Association of Handgrip Strength with Hip Fracture and Falls in Community-dwelling Middle-aged and Older Adults: A 4-Year Longitudinal Study

Tianting Guo; Fei Zhang; Lijiao Xiong; Zhihua Huang; Xiaoan Zhang; Junming Wan; Jianwen Mo

doi:10.1111/os.14029

Association of Handgrip Strength with Hip Fracture and Falls in Community-dwelling Middle-aged and Older Adults: A 4-Year Longitudinal Study

Orthop Surg. 2024 Mar 14. doi: 10.1111/os.14029. Online ahead of print.

Authors

Tianting Guo¹, Fei Zhang², Lijiao Xiong³, Zhihua Huang⁴, Xiaoan Zhang¹, Junming Wan⁵, Jianwen Mo²

Affiliations

¹ Department of Orthopedics, Ganzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital), Ganzhou, China.
² Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
³ Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, China.
⁴ Gannan Medical University, Ganzhou, China.
⁵ Department of Orthopaedics, The Seventh Affiliated Hospital, Sun Yat-sen University, Ganzhou, China.

PMID: 38485456
DOI: 10.1111/os.14029

Abstract

Objective: Hip fracture and falls are significant health concerns. Handgrip strength (HGS) is closely associated with overall muscle strength and physical health. However, the longitudinal relationship between HGS and the risk of hip fractures and falls remains unclear, particularly regarding gender differences. This longitudinal study aimed to investigate the association between HGS and the risk of hip fracture and falls in individuals aged 45 years and above, considering gender-specific differences over a 4-year period.

Methods: This study included 10,092 participants (4471 men and 5621 women) aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS). Incidents of hip fractures and falls were recorded during a 4-year follow-up, along with various demographic and clinical factors. Participants were categorized into five groups based on their HGS quintiles. Logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between HGS and hip fracture/fall risk.

Results: During the 4-year follow-up period, 223 cases of hip fracture (2.2%) and 1831 cases of falls (18.1%) were documented. Notably, higher HGS demonstrated a strong inverse association with the risk of hip fracture in both males and females (p < 0.05). In comparison to the lowest HGS quintile, the adjusted odds ratios (ORs) for hip fracture were 0.46 (0.27-0.78) for the total population, 0.4 (0.19-0.81) for males and 0.48 (0.23-0.98) for females in the highest HGS quintile. Furthermore, a profound and statistically significant negative correlation between HGS and falls was detected (p < 0.05). The adjusted ORs for falls in the highest HGS quintile, compared to the lowest quintile, were 0.62 (0.51-0.76) in the overall population, 0.59 (0.44-0.78) in males, and 0.78 (0.62-0.99) in females.

Conclusion: Our findings highlight the significant inverse association between HGS and the risk of hip fracture and falls in both males and females aged 45 years and above. Assessing handgrip strength may serve as a valuable tool for predicting fracture and fall risk.

Keywords: Fall risk; Handgrip strength; Hip fracture; The China Health and Retirement Longitudinal Study.

Abstract

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