Li Decheng, Wang Yunhe, Guo Shuai, Ren Ziyang, Su Binbin, Zhang Lichuan, Talifu Zuliyaer, Zheng Xiaoying
Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No.31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China.
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Exp Gerontol. 2025 Jan;199:112656. doi: 10.1016/j.exger.2024.112656. Epub 2024 Dec 18.
Declining intrinsic capacity (IC) significantly impacts health outcomes in aging populations. While weak handgrip strength (HGS) is associated with IC impairment, the role of HGS asymmetry remains unclear, especially among older Chinese cohorts.
We included participants aged ≥60 years from the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS). IC was evaluated across cognitive, locomotion, psychological, sensory, and vitality domains. Asymmetry and weakness were measured using the maximum value of HGS. Logistic regression models were employed to examine the association of the individual and combined groupings of HGS asymmetry and weakness with IC impairment (a total score ≥ 2 across five domains). The potential non-linear relationship was explored using a restricted cubic spline (RCS) model.
Of the 4798 participants included (median age 66.0 years, IQR 63.0-71.0 years; 56.9 % male), 35.2 % had IC impairment. HGS asymmetry (OR = 1.26, 95 % CI: 1.11-1.43) and weakness (OR = 2.09, 95 % CI: 1.78-2.45) were both independent risk factors for IC impairment. Notably, participants experiencing both HGS asymmetry and weakness were at even higher risk of IC impairment (OR = 2.47, 95 % CI: 1.99-3.08), suggesting compounded effects on IC. Further subgroup analysis showed significant associations between HGS status and impairments in specific IC domains, particularly in locomotion. In contrast to other domains, it was the Weakness only group, rather than the Both group, that had the highest risk of vitality impairment. There was a U-shaped relationship between HGS asymmetry and IC impairment.
HGS asymmetry and weakness were associated with an increased risk of composite and individual domain IC impairment. Assessing and maintaining HGS symmetry and strength may have implications for the early identification of individuals at risk for IC impairment and the prevention of related adverse health outcomes.
内在能力（IC）下降对老年人群的健康结局有显著影响。虽然握力（HGS）较弱与IC受损有关，但HGS不对称的作用仍不明确，尤其是在中国老年人群体中。
我们纳入了中国健康与养老追踪调查（CHARLS）2015年波次中年龄≥60岁的参与者。从认知、运动、心理、感官和活力领域对IC进行评估。使用HGS的最大值来测量不对称性和虚弱程度。采用逻辑回归模型来检验HGS不对称和虚弱的个体及组合分组与IC受损（五个领域总分≥2）之间的关联。使用受限立方样条（RCS）模型探索潜在的非线性关系。
纳入的4798名参与者（中位年龄66.0岁，四分位间距63.0 - 71.0岁；56.9%为男性）中，35.2%存在IC受损。HGS不对称（比值比[OR]=1.26，95%置信区间[CI]：1.11 - 1.43）和虚弱（OR = 2.09，95% CI：1.78 - 2.45）均为IC受损的独立危险因素。值得注意的是，同时存在HGS不对称和虚弱的参与者IC受损风险更高（OR = 2.47，95% CI：1.99 - 3.08），表明对IC有复合影响。进一步的亚组分析显示HGS状态与特定IC领域的受损之间存在显著关联，尤其是在运动领域。与其他领域不同，活力受损风险最高的是仅虚弱组，而非两者皆有的组。HGS不对称与IC受损之间存在U型关系。
HGS不对称和虚弱与综合及个体领域IC受损风险增加有关。评估和维持HGS的对称性和强度可能对早期识别IC受损风险个体及预防相关不良健康结局具有重要意义。
