Korean Journal of Family Medicine

"Hand Strength"

Original Articles

Cancer Survivors with Low Hand Grip Strength Have Decreased Quality of Life Compared with Healthy Controls: The Korea National Health and Nutrition Examination Survey 2014–2017: Hyunji Kim, Sunmi Yoo, Hyoeun Kim, Seung Guk Park, Minkyu Son; Korean J Fam Med 2021;42(3):204-211. Published online May 20, 2021; DOI: https://doi.org/10.4082/kjfm.20.0060

Abstract
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Background
Cancer survivors experience decreased physical function and reduced muscle strength, which leads to lower quality of life (QOL). The hand grip strength (HGS) can be a predictor of poor health-related QOL as a parameter of sarcopenia. The purpose of this study was to investigate the relationship between low HGS and QOL in cancer survivors and healthy controls.
Methods
We analyzed 392 cancer survivors and 1,176 healthy controls from the Korea National Health and Nutrition Examination Survey, 2014–2017. We defined low HGS as 2 standard deviation values for healthy young Korean adults from a previous study. QOL was evaluated using the European Quality of Life Scale-Five Dimensions. A complex sample logistic regression model was used to assess the relationship between each dimension of low HGS and QOL.
Results
The odds ratios (ORs) for decreased QOL were significantly higher in male cancer survivors with low HGS on self-care (OR, 8.51; 95% confidence interval [CI], 1.69–42.83) and usual activities (OR, 6.63; 95% CI, 1.22–36.03). The ORs for problems in mobility (OR, 5.87; 95% CI, 2.04–16.91), usual activities (OR, 14.46; 95% CI, 3.84–54.44), pain/discomfort (OR, 4.90; 95% CI, 2.00–12.01), and anxiety/depression (OR, 6.43; 95% CI, 2.16–19.12) were significantly high in female cancer survivors with low HGS. However, healthy controls showed no significant relationship between low HGS and QOL.
Conclusion
For cancer survivors, low HGS was associated with poor QOL in some domains. Strategies to increase muscle strength must be considered to improve the QOL of cancer survivors.

Citations

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Association between handgrip strength, handgrip strength asymmetry, and anxiety in Korean older adults: The Korean National Health and Nutrition Examination Survey 2022
Sang-Youn Choi, Su-Min Park, Eun-Cheol Park, Marina De Rui
PLOS ONE.2025; 20(4): e0315256. CrossRef
The quality of life impacting factors in malnourished patients with gastric cancer
Hong Zhao, Chenan Liu, Guotian Ruan, Xin Zheng, Yue Chen, Shiqi Lin, Xiaoyue Liu, Jinyu Shi, Xiangrui Li, Shuqun Li, Hanping Shi
Frontiers in Oncology.2024;[Epub] CrossRef
Cardiovascular and metabolic determinants of quality of life in patients with cancer
Ruben Evertz, Katharina Gödde, Christine Diehl, Miroslava Valentova, Tania Garfias‐Veitl, Friederike Braulke, Gerald G. Wulf, Tobias R. Overbeck, Annalen Bleckmann, Alexander O. König, Pia Weinländer, Sophia Potthoff, Sara Hadzibegovic, Alessia Lena, Ulri
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Understanding Heterogeneity in the Relationship Between Cancer and Hand Grip Strength: A Longitudinal Analysis
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Better Handgrip Strength Is Related to the Lower Prevalence of Pain and Anxiety in Community-Dwelling Older Adults
Natalia Sosowska, Agnieszka Guligowska, Bartłomiej Sołtysik, Ewa Borowiak, Tomasz Kostka, Joanna Kostka
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Predictors of lower exercise capacity in patients with cancer
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NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain
Leidy Tatiana Ordoñez-Mora, Ilem D Rosero, Marco Antonio Morales-Osorio, Rocío Guil, Giancarlo Quintero Jordan, Julian Alberto Agudelo Jimenez, Katherine Gonzalez-Ruiz, Juan Carlos Avila-Valencia
BMJ Open.2023; 13(9): e071493. CrossRef
Differences in Health-Related Quality of Life in Older People with and without Sarcopenia Covered by Long-Term Care Insurance
Masahiro Kitamura, Kazuhiro P. Izawa, Kodai Ishihara, Peter H. Brubaker, Hiroaki Matsuda, Soichiro Okamura, Koji Fujioka
European Journal of Investigation in Health, Psychology and Education.2022; 12(6): 536. CrossRef
Associations of Physical Activity and Handgrip Strength with Health-Related Quality of Life in Older Korean Cancer Survivors
Jeonghyeon Kim, Seamon Kang, Donghyun Kim, Hyunsik Kang
Cancers.2022; 14(24): 6067. CrossRef
Differences in the Relationships Between Muscle Strength, Muscle Mass, Balance Function, and Quality of Life for Middle-Aged and Older Breast Cancer Survivors
Shinichiro Morishita, Ryuichi Kasahara, Yuichi Yamamoto, Ryohei Jinbo, Aya Takano, Mitsuhiko Yasuda, Atsuhiro Tsubaki, Osamu Aoki, Jack B. Fu, Tetsuya Tsuji
Integrative Cancer Therapies.2022;[Epub] CrossRef

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Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging: Kyung Hyun Bae, Yong Ho Jo, Dong Ryul Lee, Jungun Lee; Korean J Fam Med 2021;42(1):38-46. Published online May 27, 2020; DOI: https://doi.org/10.4082/kjfm.19.0140

Background
Handgrip strength (HGS) is a good predictor of adverse health outcomes in later life. This prospective study aimed to investigate whether HGS trajectory patterns were associated with all-cause mortality among older adults in Korea.
Methods
This study used the database of the 2006–2016 Korean Longitudinal Study of Aging. Study participants included 3,069 adults aged ≥65 years without a previous history of cancer. The trajectory model was developed to identify different homogeneous trajectory patterns of HGS according to study period. Cox proportional hazards models were then applied to investigate the association between HGS and all-cause mortality.
Results
The survival probability according to HGS during the follow-up period decreased as base HGS weakened. We identified four distinct trajectory groups of HGS among men and three among women. The risk of mortality increased as the HGS of both males and females decreased. Compared with the highest HGS group, the adjusted hazard ratios for all-cause mortality of the lowest, lower-mid, and upper-mid HGS groups among males were 3.46 (95% confidence interval [CI], 2.17–6.69), 2.26 (95% CI, 1.47–3.48), and 1.58 (95% CI, 1.07–2.32). Those of the low and mid HGS groups among females were 2.69 (95% CI, 1.39–5.21) and 1.97 (95% CI, 1.05–3.69).
Conclusion
The faster HGS declined over time, the greater the all-cause mortality risk increased compared with the slowly decreasing or maintained HGS groups among men and women. HGS measurement among older adults will be helpful in assessing their health statuses and pre-assessing disease-associated morbidity.

Citations

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Alexandre Duarte Martins, Nuno Batalha, Orlando Fernandes, Bruno Gonçalves, Rafael Oliveira, Joao Paulo Brito
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Hui Chang, Yu Zhao
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Wonjeong Jeong, Jong Youn Moon, Jae-Hyun Kim
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Yun-A Shin, Won-Ho Choi, Jae-Hyun Kim
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Rubén López-Bueno, Lars Louis Andersen, Joaquín Calatayud, José Casaña, Lee Smith, Louis Jacob, Ai Koyanagi, José Francisco López-Gil, Borja del Pozo Cruz
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Association of Hand Grip Strength and Cardiometabolic Markers in Korean Adult Population: The Korea National Health and Nutrition Examination Survey 2015-2016: Hanul Chong, Young Eun Choi, Jin Young Kong, Joo Hyun Park, Hyun Jeong Yoo, Jeong Ho Byeon, Hye Jun Lee, Sang Hyun Lee; Korean J Fam Med 2020;41(5):291-298. Published online May 8, 2020; DOI: https://doi.org/10.4082/kjfm.18.0129

Abstract
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Background
Muscle strength has been suggested as a cardiovascular marker. The aim of this study was to examine the associations between hand grip strength and biomarkers of cardiovascular disease in the Korean population.
Methods
A total of 9,083 participants aged 20–80 years from Korea National Health and Nutrition Examination Survey 2015–2016 were investigated.
Results
Among men, both relative and dominant hand grip strength showed a positive association with diastolic blood pressure in those aged 65–80 years (95% confidence interval, P-value of dominant and relative hand grip strength: β=0.06, 0.01; P<0.05). Among women, relative and dominant hand grip strength showed a positive relationship to diastolic blood pressure in those aged 20–64 years (β=0.06, 0.01; P<0.001). Body mass index was positively associated with dominant hand grip strength in younger women (β=0.18, P<0.05), whereas it was positively associated with relative hand grip strength in all sex and age groups. High-sensitivity C-reactive protein showed a negative association with relative and dominant hand grip strength in all women, although the same association was observed only in younger men. Diabetes was inversely related to hand grip strength in younger women and men.
Conclusion
Increased hand grip strength may be associated with lower C-reactive protein in women and with less risk of diabetes in the Korean adult population. Further prospective studies are needed for the determination of causality between cardiometabolic markers and hand grip strength.

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Suey S.Y. Yeung, Timothy Kwok, Jean Woo
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Guochen Li, Yanqiang Lu, Liping Shao, Luying Wu, Yanan Qiao, Yi Ding, Chaofu Ke
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Lower handgrip strength levels probably precede triglyceride glucose index and associated with diabetes in men not in women
Jia Zheng, Lu Zhang, Min Jiang
Journal of Diabetes Investigation.2022; 13(1): 148. CrossRef
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21 Web of Science
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Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014–2015 Korea National Health and Nutrition Examination Survey: Bo Mi Kim, Yu Hyeon Yi, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Young Hye Cho, Young Jin Tak, Hye Rim Hwang, Seung Hun Lee, Eun Ju Park, Youngin Lee; Korean J Fam Med 2020;41(6):404-411. Published online February 12, 2020; DOI: https://doi.org/10.4082/kjfm.19.0073

Abstract
PDF

Background
Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia.
Methods
We included 6,027 adults (2,934 men, 3,093 women) aged 30–69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia.
Results
After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00–1.83), 1.29 (0.98–1.70), 1.23 (0.95– 1.60) in men and 1.81 (1.30–2.50), 1.81 (1.32–2.47), 1.39 (1.07–1.81) in women, respectively.
Conclusion
Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.

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Could calisthenic exercises improve maximal exercise capacity, peripheral muscle strength and quality of life in dyslipidemia?
Furkan Özdemir, Melda Sağlam, Aydan Aslı Aksel Uylar, Oğuz A. Uyaroğlu, Nursel Çalik Başaran, Mine Durusu Tanriöver, Naciye Vardar Yağli, Hasan Sozen
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Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations
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Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries
Rizwan Qaisar, M. Azhar Hussain, Fabio Franzese, Asima Karim, Firdos Ahmad, Atif Awad, Abeer A. Al-Masri, Shaea A. Alkahtani
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
Increasing muscular strength to improve cardiometabolic risk factors
Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
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Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people
Wonjeong Jeong, Jong Youn Moon, Jae-Hyun Kim
BMC Geriatrics.2023;[Epub] CrossRef
Identification of subgroups with poor lipid control among patients with dyslipidemia using decision tree analysis: the Korean National Health and Nutrition Examination Survey from 2019 to 2021
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2023; 25(2): 131. CrossRef
Increasing muscular strength to improve cardiometabolic risk factors
Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
Clínica e Investigación en Arteriosclerosis (English Edition).2023; 35(3): 144. CrossRef
Association between Relative Handgrip Strength and Insulin Resistance in Korean Elderly Men without Diabetes: Findings of the 2015 Korea National Health Nutrition Examination Survey
Kwang-Chae Joo, Da-Hye Son, Jae-Min Park
Korean Journal of Family Medicine.2022; 43(3): 199. CrossRef
Association Between C-Reactive Protein and Relative Handgrip Strength in Postmenopausal Korean Women Aged 45–80 Years: A Cross-Sectional Study
Da-Hye Son, Seung-Ah Song, Yong-Jae Lee
Clinical Interventions in Aging.2022; Volume 17: 971. CrossRef
Relationship Between Relative Grip Strength and Serum Total Cholesterol, High-Density Lipoprotein Cholesterol, Low-Density Lipoprotein Cholesterol, and Triglyceride Levels in Korean Middle-Aged or Older Adults: A Panel Regression Model
DooYong Park, Duck-Chul Lee, YeonSoo Kim
Metabolic Syndrome and Related Disorders.2022; 20(9): 517. CrossRef
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Importance of Handgrip Strength as a Health Indicator in the Elderly
Soo Young Kim
Korean Journal of Family Medicine.2021; 42(1): 1. CrossRef
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Sang Yoon Lee
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Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population
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Nutrición Hospitalaria.2021;[Epub] CrossRef
Grip Strength as a Cardiometabolic Marker
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Korean Journal of Family Medicine.2020; 41(5): 271. CrossRef

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Relationship between Sedentary Time and Handgrip Strength in Healthy Korean Women: Korea National Health and Nutrition Examination Survey 2014–2016: Seung-Yeon Lee, Da-Hye Son, Yong-Jae Lee; Korean J Fam Med 2020;41(6):422-426. Published online January 6, 2020; DOI: https://doi.org/10.4082/kjfm.19.0062

Abstract
PDF

Background
This study aimed to examine the association between sitting time and handgrip strength in healthy Korean women.
Methods
A total of 5,437 participants were included from the Korea National Health and Nutrition Examination Survey 2014–2016. The overall daily sitting time was estimated using health interview surveys, and handgrip strength was assessed using a digital hand dynamometer. The relationship between sitting time and handgrip strength was calculated with a weighted analysis of covariance after adjusting for confounding variables.
Results
Participants in each age group (19–39, 40–64, ≥65 years) were divided into three categories according to sitting time: ≤5, 6–9, and ≥10 h/d. The handgrip strength tended to decrease as sitting time increased after adjusting for age, body mass index, alcohol intake, cigarette smoking, resistance exercise, aerobic physical activity, household income, education level, hypertension, diabetes mellitus, dyslipidemia, and depression in all age groups (all P<0.001).
Conclusion
We observed the inverse relationship between sitting time and handgrip strength in healthy Korean women.

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Jaden E. Levinson, Rachel N. Logue Cook, Susan H. Brown
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Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef
Importance of Handgrip Strength as a Health Indicator in the Elderly
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Effects of 12 Weeks of Strength Training and Gluten-Free Diet on Quality of Life, Body Composition and Strength in Women with Celiac Disease: A Randomized Controlled Trial
Alejandro Martínez-Rodríguez, Daniela Alejandra Loaiza-Martínez, Javier Sánchez-Sánchez, Jacobo A. Rubio-Arias, Fernando Alacid, Soledad Prats-Moya, María Martínez-Olcina, Rodrigo Yáñez-Sepúlveda, Nuria Asencio-Mas, Pablo J. Marcos-Pardo
Applied Sciences.2021; 11(22): 10960. CrossRef
Grip Strength as a Cardiometabolic Marker
Jungun Lee
Korean Journal of Family Medicine.2020; 41(5): 271. CrossRef

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The Relationship between Handgrip Strength and Cognitive Function in Elderly Koreans over 8 Years: A Prospective Population-Based Study Using Korean Longitudinal Study of Ageing: Kyung Hwan Kim, Soo Kyoung Park, Dong Ryul Lee, Jungun Lee; Korean J Fam Med 2019;40(1):9-15. Published online October 29, 2018; DOI: https://doi.org/10.4082/kjfm.17.0074

Abstract
PDF

Background
Decreased physical performance, such as weakened handgrip strength and cognitive decline, is associated with disability and premature death in old age. We investigated the association between handgrip strength and cognitive impairment in Korean elderly adults with normal cognitive function.
Methods
This prospective study used the database from the Korean Longitudinal Study of Ageing. The participants included 2,378 adults aged 65 years or older with normal cognitive function (Korean Mini-Mental Status Evaluation [K-MMSE] score ≥21). Using a mixed-effects model, we examined the associations at baseline and over an 8-year follow-up period between handgrip strength and K-MMSE score. We investigated handgrip strength as a predictor of change in cognitive function.
Results
This study included 1,138 women (mean maximum handgrip strength 19.2 kg, mean K-MMSE score 25.1) and 1,240 men (mean maximum handgrip strength 30.7 kg, mean MMSE score 26.2). The baseline handgrip strength was positively associated with the baseline K-MMSE score (b=0.18, P<0.001). Using a mixed-effects model, we found that higher handgrip strength at baseline can predict MMSE scores positively over time (b=0.14, P<0.001) and the change of handgrip strength over time was a predictor of high MMSE scores over the study period (b=0.01, P<0.01).
Conclusion
We observed significant associations between baseline handgrip strength and baseline and change of cognition, as well as the longitudinal influence of handgrip strength on the change of cognitive function in elderly Korean adults with normal cognitive function.

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The Association between Frailty and Cognition in Elderly Women: Ji-Young Kang, Cheol-Hwan Kim, Eun-Ju Sung, Ho-Cheol Shin, Woon-Jung Shin, Keun-Hyeong Jung; Korean J Fam Med 2016;37(3):164-170. Published online May 26, 2016; DOI: https://doi.org/10.4082/kjfm.2016.37.3.164

Abstract
PDF

Background

Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea.

Methods

A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors.

Results

Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05).

Conclusion

In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.

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