A study conducted by Duke-NUS Medical School (Duke-NUS) measuring hand grip strength among elderly Singaporeans provides more accurate and relevant values to assess frailty, as compared to the previous benchmarks from studies done abroad.

The study is significant as the measurement of hand grip strength is often done to assess frailty and the loss of muscle mass and strength as a result of ageing among older adults. Lower hand grip strength values have been shown to be a consistent predictor of future adverse health outcomes, including disability and death.

The Duke-NUS team analysed the hand grip strength of 2,664 elderly who were healthy and without pre-existing health problems. They then established reference values for hand grip strength for Singaporeans aged 60 to 89 years. Hand grip strength is influenced by individual, genetic and nutritional factor, which vary across countries and populations. Hence, this new reference is more relevant and applicable to the elderly in Singapore, as compared to those derived from studies in other countries.

“We present the reference values for hand grip strength in the form of simple charts, similar to growth charts used for monitoring change in height or weight of children with age, which can be easily used by doctors and other health care professionals in Singapore to mark and map the hand grip strength of their patients,” said Assistant Professor Rahul Malhotra, lead author and Head of Research in the Centre for Ageing Research and Education (CARE) in Duke-NUS. “Thus, the reference values are ready for use and for real-world application.”

“Now, when a medical practitioner in Singapore measures the hand grip strength for his or her older patient, then he or she can refer to the reference values provided through this study to ‘benchmark’ the measured hand grip strength,” said Associate Professor Angelique Chan, senior author and Executive Director of CARE at Duke-NUS.

The next step for Profs Malhotra and Chan are to identify hand grip strength thresholds that are predictive of adverse health outcomes such as development of functional limitations or mortality among the elderly in Singapore.