Handgrip strength as a predictor of adverse events in hospitalized older adults: A prospective cohort study

To evaluate whether dynapenia at hospital admission predicts adverse events in older adults hospitalized for medical conditions.

Prospective observational cohort study.

Hospital Cayetano Heredia, Lima, Peru.

120 patients aged ≥60 years admitted for medical reasons between July and December 2024.

Handgrip strength was assessed within 48 h of admission using a JAMAR® dynamometer. Dynapenia was defined as <12 kg in men and <8 kg in women (sex-specific 25th percentile). Participants were followed for 30 days to identify adverse events, including mortality, delirium, readmission, healthcare-associated infections, pressure ulcers, and falls. Cox regression models estimated hazard ratios (HR).

Median age was 74 years; 49.2% were women. Dynapenia was present in 30% of participants. During follow-up, 45 adverse events were documented: mortality (12.5%), delirium (9.2%), readmission (5.8%), and others (7.4%). Patients with dynapenia had a higher incidence of adverse outcomes (41.7% vs. 16.7%, p < 0.05). Dynapenia was independently associated with adverse events (adjusted HR 2.32; 95% CI: 1.08-4.99). Sensitivity analyses using intrapopulation tertiles and EWGSOP2 thresholds yielded consistent associations.

Dynapenia at admission is an independent predictor of adverse events in hospitalized older adults. Handgrip strength is a simple bedside tool that may improve early risk stratification and support targeted preventive interventions.