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Interventions and public health nutrition

Prevalence of weakness and its relationship with limitations based on the Foundations for the National Institutes for Health project: data from the Health and Retirement Study

European Journal of Clinical Nutrition volume 70, pages 1168–1173 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

The objectives of this study were to determine the prevalence of muscle weakness using the two 2014 Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria and its relationship with physical limitations, basic activities of daily living (ADL) and instrumental ADL.

Subjects/Methods:

We performed a cross-sectional analysis of community-dwelling adults from the Health and Retirement Study 2006–2008 and identified a subsample of 5092 adults aged ⩾60 years with grip strength (GS) data. Self-reported physical limitations, basic ADL and instrumental ADL were assessed. Criteria for GS (men<26 kg; women <16 kg) and GS adjusted for body mass index (GS/BMI; men <1.0; women <0.56) were applied to the sample. We determined the prevalence of muscle weakness in each sex. Multivariable logistic regression was used to calculate the association of physical limitations, basic ADL and instrument ADL with weakness definitions in each sex.

Results:

Mean age was 72.1 years (54.9% female). Mean GS was 38.3 and 22.9 kg and mean BMI was 29 kg/m2, respectively, in men and women. Weakness prevalence using GS and GS:BMI definitions were 7.8 and 15.2 (P<0.001), respectively, in men and 11.4 and 13.3% (P=0.04) in women. Overall prevalence of physical limitations, basic ADL limitations and instrumental ADL limitations was 52.9, 28.1 and 35.9%, respectively. In those with weakness, prevalence of physical limitations, basic ADL and instrumental ADL was 78.5, 42.3 and 65.3%, respectively, using the GS definition, and 79.7, 40.7 and 58.8%, respectively, using the GS/BMI definition. GS and the GS/BMI definitions of weakness were strongly associated with physical limitations (odds ratio (OR) 2.19 (95% confidence interval (CI): (1.67–2.87)) and 2.52 (2.01–3.17)), basic ADL (OR 1.59 (1.22–2.07) and 1.66 (1.32–2.07)) and instrumental ADLs (OR 1.98 (1.28–2.54) and 1.78 (1.44–2.20)).

Conclusions:

The new FNIH guidelines for weakness are associated with higher prevalence of physical limitations, basic ADL impairments and instrumental ADL impairments as compared with individuals without weakness.

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Acknowledgements

This work was funded in part by the Department of Medicine, Geisel School of Medicine at Dartmouth and the Dartmouth Centers for Health and Aging. Support was also provided in part by the Dartmouth Health Promotion and Disease Prevention Research Center supported by Cooperative Agreement Number U48DP005018 from the Centers for Disease Control and Prevention. The findings and conclusions in this journal article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author contributions

JAB—conception, design, acquired data, analysis and interpretation, drafted the article, and final approval of the version to be published. CMG—conception, design, acquired data, analysis and interpretation, revised the article critically for important intellectual content, and final approval of the version to be published. EV—conception, design, acquired data, analysis and interpretation, revised article critically for important intellectual content, and final approval of the version to be published. SJB—analysis and interpretation, revised article critically for important intellectual content, and final approval of the version to be published.

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Authors and Affiliations

  1. Section of General Internal Medicine, Dartmouth–Hitchcock Medical Center, Lebanon, NH, USA

    J A Batsis

  2. Geisel School of Medicine at Dartmouth, Lebanon, NH, USA

    J A Batsis, C M Germain & S J Bartels

  3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA

    J A Batsis, C M Germain & S J Bartels

  4. Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH, USA

    J A Batsis & S J Bartels

  5. Health Promotion Research Center at Dartmouth, Lebanon, NH, USA

    J A Batsis & S J Bartels

  6. Dartmouth Weight & Wellness Center, Lebanon, NH, USA

    J A Batsis

  7. School of Public Health, University at Albany, State University of New York, NY, USA

    E Vásquez

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  1. J A Batsis
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Corresponding author

Correspondence to J A Batsis.

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Competing interests

JAB receives funding from Health Resources Services Administration (UB4HP19206-01-00) for medical geriatric teaching, the Junior Faculty Career Development Award, the Department of Medicine, Dartmouth–Hitchcock Medical Center, the Dartmouth Centers for Health and Aging, the National Institute of Mental Health (K12 HS0217695 (AHRQ), NIMH: T32 MH073553, R01 MH078052, R01 MH089811; R24 MH102794; CDC U48DP005018). The remaining authors declare no conflict of interest.

Additional information

Work presented at the International Conference on Frailty and Sarcopenia 2015, Boston, MA, USA.

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

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Batsis, J., Germain, C., Vásquez, E. et al. Prevalence of weakness and its relationship with limitations based on the Foundations for the National Institutes for Health project: data from the Health and Retirement Study. Eur J Clin Nutr 70, 1168–1173 (2016). https://doi.org/10.1038/ejcn.2016.90

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