Xiangya Nursing School, The Central South University, Changsha, Hunan, China.
School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.
Int J Older People Nurs. 2024 Sep;19(5):e12635. doi: 10.1111/opn.12635.
Handgrip strength and the 5-time chair-stand test are the two important muscle strength measures run through the whole sarcopenia diagnosis algorithm. There is a lack of evidence to confirm which muscle strength measures have a higher detection rate of sarcopenia among Chinese older adults, which is a challenge for community workers to choose the muscle strength measures and to identify more sarcopenia in clinical practice.
We aimed to investigate the prevalence and diagnostic agreement of sarcopenia based on handgrip strength and the 5-time chair-stand test among Chinese community-dwelling older adults.
This cross-sectional study sampled 1027 community-dwelling older adults from Hunan, China. We used handgrip strength and the 5-time chair-stand test to assess participants' muscle strength and used gait speed and bioimpedance analysis (BIA) to assess physical performance and skeletal muscle mass, respectively. The kappa values of the agreement test were used to evaluate the agreement of handgrip strength and 5-time chair-stand tests in the assessment of sarcopenia.
A total of 1027 participants were included in this analysis including 337 males and 690 females with an average age of 70.35 ± 7.24 years. The prevalence of possible sarcopenia, confirmed sarcopenia and severe sarcopenia based on handgrip strength was 50.8%, 20.3% and 14.5% respectively, while the corresponding prevalence for using the 5-time chair-stand test was 27.6%, 10.8% and 10.9%. The kappa value of the consistency test between handgrip strength and 5-time chair-stand test in the assessment of possible sarcopenia, confirmed and severe sarcopenia was 0.26, 0.51 and 0.62, respectively (p < 0.001 for all).
The prevalence of possible sarcopenia, confirmed sarcopenia and severe sarcopenia based on handgrip strength was significantly higher than that of the 5-time chair-stand test. We recommend handgrip strength as the preferred method of muscle strength measurement for Chinese community-dwelling older adults and use 5-time chair-stand tests when handgrip strength is not available.
The findings provide information and suggestions to healthcare providers for choosing the muscle strength measures to detect more sarcopenia in clinical practice. Compared with the 5-time chair-stand test, handgrip strength has a better performance to identify sarcopenia in Chinese community-dwelling older adults.
握力和 5 次椅站测试是贯穿整个肌少症诊断算法的两种重要肌肉力量测量方法。目前缺乏证据来证实握力和 5 次椅站测试中哪一种肌肉力量测量方法在中国老年人中具有更高的肌少症检出率，这对社区工作者选择肌肉力量测量方法以及在临床实践中识别更多肌少症提出了挑战。
本研究旨在调查基于握力和 5 次椅站测试的肌少症在中国社区居住的老年人中的患病率和诊断一致性。
本横断面研究从中国湖南抽取了 1027 名社区居住的老年人。我们使用握力和 5 次椅站测试来评估参与者的肌肉力量，使用步态速度和生物电阻抗分析（BIA）分别评估身体机能和骨骼肌质量。使用一致性检验的 Kappa 值评估握力和 5 次椅站测试在评估肌少症方面的一致性。
本分析共纳入 1027 名参与者，包括 337 名男性和 690 名女性，平均年龄为 70.35±7.24 岁。基于握力的可能肌少症、确诊肌少症和严重肌少症的患病率分别为 50.8%、20.3%和 14.5%，而使用 5 次椅站测试的相应患病率分别为 27.6%、10.8%和 10.9%。握力和 5 次椅站测试在评估可能肌少症、确诊肌少症和严重肌少症方面的一致性检验的 Kappa 值分别为 0.26、0.51 和 0.62（均<0.001）。
基于握力的可能肌少症、确诊肌少症和严重肌少症的患病率明显高于 5 次椅站测试。我们建议握力作为中国社区居住的老年人肌肉力量测量的首选方法，当无法进行握力测量时，使用 5 次椅站测试。
研究结果为医疗保健提供者选择肌肉力量测量方法以在临床实践中检测更多肌少症提供了信息和建议。与 5 次椅站测试相比，握力在识别中国社区居住的老年人肌少症方面具有更好的性能。
