Getting a grip on aging

Dr. Allen Huang, geriatrician at the McGill University Health Centre, comments on the latest findings from Dr. Carolina Ling’s study out of Leiden University Medical Center, Department of Gerontology and Geriatrics.

The study, entitled Handgrip strength and mortality in the oldest old: the Leiden 85-plus study, was recently published in CMAJ. Poor or declining handgrip strength linked to impending mortality in elderly A study led by researchers from The Netherlands, recently published on CMAJ, suggests that a declining handgrip in the elderly is an indication of impending mortality.

The results, founded by Dr. Carolina Ling from Leiden University Medical Center, department of Gerontology and Geriatrics, and her coauthors have shown these results in people between the ages of 85 and 89. This finding indicates that handgrip strength could have a greater impact on mortality as people age. “How may this finding, which provides clues to the biological behaviour of this age group, help us as healthcare clinicians,” asks Dr. Allen Huang, geriatrician at the McGill University Health Centre, who was invited to submit a commentary to CMAJ on this study.

Dr. Huang mentions that in Canada people aged 80 years and older are the fastest growing group in the nation and he suggests that this part of the population should have their needs better filled by society and the healthcare system. This study may offer a push in that direction. Handgrip strength as a reliable tool of assessment Dr. Huang, who is also an associate professor at the McGill University Faculty of Medicine, says that handgrip strength could be considered as a measurement for clinicians to use, in addition to other parameters that help define the concept of frailty.

As a reliable tool of assessment, a handgrip test would help health practitioners to evaluate elderly patients in order to target more appropriate procedures and interventions. We could imagine a patient elected for a surgical procedure getting delayed “because of weak handgrip strength on measurement, which implies that the patient’s physical reserves are suboptimal,” suggests Dr. Huang. This observation leads to a scenario in which “an in-depth functional assessment may reveal a condition for which preoperative rehabilitation could improve postoperative outcomes,” says Dr. Huang.

The most interesting point raised by this study, according to Dr. Huang, is whether or not a strength-based training would have an impact on this age group's survival. He suggests that future studies involving more heterogeneous cohorts need to be done in order to obtain broad information and more representative data on biologic behaviour among this age group.