Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.
Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA; Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia.
J Am Med Dir Assoc. 2021 Apr;22(4):821-826.e1. doi: 10.1016/j.jamda.2020.11.006. Epub 2020 Dec 5.
Examining strength asymmetries in assessments of muscle function may improve screenings for limitations in independent living tasks such as instrumental activities of daily living (IADL). We sought to determine the associations between handgrip strength (HGS) asymmetry and future IADL limitations in aging Americans.
Longitudinal panel.
Secondary analyses of data from participants aged at least 50 years from the 2006-2016 waves of the Health and Retirement Study. The analytic sample included 18,235 Americans who identified hand dominance and had measures of HGS for both hands in a single wave.
Hand dominance was self-reported, and a handgrip dynamometer measured HGS on each hand. The highest HGS values on each hand were used to calculate the HGS asymmetry ratio: (nondominant HGS/dominant HGS). Individuals with HGS asymmetry ratio <0.80 or >1.20 had HGS asymmetry. Persons with HGS asymmetry ratio <0.80 had dominant HGS asymmetry, whereas participants with HGS asymmetry ratio >1.20 had nondominant HGS asymmetry. Persons with HGS asymmetry ratio <1.0 also had their ratio inversed to make all HGS asymmetry ratios ≥1.0. IADL were self-reported. Covariate-adjusted generalized estimating equations were used for the analyses.
Participants with HGS asymmetry had 1.12 [95% confidence interval (CI): 1.03-1.20] greater odds for future IADL limitations. Each HGS asymmetry dominance group also had greater odds for future IADL limitations: 1.09 (CI: 1.01-1.18) for individuals with dominant HGS asymmetry and 1.29 (CI: 1.09-1.52) for persons with nondominant HGS asymmetry. Every 0.10 increase in inverted HGS asymmetry ratio was associated with 1.30 (CI: 1.07-1.57) greater odds for future IADL limitations.
Assessing HGS asymmetry, as another potential biomarker of impaired muscle function, may provide novel insights for predicting IADL limitations. Future research should continue examining how strength asymmetries, and other aspects of muscle function beyond maximal strength, factor into the disabling cascade.
评估肌肉功能时检查力量的不对称性可能会提高对独立生活任务（如工具性日常生活活动（IADL））限制的筛查效果。我们旨在确定 50 岁以上美国人的手掌握力（HGS）不对称与未来 IADL 限制之间的关联。
纵向面板。
对健康与退休研究（Health and Retirement Study）2006-2016 年各波次中至少 50 岁参与者的数据进行二次分析。分析样本包括 18235 名美国人，他们在单个波次中报告了惯用手，并对双手的 HGS 进行了测量。
惯用手由自我报告确定，使用握力计测量每只手的 HGS。使用每只手的最高 HGS 值来计算 HGS 不对称比：（非优势手 HGS/优势手 HGS）。HGS 不对称比值<0.80 或>1.20 的人有 HGS 不对称。HGS 不对称比值<0.80 的人有优势手 HGS 不对称，而 HGS 不对称比值>1.20 的人有非优势手 HGS 不对称。HGS 不对称比值<1.0 的人其比值也会被反转，以使所有 HGS 不对称比值≥1.0。IADL 通过自我报告来评估。分析采用协变量调整的广义估计方程。
有 HGS 不对称的参与者发生未来 IADL 限制的几率高 1.12 倍（95%置信区间（CI）：1.03-1.20）。每个 HGS 不对称优势组发生未来 IADL 限制的几率也更高：优势手 HGS 不对称的个体为 1.09（CI：1.01-1.18），非优势手 HGS 不对称的个体为 1.29（CI：1.09-1.52）。HGS 不对称反转比值每增加 0.10，未来发生 IADL 限制的几率就会增加 1.30 倍（CI：1.07-1.57）。
评估 HGS 不对称性作为肌肉功能受损的另一个潜在生物标志物，可能为预测 IADL 限制提供新的见解。未来的研究应继续研究力量不对称性以及肌肉功能的其他方面（超出最大力量）如何影响致残级联。
