Maicon Luís Bicigo Delinocente1, Danilo Henrique Trevisan de Carvalho2, Roberta de Oliveira Máximo2, Marcos Hortes Nisihara Chagas3, Jair Licio Ferreira Santos4, Yeda Aparecida de Oliveira Duarte5, Andrew Steptoe6, Cesar de Oliveira6, Tiago da Silva Alexandre7. 1. Post graduate program in Gerontology, Federal University of São Carlos, São Carlos, Brazil. 2. Post graduate program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil. 3. Post graduate program in Gerontology, Federal University of São Carlos, São Carlos, Brazil; Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil. 4. Department of Social Medicine, University of São Paulo, Ribeirão Preto, Brazil. 5. Department of Medical-surgical Nursing, University of São Paulo, São Paulo, Brazil. 6. Department of Epidemiology and Public Health, University College London, London, UK. 7. Post graduate program in Gerontology, Federal University of São Carlos, São Carlos, Brazil; Post graduate program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil; Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil; Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: tiagoalexandre@ufscar.br.
Abstract
BACKGROUND/ OBJECTIVE: Mobility limitation is commonly the first sign of impaired physical function and predisposes older adults to disability. Moreover, recent epidemiological studies have classified neuromuscular strength as the best explanator of mobility limitation. However, existing cutoffs have not been adequately analyzed regarding accuracy. Therefore, our aims were to define and compare the accuracy of different cutoff points of handgrip strength for the identification of mobility limitation. METHODS: Cross-sectional study with 5783 participants from the SABE (Saúde, Bem-Estar e Envelhecimento [Health, Wellbeing and Aging]) and ELSA (English Longitudinal Study of Ageing) cohorts aged 60 years or older. Handgrip strength was measured using a dynamometer. Walking speed <0.8 m/s was considered mobility limitation. Receiver operating characteristic curves and probabilities of presenting mobility limitation were calculated. RESULTS: Handgrip strength <32 kg for men and <21 kg for women demonstrated good diagnostic accuracy for mobility limitation, with 49.1% sensitivity and 79.8% specificity for men and 58.6% sensitivity and 72.9% specificity for women. The fully adjusted models had an area under the curve of 0.82 for men and 0.83 for women, with odds of presenting mobility limitation of 1.88 [95% CI: 1.50 - 2.37] for men and 1.89 [95% CI: 1.57 - 2.27] for women. CONCLUSIONS: The results of this study support the accuracy of handgrip strength as a clinical marker of mobility limitation. Furthermore, manual dynamometry is easily incorporated into clinical practice, has a good cost-benefit, besides being a simple, valid, reliable and effective method for use in both the scientific community and outpatient practice.
BACKGROUND/ OBJECTIVE: Mobility limitation is commonly the first sign of impaired physical function and predisposes older adults to disability. Moreover, recent epidemiological studies have classified neuromuscular strength as the best explanator of mobility limitation. However, existing cutoffs have not been adequately analyzed regarding accuracy. Therefore, our aims were to define and compare the accuracy of different cutoff points of handgrip strength for the identification of mobility limitation. METHODS: Cross-sectional study with 5783 participants from the SABE (Saúde, Bem-Estar e Envelhecimento [Health, Wellbeing and Aging]) and ELSA (English Longitudinal Study of Ageing) cohorts aged 60 years or older. Handgrip strength was measured using a dynamometer. Walking speed <0.8 m/s was considered mobility limitation. Receiver operating characteristic curves and probabilities of presenting mobility limitation were calculated. RESULTS: Handgrip strength <32 kg for men and <21 kg for women demonstrated good diagnostic accuracy for mobility limitation, with 49.1% sensitivity and 79.8% specificity for men and 58.6% sensitivity and 72.9% specificity for women. The fully adjusted models had an area under the curve of 0.82 for men and 0.83 for women, with odds of presenting mobility limitation of 1.88 [95% CI: 1.50 - 2.37] for men and 1.89 [95% CI: 1.57 - 2.27] for women. CONCLUSIONS: The results of this study support the accuracy of handgrip strength as a clinical marker of mobility limitation. Furthermore, manual dynamometry is easily incorporated into clinical practice, has a good cost-benefit, besides being a simple, valid, reliable and effective method for use in both the scientific community and outpatient practice.
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