Hand Grip Strength As A Potential Nutritional Assessment Tool in Long-term Care Homes - Hand Grip Strength As A Potential Nutritional Assessment Tool in Long-term Care Homes - Open Access Pub

Loss of muscle mass and functionality leads to increased risk for falls and onset of frailty, especially residents of long term care (LTC) homes. Hand grip strength (HGS) is emerging as a promising tool to measure muscle strength and a proxy for functionality. Given its promise as a screening tool, several studies report cut-offs below which measured strength was predictive of risk of poor mobility in older subjects. A scoping review was conducted to examine whether HGS was currently being used in LTC, as studies demonstrate hand grip strength as positively correlated with activities of daily living, implying increased dependence on caregivers including mealtimes. Of 19 published studies in 2015, only two report HGS use. As there is an association of grip strength with nutrition-related outcomes, hand grip strength should be used as part of nutritional assessment by dietitians in LTC, as poor muscle strength adversely affects activities of daily living that may impact intake. DOI10.14302/issn.2474-7785.jarh-16-1177 Aging is associated with loss of muscle mass and strength. Poor muscle strength, due to sarcopenia or frailty, results in deficits in physical activities of daily living (PADL) scores and possibly a poor quality of life.1, 2. As a risk factor, frailty has recently gained attention as an important reason for seniors’ loss of independence.3 These factors may be accompanied by placement in long-term care homes and increased mortality and other comorbidities in older adults.4 Thus, efforts are made to provide appropriate interventions to preserve functionality and mobility by retaining muscle mass and strength in older adults.5 Nutritional interventions are key to maintenance or improvement in functionality. Nutritional assessments traditionally relied on biochemical markers to identify malnutrition. Recently, nutritional assessment has undergone a paradigm shift in which functional assessment is used to determine malnutrition.6 One measure in this new protocol is hand grip strength.7 Thus, the purpose of this article is determine if hand grip strength is being used in long-term care and to consider whether hand grip strength is an appropriate assessment tool for older adults in long-term care homes. Search Strategy We used two methods for this review. In the first, we provide a critical examination of definitions for frailty, sarcopenia, with a focus on older adults and when possible, on adults living in long-term care (also called nursing homes). In the second method, we employ the scoping review methodology as defined by Grant and Booth8 to