Pinch Strength vs Handgrip Strength for Screening Sarcopenia and Predicting Adverse Health Outcomes in Older Adults.

OBJECTIVES

Handgrip strength (HGS) is a cornerstone of sarcopenia assessment, but its utility for screening is debated, partly because of its role as both a screener and a diagnostic component. This study aimed to evaluate pinch strength, a measure of fine motor function, as an alternative to HGS for predicting sarcopenia and adverse health outcomes in older adults.

DESIGN

A 2-year prospective cohort study.

SETTING AND

PARTICIPANTS

954 community-dwelling adults aged ≥60 years from 3 communities.

METHODS

Baseline assessments included pinch strength, HGS, body composition, and functional status. We calculated the coefficient of variation (CV) for stability and a fatigue index. Outcomes included falls, hospitalizations, and all-cause mortality. Predictive performance was evaluated using the area under the curve (AUC), with multivariate logistic regression to estimate odds ratios (ORs).

RESULTS

Pinch strength was moderately correlated with HGS (r = 0.46). Pinch strength showed greater measurement variability (CV) and a notable fatigue effect compared with HGS, especially in the oldest-old, highlighting its potential to assess muscle endurance. For sarcopenia screening, HGS showed a slightly higher AUC than pinch strength (0.694 vs 0.648, P = .034). However, pinch strength provides a valid screening alternative without the methodologic circularity of using HGS. For adverse outcomes, the predictive performance of pinch strength was comparable to HGS. Both measures were modestly associated with a lower risk of falls (Pinch OR = 0.76, 95% CI: 0.63-0.90; HGS OR = 0.75, 95% CI: 0.62-0.89). Neither measure was significantly associated with hospitalization or mortality in our cohort.

CONCLUSIONS AND IMPLICATIONS: Pinch strength may be a portable and valid tool for assessing muscle function in older adults. It offers a practical alternative for sarcopenia screening and demonstrates comparable performance to HGS in predicting fall risk. Its unique reflection of fine motor function and muscle fatigue suggests it captures different physiological aspects than HGS, warranting its integration into comprehensive geriatric assessments.