Two Methods of Handgrip Strength Assessment in Sarcopenia Evaluation: Associations with in-Hospital Mortality in Older Adults

Eliana Hanna Deschamps,1 François R Herrmann,2 David De Macedo Ferreira,3 Mauro Silva,2 Christophe E Graf,2 Aline Mendes2 1Division of Internal Medicine and Rehabilitation Beau-Séjour, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland; 2Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland; 3Division of Rehabilitation Loëx/Joli-Mont, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and University of Geneva, Geneva, SwitzerlandCorrespondence: Aline Mendes, Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Thônex, Geneva, 1226, Switzerland, Tel +41 795538365, Email [email protected]: Handgrip strength (HGS) is a key diagnostic tool for sarcopenia, yet the comparative prognostic value of the hydraulic dynamometer and pneumatic vigorimeter in hospitalized older adults remains unclear. This study is the first to examine the vigorimeter as a predictor of in-hospital mortality in this setting.Methods: This prospective cohort study included 376 hospitalized older adults (mean age: 82.7 years) across acute, rehabilitation, and long-term care wards. HGS was assessed using both the dynamometer and vigorimeter, applying two sets of cut-offs per instrument. Sarcopenia was confirmed using bioelectrical impedance analysis to calculate the fat-free mass index (FFMI), with four diagnostic criteria combining HGS and FFMI thresholds. Associations between HGS, sarcopenia, and mortality were evaluated using logistic regression and Cox proportional hazards models, with Kaplan-Meier curves illustrating survival differences.Results: Higher HGS measured by the vigorimeter was independently associated with reduced in-hospital mortality (OR 0.96, 95% CI 0.93– 0.98, p = 0.001), whereas no significant association was found for dynamometer-measured HGS. Confirmed sarcopenia was significantly associated with mortality for two diagnostic criteria (criterion 2: vigorimeter with DO-HEALTH1 cut-offs: OR 1.77, 95% CI 1.01– 3.10, p = 0.047; criterion 4: vigorimeter with DO-HEALTH2 cut-offs: OR 1.76, 95% CI 1.01– 3.07, p = 0.048), although no significant association was observed with time-to-mortality. Kaplan–Meier curves demonstrated significant survival differences only for vigorimeter-based HGS cut-offs (p = 0.04). Male sex and falls during hospitalization were associated with increased mortality, while admission to rehabilitation or long-term care wards was associated with reduced mortality.Conclusion: Vigorimeter-based HGS, especially using DO-HEALTH1 cut-offs, demonstrated superior prognostic value for in-hospital mortality compared to the dynamometer. These findings support the clinical utility of the vigorimeter for risk stratification and care planning in hospitalized older adults, particularly in settings where subtle neuromuscular deficits may influence outcomes.Plain Language Summary: Sarcopenia is a disease that leads to the loss of muscle mass and strength, increasing the risk of falls, disability, and death in older adults. Detecting sarcopenia early is essential to better support hospitalized older individuals.One simple way to assess muscle strength is by measuring how forcefully a person can hold or compress an object. Two tools are commonly used in hospitals: the dynamometer, which measures how strongly someone can grasp a rigid handle, and the vigorimeter, which records the pressure when the person compresses a soft rubber ball filled with air.In this study, we assessed 376 hospitalized older adults, with an average age of 82 years. We compared grip strength measured by both devices, combined with muscle mass evaluations, to see which method better predicted survival during hospitalization.We found that lower strength measured with the vigorimeter was significantly associated with a higher risk of death. Strength measured with the dynamometer showed no such association. One reason may be that the vigorimeter captures subtle muscle weakness more effectively, as it accommodates a broader range of hand and finger movements, making it more suitable for frail older patients.These findings suggest that using the vigorimeter could improve how healthcare teams identify older adults at higher risk and adapt care to their needs.Keywords: key-words, sarcopenia, mortality, fat-free mass index, handgrip strength, dynamometer, vigorimeter