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Health issues and nutrition in the elderly

Handgrip strength as a valid practical tool to screen early-onset sarcopenia in acute care wards: a first evaluation

Abstract

Background/objectives

Sarcopenia is an age-related muscle disease associated with higher mortality, morbidity risk and health costs. An easy and convenient sarcopenia screening test would be hugely valuable for clinical critical care. The study aimed to assess handgrip strength (HGS) as a screening tool for sarcopenia in acute care-unit inpatients, using the EWGSOP 1 reference-standard definition.

Subjects/methods

Inpatients, aged 75 years old or above, of two acute care wards—a multidisciplinary care unit (MCU) and a geriatric care unit (GCU), were included between September 2017 and June 2018 in a cross-sectional study. HGS, sarcopenia, nutritional status, functional status, number of medications and sociodemographic data were collected. The accuracy of HGS as a screening test for sarcopenia was assessed by gender using receiver operating characteristic (ROC) curves and area under the curve (AUC) in a population of older patients (n = 223; age: 85.8 yrs; BMI: 26.7 kg/m²).

Results

Screening was positive (patients confirmed with sarcopenia by the HGS test) with cut-off values of 18 kg for women and 25.5 kg for men, with ROC analysis giving a sensitivity of 92.9% in women and 78.6% in men. ROC curve analysis found also that HGS should be strictly higher than 15 kg in women and 18 kg in men to maximise AUC. Prevalence of sarcopenia according to the EWGSOP1 definition was 31.8% (95% CI: 22.1–41.6%) in the MCU and 27.8% (95% CI: 19.6–36.0%) in the GCU.

Conclusions

Acute care wards can use HGS as a valid, easy tool for early screening of sarcopenia.

Highlights

  • Handgrip strength is a valid and clinically practicable test, for screening early-onset sarcopenia during hospitalisation.

  • Handgrip strength cut-off values of 18 kg in women and 25.5 kg in men gave 92.9% and 78.6% sensitivity, respectively.

  • One-third of patients admitted to acute care wards have sarcopenia.

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Fig. 1: In women, ROC curves is for HGS > 15 kg and in men for HGS > 18 kg.

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Acknowledgements

The research team thanks paramedical and medical staff of the two acute care wards.

Funding

The study was funded by Clermont-Ferrand University Hospital and two local hospitals. The study was sponsored by Nutriset and Nutricia (support from a national congress research price). These financial supports played no role in the design, execution, analysis and interpretation of the data.

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Authors

Contributions

MB was responsible for designing the protocol, writing the protocol, conducting the clinical research, interpreting results and writing the article. GD was responsible for designing the protocol, conducting the clinical research and reading the article. AS was responsible for reading the article. SD and NF were responsible for designing the protocol and writing the article. VG was responsible for conducting the clinical research and reading the article. CGA and PB were responsible for designing the protocol, writing the protocol, extracting and analysing data, interpreting results and writing the article. JB was responsible for designing the protocol and reading the article. YB and LG were responsible for designing the protocol, interpreting results and writing the article.

Corresponding author

Correspondence to Marie Blanquet.

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Blanquet, M., Ducher, G., Sauvage, A. et al. Handgrip strength as a valid practical tool to screen early-onset sarcopenia in acute care wards: a first evaluation. Eur J Clin Nutr 76, 56–64 (2022). https://doi.org/10.1038/s41430-021-00906-5

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