Handgrip Strength and Dehydroepiandrosterone Sulfate in a Frailty Unit: A Retrospective Study

Area of Science:

• Gerontology
• Endocrinology
• Rehabilitation Medicine

Background:

• Frailty is a complex condition characterized by decreased physical, mental, and social activity, leading to adverse health outcomes.
• Key components of frailty include nutritional status, muscle strength, inflammation, and hormonal changes, with Dehydroepiandrosterone sulfate (DHEAS) being a hormone of interest.
• Handgrip strength (HGS) serves as a proxy for overall muscle strength, and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale is a tool for frailty screening.

Purpose of the Study:

• To investigate the associations between frailty, HGS, and DHEAS in patients within a Portuguese frailty unit (FU).
• To determine if DHEAS levels correlate with frailty status or HGS measurements.
• To evaluate the relationship between HGS and frailty as assessed by the FRAIL scale.

Main Methods:

• An observational retrospective study was conducted in a FU involving patients undergoing a rehabilitation program.
• Frailty was assessed using the FRAIL scale, and DHEAS levels were measured upon admission.
• HGS was measured at admission (i-HGS) and discharge (f-HGS), with HGS variation (∆ HGS) and length of stay also considered.

Main Results:

• Frail patients (FRAIL scale score ≥ 3) exhibited significantly lower i-HGS and f-HGS compared to non-frail patients.
• DHEAS levels showed no significant association with frailty status, FRAIL scale categories, or HGS measurements.
• Lower i-HGS was independently associated with frailty, with each kilogram increase in i-HGS reducing the probability of being frail by 15%.

Conclusions:

• Frail patients demonstrate reduced HGS and longer lengths of stay in the FU.
• This study found no association between frailty and DHEAS, nor correlations between DHEAS and HGS.
• Implementing FRAIL scale screening and HGS measurement in FUs can aid in identifying frail individuals and guiding multidisciplinary interventions.