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The association between nutritional status and handgrip strength in older Rwandan refugees


Objectives: To investigate the association between nutritional status and handgrip strength in older Rwandan refugees.

Design: Cross-sectional study.

Setting: Rwandan refugee camp located in Karagwe district in the north-west of Tanzania. The study was carried out in the post-emergency phase. The response rate was 85%.

Subjects: A total of 413 men and 415 women aged 50–92 y participated in the study.

Methods: Weight, height, mid-upper-arm circumference (MUAC) and triceps skinfold were obtained using standard techniques. For people with visible kyphosis, height was estimated from armspan using regression equations developed from non-kyphotic subjects within the sample. Handgrip was measured using a mechanical handgrip dynamometer. Information regarding physical activity and health status was obtained by interview and clinical screening.

Results: Handgrip strength (kg) was significantly higher in men than in women (30.3±6.7 vs 22.3±5.1), and significantly lower in each older age group in both sexes. Handgrip strength was positively correlated to BMI (body mass index) and AMA (arm muscle area). The relative risk of impaired handgrip strength in individuals with poor nutritional status (BMI<18.5 kg/m2) compared with those of adequate nutritional status was 1.75. After controlling for potential confounders (sex, age and height), BMI remained a significant contributor to the variation in handgrip strength.

Conclusion: Poor nutritional status is associated with poor handgrip strength independent of sex, age and height, in this refugee population. This may indicate that underweight older people are likely to have more difficulties in functioning independently in the community. Research is needed to investigate if improving nutritional status can lead to better functional ability.

Sponsorship: Department for International Development (UK) and HelpAge International.

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  1. Although this is an arbitrary cut-off, it does not assume any particular distribution and it is population-referenced rather than based on any criteria. Non-performers were recoded as ‘impaired’.


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The Department for International Development (UK) was the main funder of this study. HelpAge International initiated and partly funded the study and provided logistical and other support in collaboration with HelpAge Tanzania. None of these organisations are responsible for the content of this article. We are grateful to the field team and the study participants for their invaluable contributions.

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Pieterse, S., Manandhar, M. & Ismail, S. The association between nutritional status and handgrip strength in older Rwandan refugees. Eur J Clin Nutr 56, 933–939 (2002).

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