The effect of grip strength on geriatric syndromes in elderly inpatients / 中华老年医学杂志

ABSTRACT

Objective:To investigate the occurrence of geriatric syndromes in elderly inpatients with different grip strength levels and the effect of grip strength on geriatric syndromes and thus to provide insight for the management of geriatric syndromes in elderly inpatients.Methods:A total of 225 elderly inpatients who had received comprehensive geriatric assessment at the geriatrics department of our hospital were selected retrospectively, and their general and geriatric syndrome data were collected.With grip strength of 28 kg for men and 18 kg for women as the cut-offs, the patients were divided into the normal grip strength group(114 cases)and the decreased grip strength group(111 cases). Based on demographic characteristics including age, gender, type of work, income, educational background and social support, 1∶1 propensity score matching(PSM)for the two groups was conducted, successfully resulting in a total of 77 pairs.Differences in geriatric syndromes between the two groups were compared, and the relationship between grip strength and geriatric syndromes was analyzed in these elderly inpatients.Results:After adjustment for the general demographic characteristics by PSM, the decreased grip strength group showed higher rates than the normal grip strength group of frailty/pre-frailty(87.0% vs.55.8%), disability(53.2% vs.27.3%), malnutrition/malnutrition risk(57.1% vs.22.1%), cognitive impairment(35.1% vs.9.1%), constipation(44.2% vs.20.8%), falls(32.5% vs.13.0%)and number of geriatric syndromes(4, range 2-5 vs.2, range 0-4)and higher Carlson comorbidity index(CCI)scores(6, range 5-8 vs.5range 4-6)and higher body mass index scores[(25±3)kg/m 2vs.(23±4)kg/m 2](all P<0.05). There was no significant difference in the incidence of pain, sleep disorders, depression, anxiety or polypharmacy, or in short physical performance scores between the two groups(all P>0.05). Spearman correlation analysis showed that decreased grip strength was positively correlated with the incidence of frailty/pre-frailty( r= 0.345), disability( r= 0.265), malnutrition/malnutrition risk( r= 0.358), cognitive impairment( r=0.313), constipation( r= 0.250), falls( r= 0.232)and number of geriatric syndromes( r=0.370)(all P<0.05). There was no significant correlation between grip strength and the incidence of pain, sleep disorder, depression or anxiety(all P> 0.05). Multivariate logistic regression analysis showed that, compared with the normal grip strength group, the decreased grip strength group had a higher risk of developing geriatric syndromes such as frailty/pre-frailty( OR=10.906), disability( OR=4.025), malnutrition/ malnutrition risk( OR=2.699), cognitive impairment( OR=6.620), constipation( OR=2.848)and falls( OR=4.145, all P<0.05). Conclusions:Decreased grip strength is an independent risk factor for many common geriatric syndromes such as frailty/pre-frailty, disability, malnutrition/ malnutrition risk, cognitive impairment, constipation and falls.Elderly patients with decreased grip strength should be a key population group when screening for geriatric syndromes.