Skip to main content
Top
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Research

The influence of vitamin D on handgrip strength in elderly trauma patients

Authors: Tamara Ostermeier, Leon Faust, Adrian Cavalcanti-Kußmaul, Christian Kammerlander, Matthias Knobe, Wolfgang Böcker, Maximilian M. Saller, Carl Neuerburg, Alexander M. Keppler

Published in: European Journal of Medical Research | Issue 1/2023

Login to get access

Abstract

Background and objectives

The treatment of elderly patients is an increasing challenge and the long-term sequelae often affect activities of daily living and quality of life in those patients. Handgrip strength (HGS) appears as a promising value to predict the outcome after trauma in elderly patients and to assess the overall muscle strength. Besides the possible role of psychological and hormonal factors, vitamin D may have a positive influence. Furthermore, some data suggest that Vitamin D is beneficial regarding muscle strength and possibly prevents further falls and injuries in orthogeriatric patients. The purpose of this study was to identify if Vitamin D is an influencing factor for HGSin elderly trauma patients.

Materials and methods

94 elderly patients in a Level I Trauma Center aged 60 years or older were prospectively enrolled and HGS as well as serum 25-OH Vitamin D concentration (VDC) were measured. In addition, the standardized questionnaires Barthel Index (BI), Parker Mobility Score (PMS), Short Physical Performance Battery (SPPB), Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) and European Quality of Life 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L), were used to record mental health status and demographic data.

Results

HGS is mainly related to age and sex in elderly trauma patients. HGS was higher in men (meanmale = 27.31 kg (± 8.11), meanfemale = 15.62 kg (± 5.63), p < 0.001 and decreased with age (βage = − 0.58, p < 0.001). A significant negative correlation between HGS and VDC exists in the overall sample (βVDC = − 0.27, pVDC < 0.008), which still remains after adjusting for age (pVDC < 0.004), but is not significant after adjustment for both main confounders, age and sex (pVDC < 0.08). Furthermore, the HGS was lower in pateints who reported frequent falls, stumbling, dizziness or a late onset of menopause, and decreased if patients felt anxious or depressed during measurements (βanxiety+depression = − 0.26, panxiety+depression < 0.01).

Conclusions

These results do not support the hypothesis that Vitamin D has a positive influence on muscle strength measured by HGS. Nevertheless, this study could confirm the usefulness of HGS as a tool to detect the risk for frequent falls or stumbling. Furthermore, HGS seems to be associated with dizziness and age at onset of menopause. A significant decrease of HGS could also be shown in patients with anxiety and depression. This underlines the importance of interdisciplinary treatment of elderly trauma patients and needs to be taken into account for further studies, as especially the psychological motivation seems to have a significant influence and is sometimes not considered enough in elderly musculo-skeletal patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fabre JM, et al. Falls risk factors and a compendium of falls risk screening instruments. J Geriatr Phys Ther. 2010;33(4):184–97.CrossRefPubMed Fabre JM, et al. Falls risk factors and a compendium of falls risk screening instruments. J Geriatr Phys Ther. 2010;33(4):184–97.CrossRefPubMed
2.
go back to reference Forrest KYZ, et al. Patterns and correlates of grip strength in older americans. Curr Aging Sci. 2017;11(1):63–70.CrossRef Forrest KYZ, et al. Patterns and correlates of grip strength in older americans. Curr Aging Sci. 2017;11(1):63–70.CrossRef
3.
go back to reference Distefano G, Goodpaster BH. Effects of exercise and aging on skeletal muscle. Cold Spring Harb Perspect Med. 2018;8. Distefano G, Goodpaster BH. Effects of exercise and aging on skeletal muscle. Cold Spring Harb Perspect Med. 2018;8.
4.
go back to reference Stiefelhagen P Wenn die Muskelkraft im Alter schwindet: Verordnen Sie Sport und Aufbaukost! MMW-Fortschritte der Medizin. 2011;153(41):16. Stiefelhagen P Wenn die Muskelkraft im Alter schwindet: Verordnen Sie Sport und Aufbaukost! MMW-Fortschritte der Medizin. 2011;153(41):16.
5.
go back to reference Seldeen KL et al. Vitamin d insufficiency reduces grip strength, grip endurance and increases frailty in aged c57bl/6j mice. Nutrients. 2020;12(10). Seldeen KL et al. Vitamin d insufficiency reduces grip strength, grip endurance and increases frailty in aged c57bl/6j mice. Nutrients. 2020;12(10).
6.
go back to reference Casseb GAS, et al. Potential role of vitamin D for the management of depression and anxiety. CNS Drugs. 2019;33(7):619–37.CrossRefPubMed Casseb GAS, et al. Potential role of vitamin D for the management of depression and anxiety. CNS Drugs. 2019;33(7):619–37.CrossRefPubMed
7.
go back to reference Bischoff-Ferrari HA, Staehelin HB. Importance of vitamin D and calcium at older age. Int J Vitam Nutr Res. 2008;78(6):286–92.CrossRefPubMed Bischoff-Ferrari HA, Staehelin HB. Importance of vitamin D and calcium at older age. Int J Vitam Nutr Res. 2008;78(6):286–92.CrossRefPubMed
8.
go back to reference Chien-Ming C, et al. Effects of vitamin D supplementation on muscle strength in athletes: a systematic review. J Strength Cond Res. 2017;31(2):566–74.CrossRef Chien-Ming C, et al. Effects of vitamin D supplementation on muscle strength in athletes: a systematic review. J Strength Cond Res. 2017;31(2):566–74.CrossRef
9.
go back to reference Annweiler C, et al. Vitamin D and walking speed in older adults: systematic review and meta-analysis. Maturitas. 2017;106:8–25.CrossRefPubMed Annweiler C, et al. Vitamin D and walking speed in older adults: systematic review and meta-analysis. Maturitas. 2017;106:8–25.CrossRefPubMed
11.
go back to reference Aksoy MK, et al. Associations between Handgrip Strength and Vitamin 25(OH)D Levels in Geriatric Patients. Folia Med. 2019;61(3):397–403.CrossRef Aksoy MK, et al. Associations between Handgrip Strength and Vitamin 25(OH)D Levels in Geriatric Patients. Folia Med. 2019;61(3):397–403.CrossRef
12.
go back to reference Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3–10.CrossRefPubMed Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3–10.CrossRefPubMed
14.
go back to reference Cruz-Jentoft AJ, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31.CrossRefPubMed Cruz-Jentoft AJ, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31.CrossRefPubMed
15.
go back to reference Chen LK, et al. Sarcopenia in Asia: Consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15:95–101.CrossRefPubMed Chen LK, et al. Sarcopenia in Asia: Consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15:95–101.CrossRefPubMed
16.
go back to reference Knobe M, et al. The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale. Eur J Trauma Emerg Surg. 2016;42(5):537–45.CrossRefPubMed Knobe M, et al. The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale. Eur J Trauma Emerg Surg. 2016;42(5):537–45.CrossRefPubMed
18.
go back to reference Gupta R, et al. Effect of cholecalciferol and calcium supplementation on muscle strength and energy metabolism in vitamin D-deficient Asian Indians: a randomized, controlled trial. Clin Endocrinol. 2010;73(4):445–51. Gupta R, et al. Effect of cholecalciferol and calcium supplementation on muscle strength and energy metabolism in vitamin D-deficient Asian Indians: a randomized, controlled trial. Clin Endocrinol. 2010;73(4):445–51.
19.
go back to reference Rosendahl-Riise H, et al. Vitamin D supplementation and its influence on muscle strength and mobility in community-dwelling older persons: a systematic review and meta-analysis. J Hum Nutr Diet. 2017;30(1):3–15.CrossRefPubMed Rosendahl-Riise H, et al. Vitamin D supplementation and its influence on muscle strength and mobility in community-dwelling older persons: a systematic review and meta-analysis. J Hum Nutr Diet. 2017;30(1):3–15.CrossRefPubMed
20.
go back to reference Glendenning P, et al. Effects of three-monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: a randomized controlled trial. J Bone Miner Res. 2012;27(1):170–6.CrossRefPubMed Glendenning P, et al. Effects of three-monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: a randomized controlled trial. J Bone Miner Res. 2012;27(1):170–6.CrossRefPubMed
21.
go back to reference Ranathunga RMTK, et al. No effect of monthly supplementation with 12000 IU, 24000 IU or 48000 IU vitamin D3 for one year on muscle function: the vitamin D in older people study. J Steroid Biochem Mol Biol. 2019;190:256–62.CrossRefPubMedPubMedCentral Ranathunga RMTK, et al. No effect of monthly supplementation with 12000 IU, 24000 IU or 48000 IU vitamin D3 for one year on muscle function: the vitamin D in older people study. J Steroid Biochem Mol Biol. 2019;190:256–62.CrossRefPubMedPubMedCentral
22.
go back to reference Matheï C, et al. No relation between vitamin D status and physical performance in the oldest old: results from the belfrail study. Age Ageing. 2013;42:186–90.CrossRefPubMed Matheï C, et al. No relation between vitamin D status and physical performance in the oldest old: results from the belfrail study. Age Ageing. 2013;42:186–90.CrossRefPubMed
23.
go back to reference Faulkner KA, et al. Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women. Osteoporos Int. 2006;17:1318–28.CrossRefPubMed Faulkner KA, et al. Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women. Osteoporos Int. 2006;17:1318–28.CrossRefPubMed
25.
go back to reference Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMed Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMed
26.
go back to reference Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Jt Surg Ser B. 1973;75(5):797–8. Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Jt Surg Ser B. 1973;75(5):797–8.
28.
go back to reference Malmstrom TK, et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28–36.CrossRefPubMed Malmstrom TK, et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28–36.CrossRefPubMed
29.
30.
go back to reference Shechtman O, et al. Reliability and validity of the DynEx dynamometer. J Hand Ther. 2005;18(3):339–47.CrossRefPubMed Shechtman O, et al. Reliability and validity of the DynEx dynamometer. J Hand Ther. 2005;18(3):339–47.CrossRefPubMed
31.
go back to reference Shechtman Orit, Sindhu Bhagwant S. Key Recommendations for Outcome Evaluation of Grip Strength. In: Clinical Assessment Recommendations. 3rd ed. American Society of Hand Therapists; 2015. p. 1–18. Shechtman Orit, Sindhu Bhagwant S. Key Recommendations for Outcome Evaluation of Grip Strength. In: Clinical Assessment Recommendations. 3rd ed. American Society of Hand Therapists; 2015. p. 1–18.
32.
go back to reference Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - A systematic review. BMC Geriatr. 2017;17(238). Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - A systematic review. BMC Geriatr. 2017;17(238).
33.
go back to reference Shechtman O, Sindhu BS. Key Recommendations for Outcome Evaluation of Grip Strength. American Society of Hand Therapists. Shechtman O, Sindhu BS. Key Recommendations for Outcome Evaluation of Grip Strength. American Society of Hand Therapists.
34.
go back to reference Verreault R, et al. Low Serum Vitamin D Does not predict new disability. Am Geriatr Soc. 2002;50(5):912–7.CrossRef Verreault R, et al. Low Serum Vitamin D Does not predict new disability. Am Geriatr Soc. 2002;50(5):912–7.CrossRef
35.
go back to reference Fried LP, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci. 2001;56A(3):146–56.CrossRef Fried LP, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci. 2001;56A(3):146–56.CrossRef
36.
go back to reference Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist. 2008;14(6):355–64.CrossRefPubMed Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist. 2008;14(6):355–64.CrossRefPubMed
38.
go back to reference Kurina LM, et al. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women’s Health Across the Nation. Am J Epidemiol. 2004;160(5):484–91.CrossRefPubMed Kurina LM, et al. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women’s Health Across the Nation. Am J Epidemiol. 2004;160(5):484–91.CrossRefPubMed
39.
go back to reference Phillips SK, et al. Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. Clin Sci. 1993;84(1):95–8.CrossRef Phillips SK, et al. Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. Clin Sci. 1993;84(1):95–8.CrossRef
40.
go back to reference Maltais ML, et al. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009;9(4):186–97.PubMed Maltais ML, et al. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009;9(4):186–97.PubMed
Metadata
Title
The influence of vitamin D on handgrip strength in elderly trauma patients
Authors
Tamara Ostermeier
Leon Faust
Adrian Cavalcanti-Kußmaul
Christian Kammerlander
Matthias Knobe
Wolfgang Böcker
Maximilian M. Saller
Carl Neuerburg
Alexander M. Keppler
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01123-5

Other articles of this Issue 1/2023

European Journal of Medical Research 1/2023 Go to the issue