall, Cyrus Cooper, H J Martin, Harnish P Patel, Hayley J Denison, Avan Aihie SayerAbstract:Background: the European Working Group on Sarcopenia in Older People has developed a clinical definition of sarcopenia based on low muscle mass and reduced muscle function (Strength or performance). Grip Strength is recommended as a good simple measure of muscle Strength when ‘measured in standard conditions’. However, standard conditions remain to be defined. Methods: a literature search was conducted to review articles describing the measurement of Grip Strength listed in Medline, Web of Science and Cochrane Library databases up to 31 December 2009. Results: there is wide variability in the choice of equipment and protocol for measuring Grip Strength. The Jamar hand dynamometer is the most widely used instrument with established test–retest, inter-rater and intra-rater reliability. However, there is considerable variation in how it is used and studies often provide insufficient information on the protocol followed making comparisons difficult. There is evidence that variation in approach can affect the values recorded. Furthermore, reported summary measures of Grip Strength vary widely including maximum or mean value, from one, two or three attempts, with either hand or the dominant hand alone. Conclusions: there is considerable variation in current methods of assessing Grip Strength which makes comparison between studies difficult. A standardised method would enable more consistent measurement of Grip Strength and better assessment of sarcopenia. Our approach is described.
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diet and its relationship with Grip Strength in community dwelling older men and women the hertfordshire cohort study
Journal of the American Geriatrics Society, 2008Co-Authors: S M Robinson, Elaine M Dennison, Holly E. Syddall, Cyrus Cooper, H J Martin, Karen A Jameson, Sue F Batelaan, Avan Aihie SayerAbstract:OBJECTIVES: To examine relationships between diet and Grip Strength in older men and women and to determine whether prenatal growth modifies these relationships. DESIGN: Cross-sectional and retrospective cohort study. SETTING: Hertfordshire, United Kingdom. PARTICIPANTS: Two thousand nine hundred eighty-three men and women aged 59 to 73 who were born and still living in Hertfordshire, United Kingdom. MEASUREMENTS: Weight at birth recorded in Health Visitor ledgers; current food and nutrient intake assessed using an administered food frequency questionnaire; and Grip Strength measured using a handheld dynamometer. RESULTS: Grip Strength was positively associated with height and weight at birth and inversely related to age (all P<.001). Of the dietary factors considered in relation to Grip Strength, the most important was fatty fish consumption. An increase in Grip Strength of 0.43 kg (95% confidence interval (CI)=0.13-0.74) in men (P=.005) and 0.48 kg (95% CI=0.24-0.72) in women (P<.001) was observed for each additional portion of fatty fish consumed per week. These relationships were independent of adult height, age, and birth weight, each of which had additive effects on Grip Strength. There was no evidence of interactive effects of weight at birth and adult diet on Grip Strength. CONCLUSION: These data suggest that fatty fish consumption can have an important influence on muscle function in older men and women. This raises the possibility that the antiinflammatory actions of omega-3 fatty acids may play a role in the prevention of sarcopenia.
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Grip Strength and the metabolic syndrome findings from the hertfordshire cohort study
QJM: An International Journal of Medicine, 2007Co-Authors: Avan Aihie Sayer, Elaine M Dennison, Holly E. Syddall, Cyrus Cooper, H J Martin, D I W Phillips, Christopher D ByrneAbstract:INTRODUCTION: Sarcopenia, the loss of muscle mass and Strength with age, is significantly associated with type 2 diabetes in older people. AIM: To determine whether there is a relationship between Grip Strength and features of the metabolic syndrome. DESIGN: Cross-sectional study. METHODS: Data were collected on Grip Strength, fasting glucose, triglycerides and HDL cholesterol, blood pressure, waist circumference and 2 h glucose after an oral glucose tolerance test, in a population-based sample of 2677 men and women aged 59-73 years. RESULTS: In men and women combined, a standard deviation (SD) decrease in Grip Strength was significantly associated with higher: fasting triglycerides (0.05 SD unit increase, 95%CI 0.02-0.09, p = 0.006); blood pressure (OR 1.13, 95%CI 1.04-1.24, p = 0.004); waist circumference (0.08 SD unit increase, 95%CI 0.06-0.10, p DISCUSSION: Our findings suggest that impaired Grip Strength is associated with the individual features, as well as with the overall summary definitions, of the metabolic syndrome. The potential for Grip Strength to be used in the clinical setting needs to be explored.
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is Grip Strength associated with health related quality of life findings from the hertfordshire cohort study
Age and Ageing, 2006Co-Authors: Avan Aihie Sayer, Elaine M Dennison, Holly E. Syddall, Helen C Roberts, H J Martin, Cyrus CooperAbstract:Objective: to investigate the relationship between Grip Strength and health-related quality of life (HRQoL). Design: cross-sectional survey within a cohort study design. Setting: the county of Hertfordshire in the UK. Participants: a total of 2,987 community-dwelling men and women aged 59–73 years of age. Measurements: Grip Strength was used as a marker of sarcopaenia and measured using a Jamar dynamometer. HRQoL was assessed using the eight domain scores of the Short Form-36 (SF-36) questionnaire, and subjects in the lowest sex-specific fifth of the distribution were classified as having ‘poor’ status for each domain. Results: men and women with lower Grip Strength were significantly more likely to report a poor as opposed to excellent to fair overall opinion of their general health (GH) [odds ratio (OR) per kilogram decrease in Grip Strength = 1.13, 95% CI = 1.06–1.19, P<0.001 in men, 1.13, 95% CI = 1.07–1.20, P<0.001 in women]. Among men, after adjustment for age, size, physical activity and known co-morbidity, decreased Grip Strength was associated with increased prevalence of poor SF-36 scores for the physical functioning (PF) (OR per kilogram decrease in Grip Strength = 1.03, 95% CI = 1.01–1.06, P = 0.007) and GH domains (OR = 1.03, 95% CI = 1.01–1.05, P = 0.01). Similar associations were seen in women. Conclusions: our findings suggest that lower Grip Strength is associated with reduced HRQoL in older men and women. This does not appear to be explained by age, size, physical activity or co-morbidity and may reflect the link between sarcopaenia and generalised frailty. Individuals with sarcopaenia may benefit from interventions to improve muscle mass and Strength before the onset of chronic disorders usually associated with impaired HRQoL.
