Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-24T11:36:51.336Z Has data issue: false hasContentIssue false

Nutrition and handgrip strength of older adults in rural Malawi

Published online by Cambridge University Press:  02 January 2007

Dorothy M Chilima*
Affiliation:
Public Health Nutrition Unit, London School of Hygiene and Tropical Medicine, 49–51 Bedford Square, London WC1B 3DP, UK
Suraiya J Ismail
Affiliation:
Public Health Nutrition Unit, London School of Hygiene and Tropical Medicine, 49–51 Bedford Square, London WC1B 3DP, UK
*
*Corresponding author
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To examine the relationship between the nutritional status and handgrip strength of older people in rural Malawi.

Design:

Cross-sectional study.

Setting:

Lilongwe rural, Malawi, situated approximately 35–50 km from the city.

Subjects:

Ninety seven males and 199 females participated in this study.

Methods:

Selected anthropometric measurements were taken and nutrition indices were computed using standard equations. Handgrip strength was measured using an electronic grip strength dynamometer.

Results:

The mean handgrip strength (in kg) for men was significantly higher than for women (28.0±5.9 vs. 21.7±4.5). In addition, there was a significant decline in handgrip strength with age in both sexes. Furthermore, handgrip strength was positively correlated to the following nutritional status indicators: BMI (r = 0.40 in males and r = 0.34 in females), mid-upper arm circumference (MUAC) (r = 0.45 in males and r = 0.38 in females) and arm-muscle area (AMA) (r = 0.39 in males and r = 0.37 in females). After controlling for potential confounders, namely sex, height and age, the correlations between handgrip strength and the nutrition indices were still significant.

Conclusion:

The results of this study support the hypothesis that poor nutritional status is associated with poor handgrip strength. Malawian males had both lower handgrip strength and lower arm muscle area than their counterparts from industrialised countries. However, Malawian females had similar handgrip strength despite lower arm muscle area, in comparison with women from industrialised countries, reflecting perhaps their higher level of physical activity. Further studies are required to determine whether by alleviating nutritional problems a concomitant improvement in handgrip strength can be obtained.

Type
Research Article
Copyright
Copyright © CABI Publishing 2001

References

1Bassey, EJ. Tests of muscle strength. In: Collins, KJ, ed. Handbook of Methods for the Measurement of Work Performance, Physical Fitness and Energy Expenditure in Tropical Populations. London: International Union of Biological Sciences, Medical Research, 1990: 5965.Google Scholar
2Bassey, EJ, Harries, UJ. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin. Sci. 1991; 84: 331–7.CrossRefGoogle Scholar
3Skelton, DA, Greig, CA, Davies, JM, Young, A. Strength, power and related functional ability of healthy people aged 65–89 years. Age and Ageing 1994; 23: 371–7.CrossRefGoogle ScholarPubMed
4Klidjian, AM, Foster, KJ, Kammerling, RM, Cooper, A, A, Karran. Relation ofanthropometric and dynamometric variables to serious post-operative complications. Br. Med. J. 1980; 281: 899901.CrossRefGoogle Scholar
5Phillips, P. Grip strength, mental performance and nutritional status as indicators of mortality risk among female geriatric patients. Age and Ageing 1986; 15: 356.CrossRefGoogle ScholarPubMed
6Wickham, C, Cooper, C, Margetts, BM, Barker, DJP. Muscle strength, activity, housing and the risk of falls in the elderly people. Age and Ageing 1989; 18: 751.CrossRefGoogle ScholarPubMed
7Hughes, S, Gibbs, J, Dunlop, D, Edelmas, P, Singer, R, Chang, RW. Predictors of decline in manual performance in older adults. J. Am. Geriatr. Soc. 1997; 45: 905–10.CrossRefGoogle ScholarPubMed
8Hyatt, RH, Whitelaw, MN, Bhat, A, Scott, S, Maxwell, JD. Association of muscle strength with functional status of elderly people. Age and Ageing 1990; 19: 330–6.CrossRefGoogle ScholarPubMed
9Guo, C, Zhang, W, Ma, D, Zhang, K, Huang, J. Hand grip strength: an indicator of nutritional state and the mix of post-operative complications in patients with oral and maxillofacial cancers. Br. J. Oral Maxillofac. Surg. 1996; 34, 325–7.CrossRefGoogle Scholar
10Chilima, DM, Ismail, SJ. Anthropometric characteristics of older people in rural Malawi. Eur. J. Clin. Nutr. 1998; 52: 643–9.CrossRefGoogle ScholarPubMed
11Pieterse, S, Manandhar, M, M, Ismail. The nutritional status of older Rwandan refugees. Publ. Health Nutr. 1998; 1: 259–64.CrossRefGoogle ScholarPubMed
12Torres-Gil, FMMalnutrition and hunger in the elderly. Nutr. Rev. 1996; 54(II): S7–8.CrossRefGoogle ScholarPubMed
13Frisancho, AR. Anthropometric Standards for the Assessment of Growth and Nutritional Status. Ann Arbor, USA: The University of Michigan Press, 1990.CrossRefGoogle Scholar
14Lehmann, AB, Bassey, EJ. Longitudinal weight changes over four years and associated health factors in 629 men and women aged over 65. Eur. J. Clin. Nutr. 1996; 50: 611.Google ScholarPubMed
15Finch, S, Doyle, W, Lowe, C, Bates, CJ, Prentice, A, Smithers, G, Clarke, PC. National Diet and Nutrition Survey: People Aged 65 Years and Over. Vol. 1: Report of the Diet and Nutrition Survey. London: HMSO, 1998.Google Scholar
16Lexell, J. Human aging, muscle mass and fiber type composition. J. Gerontol. 1995; 50A(special issue): 1116.Google Scholar
17Grimby, G. Muscle performance and structure in the elderly as studied cross-sectionally and longitudinally. J. Gerontol. 1995; 50A(special issue): 1722.Google Scholar
18Manandhar, MC. Undernutrition and impaired functional ability amongst elderly slum dwellers in Mumbai, India. PhD thesis, London School of Hygiene and Tropical Medicine, 1999.Google Scholar
19Pieterse SGEM. Nutritional vulnerability of older refugees. PhD thesis. London School of Hygiene and Tropical Medicine, 1999.Google Scholar
20Manandhar, MC, Anklesaria, PS, Myatt, M, Ismail, SJ. Undernutrition and functional ability amongst poor elderly people in urban India. J. Nutr. Health Aging 1997; 1: 75–6.Google Scholar
21Vaz, M, Thangan, S, Prabhu, A, Shetty, PS. Maximal voluntary contraction as a functional indicator of adult chronic undernutrition. Br. J. Nutr. 1996; 76: 915.CrossRefGoogle ScholarPubMed
22Harries, AD. A comparison of hand-grip dynamometry and arm muscle size amongst most Africans in North-East Nigeria. Hum. Nutr.: Clin. Nutr. 1985 39C, 309–13.Google Scholar
23Kalache, A. Ageing in developing countries. In: Pathy, MSJ, ed. Principles and Practice of Geriatric Medicine. Chichester, UK: John Wiley and Sons, 1991: 1517–28.Google Scholar
24Sharpe, PA, Jackson, KL, White, C, Vaca, VL, Hickey, T, Gu, J, Otterness, C. Effects of a one year physical activity intervention for older adults at congregate nutrition sites. The Gerontologist 1997; 37: 208–15.CrossRefGoogle ScholarPubMed
25Hennekens, CH, Buring, JE. Descriptive studies. In: Mayrent, SL, ed. Epidemiology in medicine. Boston, Toronto: Little, Brown and Company, 1987: 101–31.Google Scholar