Correlation Between Handgrip Strength and Bone Density and Fragility Fracture Risk Among Older Adults: A Cross-Sectional Study

Population aging has led to a surge in elderly care needs worldwide. Bone aging, skeletal muscle degeneration, and osteoporosis pose critical health challenges for the elderly. The process of bone and skeletal muscle aging not only impacts the functional abilities but also increases fragility fracture risk. Although a negative correlation between handgrip strength and fragility fracture risk has been identified in elderly populations, there is a lack of related research in Taiwan. This cross-sectional study was designed to investigate the association between handgrip strength and two outcome variables, bone density and risk of fragility fracture, in Taiwanese individuals aged 65 years and older with low bone mass. A total of 548 older adults, including 84 men and 464 women, were recruited between August 2019 and July 2021. Bone mineral density T-scores acquired using dual-energy X-ray absorptiometry scan, the total score for the Taiwan-specific Fracture Risk Assessment (FRAX) tool, and bilateral handgrip strength acquired using a digital hand dynamometer were recorded along with other factors such as comorbidities, dietary habits, and daily activities. In this study, the mean age was 70.9 (SD = 5.6) years, mean bone mass index was 24.1 (SD = 3.5) kg/m2, mean FRAX main fracture risk score was 19.5% (SD = 8.3), and mean FRAX hip fracture risk score was 7.7% (SD = 5.7). Lumbar and hip T-scores were both significantly correlated with both dominant and nondominant handgrip strength in older woman. Older age; both lower hip and spine T-scores; both lower dominant and nondominant handgrip strengths; having Type 2 diabetes, coronary artery disease, or chronic hepatic disease; and lacking a steady job were significantly associated with a higher risk of fragility fracture. The results of this study provide important information regarding the correlation between handgrip strength and several variables, including bone mineral density T-score, FRAX score, comorbidities, and job status, among older adults. Notably, these correlations were found to be particularly strong in the female participants. This information may be used to facilitate the early identification of elderly individuals at a high risk of fragility fractures, enabling the timely development of preventive nursing strategies and the provision of targeted interventions.