Can handgrip strength alone detect individuals living with frailty according to the Clinical Frailty Scale?

Objective: Several studies have been conducted to determine handgrip strength cutoffs that can identify people living with frailty. However, the handgrip strength cutoff value, which can detect individuals living with frailty based on the Clinical Frailty Scale, has not been determined before. The aim of this study was to investigate the capacity of handgrip strength to detect individuals living with frailty by using Clinical Frailty Scale as a reference scale.

Methods: This retrospective study was carried out by including patients who applied to the geriatric outpatient clinic of a university hospital. A comprehensive geriatric assessment was performed on all patients. Level 4 and above were considered as living with frailty according to Clinical Frailty Scale. Receiver operating characteristic curve analysis was performed to determine the handgrip strength cutoff values for predicting individuals living with frailty.

Results: The median age of 742 patients included in this study was 72.0 years (25p-75p: 68.0-77.0), of which 59.3% (n=440) were female and 49.3% (n=366) were living with frailty. The median Clinical Frailty Scale level was 3.0 (25p-75p: 3.0-4.0). According to the results of binary logistic regression analysis, age, sex, and handgrip strength displayed a statistically significant relationship with frailty (p<0001, p=0.001, and p<0.001, respectively). As a result of the receiver operating characteristic analysis performed to determine the handgrip strength cutoff values that predict frailty, cutoff values of 16 kg for females and 26.7 kg for males were identified. The area under the curve values for females and males were 0.679 (p<0.001) and 0.790 (p<0.001), respectively.

Conclusion: Handgrip strength can be used alone as a predictor to identify individuals living with frailty.