A cross-cohort investigation of grip strength across the life course

Abstract

Introduction: Grip strength across the life course is associated with disability, morbidity and mortality, and forms a key component of the sarcopenia and frailty phenotypes in older people. However it is unclear how individual measurements of grip strength should be interpreted. My objectives were to produce centile values for grip strength across the life course in Great Britain (GB), and then to compare with those in international settings.

Methods: I combined data from 12 general population studies in GB to produce centile curves using the Box-Cox Cole and Green distribution. I estimated the prevalence of weak grip, defined as at least 2.5 SDs below the gender-specific peak mean. I then did a systematic literature search and expressed the resulting international normative data as Z-scores relative to my British centiles. I used metaregression to pool these by world region.

Results: I combined 60,803 grip strength observations from GB at ages 4 to 90. I saw an increase to a peak median in early adulthood of 51kg in males and 31kg in females, maintenance to midlife and then decline. The prevalence of weak grip increased with age, reaching 23% in males and 27% in females by age 80. My systematic literature search returned 60 papers containing 730 international normative data items. Those from developed regions were similar to my GB centiles, pooled Z-score 0.12 (95% CI: 0.07, 0.17), whereas those from developing regions were clearly lower, pooled Z-score -0.86 (95% CI: -0.95, -0.77).

Conclusion: My GB centiles are the first to cover the entire life course. Published normative data showed a similar pattern, but with clear differences in magnitude between developing and developed regions. The findings have the potential to inform the clinical assessment of grip strength, recognised as an important part of the identification of people with sarcopenia and frailty

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Identifiers

ORCID for Richard Dodds: orcid.org/0000-0003-4968-7678

ORCID for Holly Syddall: orcid.org/0000-0003-0171-0306

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