Handgrip strength, chronic physical conditions and physical multimorbidity in middle-aged and older adults in six low- and middle income countries

Purpose: Handgrip strength provides a clinically validated marker of overall health and mortality risk. There are however, no multi-national population-based studies investigating the associations between handgrip strength, chronic physical conditions, and physical multimorbidity (i.e., ≥2 chronic conditions). We aimed to assess these associations among community-dwelling middle-aged and older adults using nationally representative data from six in low- and middle-income countries (LMICs). Methods: Cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. Eleven chronic physical conditions (angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing problems, hypertension, stroke, visual impairment) were assessed. Weak handgrip strength was defined as <30 kg for men and <20 kg for women. Multivariable logistic regression analysis was conducted. Results: The final sample included 34,129 individuals (62.4 ± 16.0 years; 52.1% female). After adjustment for potential confounders, when compared to those with no chronic physical conditions, having 1, 2, 3, and ≥4 physical chronic conditions was associated with 1.22 (95%CI = 1.08–1.37), 1.29 (95%CI = 1.11–1.50), 1.41 (95%CI = 1.18–1.68), and 1.78 (95%CI = 1.46–2.18) times higher odds for weak handgrip strength. Similar associations were observed in the analyses stratified by age and sex. There was a moderate level of between-country heterogeneity in the association between weak handgrip strength and physical multimorbidity (Higgin's I 2 = 67.8%) with the pooled estimate being 1.26 (95%CI = 1.06–1.50). Conclusion: Weaker handgrip strength is associated with a range of chronic physical conditions and multimorbidity. Future research should seek to establish the predictive value of this inexpensive measure for clinical use.