ORIGINAL
ARTICLE
CORRELATION BETWEEN
FUNCTIONAL CAPACITY AND GRIP STRENGTH OF THE HAND IN ELDERLY VISITORS TO A
COMMUNITY CENTER
CORRELACIÓN ENTRE LA CAPACIDAD
FUNCIONAL Y LA FUERZA DE AGARRE DE LA MANO EN ANCIANOS QUE FRECUENTAN UN CENTRO
DE CONVIVENCIA
CORRELAÇÃO ENTRE A CAPACIDADE
FUNCIONAL E FORÇA DE PREENSÃO DA MÃO EM IDOSOS FREQUENTADORES DE UM CENTRO DE
CONVIVÊNCIA
https://doi.org/10.31011/reaid-2025-v.99-n.4-art.2477
1Hellyangela
Bertalha Blascovich
2Marcelo Henrique
Ribeiro de Azevedo
3Gabriel Bertalha
Alves
4Francisco Dimitre
Rodrigo Pereira Santos
5Marciene de Sousa
Cavalcante Costa
1Universidade
Federal do Amazonas. Imperatriz – MA – Brazil. Orcid: https://orcid.org/0000-0002-4174-5899
2Unidade De Ensino
Superior do Sul do Maranhão (UNISULMA). Imperatriz
– MA – Brazil. Orcidhttps://orcid.org/0009-0000-3241-9058
3Universidade
Federal do Pará. Belém – PA - Brazil. Orcid:
https://orcid.org/0009-0006-6339-7633
4Universidade
Estadual do Tocantins. Palmas
– TO – Brazil. Orcid:
https://orcid.org/0000-0003-3036-7631
5Unidade De Ensino
Superior do Sul do Maranhão (UNISULMA). Imperatriz
– MA – Brazil. Orcid: https://orcid.org/0000-0001-7885-9817
Corresponding
Author
Hellyangela
Bertalha Blascovich
Universidade
Federal do Amazonas. Imperatriz – MA – Brasil -
E-mail: hellybertalha@hotmail.com
Submission:
27-01-2025
Approval:
22-08-2025
ABSTRACT
The objective of this study was to
correlate the functional capacity and grip strength of the hand in elderly
people. It is a field research, descriptive type with cross-sectional design
and quantitative approach of the data. We included elderly of both sexes,
frequenters of the Center for Coexistence and Strengthening of Ties for Elderly
in the city of Imperatriz, Maranhão. The exclusion criteria were: failure to
complete the study instruments, elderly with communication deficit and unable
to hold the dynamometer. The study was approved by the Committee on Ethics and
Research in Human Beings, through the opinion N.: 4.067.734. The sample was
composed of 83 elderly people, the majority being female (73.5%), white
(38.5%), with incomplete elementary school education (63%), retired (89%),
income between 1 and 2 salaries (92%), widows (43%). About 84% of the elderly
practiced physical activity, 81% had some disease, with arterial hypertension
being the most reported (70%). Regarding the functional capacity, 64% of the
elderly were independent and with an average grip strength of 17.8kgf for women
and 27.0kgf for men. There was a statistically significant positive correlation
between the functional capacity and the grip strength of the hand. It is
concluded that the grip strength of the hand is an important functional marker
in the elderly, because the higher the grip strength of the hand, the greater
the functional capacity. Thus, elderly people attending a community center were
more active and able to carry out their daily life activities.
Keywords: Functional
Capacity; Hand grip Strength; Elderly Population; Living Centers for the
Elderly.
RESUMEN
El
objetivo de este estudio fue correlacionar la capacidad funcional y la fuerza
de agarre de la mano en ancianos. Se trata de una investigación de campo, del
tipo descriptiva con diseño transversal y enfoque cuantitativo de los datos. Se
incluyeron ancianos de ambos sexos, frecuentadores del Centro de Convivencia y
Fortalecimiento de Vínculos para Ancianos de la ciudad de Imperatriz, Maranhão.
Los criterios de exclusión fueron: el no llenado completo de los instrumentos
del estudio, ancianos con déficit de comunicación e incapaces de sostener el
dinamómetro. El estudio fue aprobado por el Comité de Ética e Investigación en
Seres Humanos, a través del dictamen N.: 4.067.734. La muestra estaba compuesta
por 83 ancianos, siendo la mayoría del sexo femenino (73,5%), raza blanca (38,5%),
con escolaridad primaria incompleta (63%), jubilados (89%), ingresos entre 1 y
2 salarios (92%), viudos (43%). Alrededor del 84% de los ancianos practicaban
actividad física, el 81% presentaba alguna enfermedad, siendo la hipertensión
arterial la más reportada (70%). En relación a la capacidad funcional, el 64%
de los ancianos eran independientes y con una fuerza media de agarre de la mano
de 17.8kgf para las mujeres y 27.0kgf para los hombres. Hubo correlación
positiva, estadísticamente significativa, entre la capacidad funcional y la
fuerza de agarre de la mano. Se concluye que la fuerza de agarre de la mano es
importante marcador funcional en los ancianos, pues cuanto mayor sea la fuerza
de agarre de la mano, mayor será la capacidad funcional. Así, los ancianos que
frecuentan un centro de convivencia, se mostraron más activos y capaces de
realizar sus actividades de vida diaria.
Palabras
Clave: Capacidad Funcional; Fuerza de Agarre de
la Mano; Población Anciana; Centros de Convivencia para Ancianos.
RESUMO
O objetivo deste estudo foi correlacionar a capacidade funcional e
a força de preensão da mão em idosos. Trata-se de uma pesquisa de campo, do
tipo descritiva com delineamento transversal e abordagem quantitativa dos
dados. Foram incluídos idosos de ambos os sexos, frequentadores do Centro de
Convivência e Fortalecimento de Vínculos para Idosos da cidade de Imperatriz, Maranhão.
Os critérios de exclusão foram: o não preenchimento completo dos instrumentos
do estudo, idosos com déficit de comunicação e incapazes de segurar o
dinamômetro. O estudo foi aprovado pelo Comitê de Ética e Pesquisa em Seres
Humanos, através do parecer Nº: 4.067.734. A amostra foi composta por 83
idosos, sendo a maioria do sexo feminino (73,5%), raça branca (38,5%), com ensino
fundamental incompleto (63%), aposentados (89%), renda entre 1 e 2 salários
(92%), viúvos (43%). Cerca de 84% dos idosos praticavam atividade física, 81%
apresentavam alguma doença, sendo a hipertensão arterial a mais relatada (70%).
Em relação a capacidade funcional, 64% dos idosos eram independentes e com média
de força de preensão da mão de 17.8kgf para mulheres e 27.0kgf para homens. Houve
correlação positiva, estatisticamente significativa,
entre a capacidade funcional e a força de preensão da mão. Conclui-se
que a força de preensão da mão é importante marcador funcional nos idosos, pois
quanto maior a força de preensão da mão, maior é a capacidade funcional. Assim,
idosos frequentadores de um centro de convivência, se
mostraram mais ativos e capazes de realizar suas atividades de vida diária.
Palavras-Chave: Capacidade
Funcional; Força de Preensão da Mão; População Idosa; Centros de Convivência para Idosos.
INTRODUCTION
Population aging
is a global phenomenon understood as one of the most significant trends of the
21st century, linked to different factors, such as the decline in
birth rates and mortality(1). In Brazil,
it is estimated that 30% of the population will be 65 years or older by 2050,
due to both technological advances in health and reduced fertility rates,
promoting an increase in the proportion and life expectancy of the elderly
population(2).
According
to the World Health Organization(3), an individual aged 60 years or
more in developing countries and 65 years in developed countries is considered
elderly. Thus, aging is a process that causes significant changes in the
social, psychological and biological scope of every human being, since each
person ages in a unique way, according to his genetics, life habits and space
where he is inserted(4).
According
to the Brazilian Institute of Geography and Statistics(5), in Brazil
the population has maintained its propensity to age over the last 10 years.
Between the years of 2012 and 2021, the proportion of individuals aged 60 years
or more rose from 11.3% to 14.7% of the population, obtaining an estimated
value of 31.2 million new elderly who correspond to a significant increase in
the age group in the country.
The
aging process evidences active conditions in physiological systems, especially
in the neuromuscular system, generating biological alterations capable of
leading to a decrease in musculoskeletal mass, muscle strength and functional
capacity. Thus, the reduction of muscle mass is considered to be responsible
for the decrease in strength and quality of life of the elderly population,
which may affect the functional capacity and independence to perform activities
of daily living, having the potential to negatively influence the well-being
the satisfaction of the elderly person, exposing them to a significant risk of
morbidity and mortality(6).
The
hand is one of the fundamental components of the human body with action in
large part of the evolution of humanity, especially for its unique ability to
hold relative to strength and precision(7). In view of this, the
Palmar Gripping Force (PGF) or also called Hand Gripping Force (HGF) is defined
as a general indicative of strength and motor skills of the upper limbs in the
execution of daily tasks, being considered a relevant identifier of functional
declines corresponding to age. The palm grip strength test detects muscle mass
losses and is widely used because it is fast, easy and relatively low cost(8).
Therefore,
the evaluation of HGF using the dynamometer becomes relevant to investigate the
general state of strength of the elderly, as well as to understand their
ability and independence in carrying out their daily activities, since the
reduction of this force is correlated to the inability and dependence of these
individuals in fulfilling them(9).
Functional
capacity assists in maintaining the health and quality of life of the elderly,
since it assures their ability to perform their trivial activities(10).
It indicates the maximum level of functionality that an individual can achieve
in a given assignment, intervenes in the decision of a therapeutic intervention
and acts as a fundamental health indicator(11). Corresponding to
this, the evaluation of functional capacity aims to maintain the health
condition, prevent injuries, and guarantee autonomy and independence to the
elderly person(12).
In
addition, functional capacity can be evaluated by devices composed of several
indicators, including the Barthel index. This scale presents itself as an
effective alternative in the evaluation and quantification of the level of
independence of the elderly, by performing 10 activities such as: eating,
sanitizing, using toilets, bathing, dressing and undressing, controlling the
sphincters, walk, move from chair to bed, climb and descend stairs, and their
total can vary from 0 to 100 points(13).
Given
the above, it is important to know the correlation between functional capacity
and HGF, since both are configured as predictors of independence and
functionality. In addition, they may guide new means of promotion, prevention
and treatment of health complications in the elderly.
Thus,
this study aims to correlate the functional capacity with the grip strength of
the hand in elderly people attending a living center.
MATERIALS AND METHODS
The
present study is a field research, descriptive type with cross-sectional design
and quantitative data approach. The study was approved by the Committee of
Ethics and Research in Human Beings of the Center for Higher Studies of Caxias
of the State University of Maranhão (CESC/UEMA), through the CAAE:
30609320.9.0000.5554 and opinion N.: 4.067.734.
The
study was conducted at the Center for Coexistence and Strengthening of Ties for
elderly people in the city of Imperatriz, Maranhão. The institution offers
health services, provided by nutritionists, physical educators, nurses,
psychologists and physiotherapists, as well as administrative and assistance
services, with the aim of developing a healthy and active aging, greater social
conviviality, and improvement of quality of life.
The
data collection took place between the months of March and August 2023, with
the sample formed by convenience and the study population composed of all the
elderly who were attending the living center during the data collection period.
The
study included elderly people (aged 60 years or over) of both sexes, who
frequented the Center for Coexistence and Strengthening of Ties for the
Elderly. The exclusion criteria were: failure to complete the instruments of
the study, elderly with communication deficit and unable to hold the
dynamometer.
To obtain the information, the elderly
were approached at the reception of the study site, where it was explained
about the objectives and benefits of the study, being then invited to
participate in this research. After the consent of the participants, by signing
the informed Free Consent Form, data collection was carried out.
Initially,
sociodemographic and clinical data of the participants were collected from a
questionnaire prepared by the authors and divided into three parts. In the
first part, the items were collected: name, age, sex, race, weight, height,
body mass index (BMI), schooling, income, marital status, profession and
household composition. The second part was composed of questions on:
comorbidities, life habits, drug history and complementary information. The
third part was composed of data related to the history of falls and
hospitalization in the last 12 months. In addition, the Barthel Index was
applied to evaluate the functional capacity and evaluation with dynamometer to
verify the grip strength of the hand.
The Barthel Index was created in 1955 by Dorothea W. Barthel,
it is used as a resource that evaluates the functional condition and the level
of independence of the human being in the execution of its activities of daily
life, such as bowel and bladder control, use of the bathroom, transfers (bed to
chair and vice versa), mobility (on flat surfaces) and stairs(14).
Information can be obtained quickly,
through dialogue with the elderly or their caregiver. The total score varies
from 0 to 100, making it possible to stratify the level of dependency in: <
20: total dependence; 21-60: severe dependence; 61-90: moderate dependence;
91-99: mild dependence; and 100: independence(15).
The
grip strength of the hand was verified with the use of the digital dynamometer
model EH101, brand Instruterm. The test was performed with a patient sitting
with his feet on the floor, elbow flexed at 90o, forearm adjacent to
the body and the device adjusted to the size of the patient’s hand, then, the
individual used the maximum palm gripping force with his dominant hand around
three seconds, in triplicate, with 30-second intervals between one measurement
and another, to consider the average of the three measurements. For the classification,
values below 27kgf for men and 16kgf for women were used as low hand grip
strength parameters, respectively(16).
The collected data were organized in
spreadsheets of the Microsoft Excel program, and statistical analysis was
performed through the Statistical Package for the Social Sciences (SPSS)
program considering significance level of 5% (p<0.05). Continuous variables
with normal distribution were expressed with mean standard deviation. The
categorical variables were expressed as percentages and frequency. For
correlation between two numerical variables (Barthel index and hand grip
strength) the Pearson coefficient was used, with a reliability index of 95% and
p ≤0.05.
RESULTS
The sample
consisted of 83 elderly with mean age of 71.1 years (SD=6.54), with minimum 60
and maximum 89 years. The majority of the elderly were female (73.5%), white
(38.5%), with incomplete elementary school education (63%), retired (89%),
income between 1 to 2 salaries (92%) and widows (43%). Regarding housing, 40%
of the elderly lived with only one person, being some family member. Data on
sociodemographic characteristics are presented in table 1.
Table 1 - Sociodemographic
characteristics of the elderly participating in the study (N=83). Imperatriz-Maranhão
(2023).
|
Variables
|
N
|
%
|
|
Sex
|
|
Q
|
|
Female
|
61
|
73.5%
|
|
Male
|
22
|
26.5%
|
|
Race
|
|
|
|
White
|
32
|
38.5%
|
|
Black
|
29
|
35%
|
|
Brown
|
22
|
26.5%
|
|
Education
|
|
|
|
Illiterate
|
14
|
17%
|
|
Incomplete
primary school
|
52
|
63%
|
|
Complete
primary school
|
2
|
2%
|
|
Incomplete
high school
|
5
|
6%
|
|
Complete
high school
|
4
|
5%
|
|
Complete
higher education
|
6
|
7%
|
|
Profession
|
|
|
|
Working
|
1
|
1%
|
|
Unemployed
|
5
|
6%
|
|
Retiree
|
74
|
89%
|
|
Others
|
3
|
4%
|
|
Income
|
|
|
|
No
income
|
2
|
2%
|
|
<01
wage
|
5
|
6%
|
|
Between
01 and 02 wages
|
76
|
92%
|
|
Marital
status
|
|
|
|
Single
|
15
|
18%
|
|
Married
|
23
|
28%
|
|
Divorced
|
9
|
11%
|
|
Widowed
|
36
|
43%
|
|
How
many people live with the elderly
|
|
|
|
None
|
26
|
31%
|
|
One
person
|
33
|
40%
|
|
Two
people
|
14
|
17%
|
|
Three
people
|
4
|
5%
|
|
Four
people
|
3
|
4%
|
|
Five
people
|
1
|
1%
|
|
Over
five people
|
2
|
2%
|
|
Kinship
of the people who live with the elderly
|
|
|
|
Spouse/partner
|
16
|
19%
|
|
Children
|
8
|
10%
|
|
Alone
|
26
|
31%
|
|
Other
family members
|
33
|
40%
|
Source:
Research data (2023).
As for health
conditions, a higher number of elderly with comorbidities (81%) was found, and
systemic arterial hypertension was the most reported (70%). There was a
prevalence of elderly people who used some type of medication (84%), with
antihypertensives (69%) being the most used. Most of these elderly practiced
physical activities (70%), 30% denied alcoholism, 51% were ex-smokers and with
Body Mass Index (BMI) classified as overweight (47%). Regarding the history of
falls and hospitalization in the last year, 70% did not suffer falls and 94%
did not require hospitalization.
Given the
importance of falls in the context of gerontology, information about the fall
episode was investigated in the elderly of the sample who reported falling
(n=25). Of these, 19% reported an accidental fall, with the out-of-home
environment being the most prevalent (18%) and only 23% presented
complications. Table 2 presents data on the health conditions of the elderly
participants in this study.
Table 2 – Characteristics
of the conditions of the participating elderly’s health (N=83).
Imperatriz-Maranhão
(2023).
|
Variables
|
N
|
%
|
|
Disease
|
|
|
|
Yes
|
67
|
81%
|
|
No
|
16
|
19%
|
|
Comorbidities*
|
|
|
|
Arterial
hypertension
|
57
|
70%
|
|
Diabetes
mellitus
|
17
|
20%
|
|
Anxiety
|
14
|
17%
|
|
Arthritis/arthrosis
|
11
|
13%
|
|
Heart Diseases
|
8
|
10%
|
|
Others
|
32
|
39%
|
|
Use of drugs
|
|
|
|
Yes
|
70
|
84%
|
|
No
|
13
|
16%
|
|
Number of drugs
|
|
|
|
None
|
13
|
16%
|
|
1 or 2 drugs
|
49
|
59%
|
|
3 or 4 drugs
|
20
|
25%
|
|
5 or more drugs
|
1
|
1%
|
|
Most used drugs+
|
|
|
|
Antihypertensive
|
57
|
69%
|
|
Hypoglycemic
|
13
|
16%
|
|
Anxiolytic
|
5
|
6%
|
|
Anti-inflammatory
|
3
|
4%
|
|
Others
|
9
|
11%
|
|
Physical activity
|
|
|
|
Yes
|
70
|
84%
|
|
No
|
13
|
16%
|
|
Alcohol
|
|
|
|
Yes
|
14
|
17%
|
|
No
|
44
|
53%
|
|
Quit
|
25
|
30%
|
|
Smoking
|
|
|
|
Yes
|
1
|
1%
|
|
No
|
40
|
48%
|
|
Quit
|
42
|
51%
|
|
Body Mass Index (BMI)
|
|
|
|
Normal (18.5 -
24.9)
|
26
|
32%
|
|
Overweights (25 -
29.9)
|
39
|
47%
|
|
Obesity (≤30)
|
18
|
21%
|
|
Hospitalization in the last year
|
|
|
|
Yes
|
5
|
6%
|
|
No
|
78
|
94%
|
|
History of fall in the last year
|
|
|
|
Yes
|
25
|
30%
|
|
No
|
58
|
70%
|
|
Cause of the fall (N=25)
|
|
|
|
Accidental
|
16
|
19%
|
|
Imbalamce
|
8
|
10%
|
|
Dizzinness
|
1
|
1%
|
|
Place of the fall (N=25)
|
|
|
|
House
|
10
|
12%
|
|
Out of home
|
15
|
18%
|
|
Complications due to the fall (N=25)
|
|
|
|
Yes
|
23
|
28%
|
|
No
|
2
|
2%
|
*: the
participants may have reported more than one type of comorbidity.
+:
the
participants may use more than one drug.
Source: Research data (2023).
The general
classification of participants according to the degree of dependence, according
to the Barthel Index, showed that the elderly interviewed were mostly
independent, because 64% did not need any help to carry out their basic
activities of daily living and 36% had mild dependence. Data on the
independence levels of the elderly studied are presented in table 3.
Table 3 – Classification from
the scores of the Barthel Index in the elderly participating in the study
(N=83). Imperatriz-Maranhão
(2023).
|
Score
|
Result
interpretation
|
N
|
%
|
|
100
Points
|
Totally
independent
|
53
|
64%
|
|
91
- 99 points
|
Mild
dependence
|
30
|
36%
|
|
61
- 90 points
|
Moderate
dependence
|
0
|
0,0
|
|
21
- 60 points
|
Severe
dependence
|
0
|
0,0
|
|
<
20 points
|
Total
dependence
|
0
|
0,0
|
|
Total
|
|
83
|
100
|
Source: Research data (2023).
In the evaluation of HGF,
it was found that both men and women had adequate grip strength with the
dominant hand in relation to the standard of normality for each sex (≥27kgf
for men and ≥16kgf for women). Table 4 shows the
data related to the average grip force resulting from the evaluation with the
dynamometer.
Table
4
– Gripping force of the hand in relation to the sex of the elderly
participating in the study (N=83). Imperatriz-Maranhão (2023).
|
Variable
|
Sex
|
N
|
Mean
|
Median
|
Desvio - padrão
|
|
Gripping
force of the hand
|
Women
|
61
|
17.8
|
17.8
|
3.96
|
|
|
Men
|
22
|
27.0
|
26.4
|
7.56
|
|
Source: Research data (2023).
On
the correlation of the grip force of the hand evaluated with the dynamometer
and the functional capacity through the Barthel Index score, it was observed that
there was a weak positive correlation (r of pearson=0.2146; p=0.05)
statistically significant in the total sample. Thus, the greater the grip
strength of the hand, the greater the functional capacity. We also verified the
correlation of the handgrip strength score and the Barthel scale with other
variables, such as: age, BMI, and amount of medication. Observed - if
statistical significance only in the correlation between PPF and age, weak
negative correlation (r=-0.212; p=0.05). Where, the older the age, the younger
the FPP. In relation to the Barthel scores, this did not present a significant
correlation with the variables analyzed. Data on the correlation between hand
grip strength, functional capacity, age and body mass index are presented in
table 5.
Table 5 – Correlation between Gripping
force of the hand, Barthel Index, age and Body Mass Index (BMI) in the elderly
participating in the study (N=83). Imperatriz-Maranhão (2023).
|
|
|
Gripping force of the hand
|
Barthel
|
|
Gripping force of the hand
|
Pearson R
|
—
|
|
|
|
p-value
|
—
|
|
|
Barthel
|
Pearson R
|
0.215
|
—
|
|
|
p-value
|
0.051
|
—
|
|
Age
|
Pearson R
|
-0.212
|
0.048
|
|
|
p-value
|
0.054
|
0.666
|
|
Body Mass Index
|
Pearson R
|
-0.107
|
-0.051
|
|
(BMI)
|
p-value
|
0.335
|
0.645
|
|
Number of drugs
|
Pearson R
|
-0.050
|
0.097
|
|
|
p-value
|
0.652
|
0.381
|
Source: Research data (2023).
DISCUSSION
The
findings of the current study sought to know the correlation between the
functional capacity and the grip strength of the hand of 83 elderly people
attending a Center for Coexistence and Strengthening of Ties for the Elderly in
the city of Imperatriz do Maranhão.
Regarding the
sociodemographic characteristics of the sample, this study showed the
predominance of female elderly. This fact is justified from the process of
feminization of old age and explained by the longevity of women, based on some
aspects such as: hormonal factors, life habits, greater search for health
services and less exposure to risk agents such as smoking, alcoholic beverages,
workplace accidents and automobile accidents(17). In addition,
according to the demographic data of IBGE(18), women reached a life
expectancy of 80.1 years while men 73.1 years, since there is a greater
discrepancy between the mortality rate of men and women, being explained by the
high incidence of deaths due to unnatural or external causes, which affect more
strongly the male population.
Of
course, the prevalence of women stands out among men in the search for living
centers, this may be related to looking at the difference in representation of
old age for both sexes, since women are more interested in social issues and
health care, while men, by culturally acting as providers of the home or by
prejudice, end up opposing to participate in these centers of coexistence(19).
Most of the elderly
self-declared themselves as white, corroborating with a study that evaluated
the prevalence between functional capacity and chronic diseases in 207 elderly
registered in the family health strategy in the city of Diamantina, Minas
Gerais(20). The same, identified the prevalence of white elderly,
female, retired and hypertensive.
When
the analysis of education level was performed, most participants had incomplete
elementary school. This result was similar to a study conducted in a community
center that evaluated the relationship between functional capacity and
depression level in 55 elderly participants of this group(21), where
there was a predominance of elderly with incomplete elementary school, thus,
they found that the higher the level of schooling in the elderly, the better is
the quality of life, access to information and self-perception related to
health.
From the perspective of
economic determinants, most elderly participants were retired and received
between one and two minimum wages. The elderly pensioners have their income
restricted to a minimum wage, imposing a limit on the acquisition of services
and consumer goods, forcing the need for an extra income to ensure better
survival conditions(22).
There is also a
predominance of widowed elderly (43%) who constitute a dominant part of the
demand for this type of social participation. The death of the spouse can
promote the search for centers of coexistence, serving as a subterfuge to face
the pain of loss, moreover, widowhood for women, benefits the interest for
other relationships outside the family environment, since the elderly woman
sees herself detached from the obligations belonging to the previous marriage,
enabling quality of life in old age and the implementation of other activities
in the routine(23).
As for
the family composition of the research participants, it is known that most of
them do not live alone but in the company of a relative. Studies reiterate that
the family is a primary source of base and strengthening of the general health
of the elderly, in short, good family functionality correlates with a greater
perception of health of the elderly person, absence of falls, depression and
functional disability(24).
Regarding health
conditions, in general, the elderly presented with comorbidity and use of 1 to
2 drugs. Systemic arterial hypertension was the most reported pathology in this
study; elderly people with this disease have more health problems and use more
medicines than those without hypertension(25). Regarding the history
of medication, antihypertensives were highlighted as the most consumed by the
elderly. The high prevalence of comorbidities among the elderly explains the
consumption of drugs in large quantities in this age group. Among the most
prescribed drugs for elderly people are those with action on the cardiovascular
system, since the main diseases responsible for the death of this population
are cardiovascular(26).
The
present study observed a high incidence of elderly people who practiced
physical activity. According to a study that aimed to compare the satisfaction
with life of 133 elderly people who frequented living centers and their
attitudes towards old age, as a function of the level of physical activity, it
was found that most of these with a degree of active physical activity,
resulting from living together within this environment that promotes the
practice of physical activities(27).
Regarding
alcoholism and smoking, 53% of the elderly participants in the survey reported
not using alcoholic beverages and 51% being ex-smokers. A study conducted on
the sociodemographic and clinical profile of 381 elderly people accompanied by
Family Health teams revealed that there was a prevalence of elderly ex-smokers
who did not consume alcoholic beverages(28).
The BMI
is calculated according to the formula of weight divided by height squared,
which allows verifying whether or not the person has the appropriate weight(29).
The assessment of BMI in the elderly person is classified as low weight
(<18.5kg/m2), normal weight (18.5 to 24.9kg/m2),
overweight (25 to 29.9kg/m2) and obesity (equal or greater than
30kg/m2), and above the normal assumes overweight with tendency to
obesity and below the normal, indicates a state of malnutrition(30).
In relation to the Body
Mass Index (BMI) of the elderly participants of the survey, in general, they
were overweight. Consenting to a study that aimed to describe the evolution of
BMI and analyze its association with the sociodemographic variables of
35,214,802 elderly Brazilians, through data from Family Budget Surveys (FBS) available
from the Brazilian Institute of Geography and Statistics (IBGE) in 2002/03 and
2008/09, where it obtained as a result the prevalence of overweight elderly
people(31).
With regard to falls and
hospitalization, there was a predominance of elderly without a history of falls
and hospitalization in the last year. Revalidating the result, a study aimed at
analyzing the clinical-functional vulnerability of 216 elderly participants
from a community center found that most of them also reported not having experienced
episodes of falls and hospitalization in the last 12 months(32).
The elderly who attend
community centers other than institutionalized ones have more access to
activities that improve their fitness and make them active. Explained by a
study, where the elderly presented a lifestyle far from sedentary life with the
practice of physical exercises developed in community centers, being able to
avoid the process of frailty, functional disability, hospitalization and falls(33).
On the other hand, the elderly
participants of the study who reported falls presented the reason for the fall
in an accidental way, outside the home and with complications. In a study that
evaluated falls and health-related quality of life in 1000 elderly, showed as
results, the report of elderly who suffered from episodes of falls within the
household and showed greater impairment in functional capacity than those who
suffered falls outside the household, moreover, the most frequent circumstances
were those caused by accidental loss of balance(34).
According to the results
of the Barthel Index, it was observed that 64% of the survey participants
classified themselves as independent. Similar data with a study that correlated
the results of tests to assess functional capacity, using the Katz Index,
Lawton-Brody Index, Barthel Index and Pfeffer Index in elderly participants of
a social inclusion project in Teresina, Piauí, where he stated that the sample
studied was considered independent functional(35).
In a study aimed at
analyzing the functional capacity and quality of life in elderly participants
and non-participants of health promotion groups, it was found that the elderly
frequenters living groups, presented a higher level of functional capacity and
quality of life than those who do not participate in any group. This shows that
despite the intrinsic functional deficits in old age, the elderly who remain
active and engaged in social interaction can age in a healthier and more
functional way(36).
The HGF
of the elderly participants remained within normal parameters for both sexes.
The literature argues that the hand grip strength test is an excellent
predictor of overall strength and has higher levels in men than women, due to
the fact that they have a high proportion of muscle mass and better functional
level, nevertheless, active women are within the normal standards in relation
to grip strength(37).
The
present study showed a weak positive correlation (r of pearson=0.2146; p=0.05),
statistically significant between palm grip strength and functional capacity. A
study that evaluated the correlation of functional and nutritional status in
elderly patients admitted to a general surgery service with a sample of 89
participants. We then measured your grip strength of the hand using a
dynamometer, to measure the grip force in people with possible disorders that
may affect the upper limbs, then performed an assessment of functional
independence through the Barthel Index that investigates the individual’s
ability to perform some activities. They resulted in a moderate positive
correlation (R = 0.531; p < 0.01) and the greater the grip strength of the
dominant hand, the better the functional capacity(38).
In relation to age and grip strength of the hand, in
this study there was a weak negative correlation (r=-0.212; p=0.05).
Corroborating with a study conducted in a northeastern Brazilian city, which
aimed to evaluate and correlate the grip strength of the hand and the
nutritional status of elderly women attending a living center for the elderly,
also verified the HGF in relation to age and concluded that the higher the age,
the lower the HGF and that these have a negative correlation with each other(39).
The results of this study confirmed the presence of a
correlation between functional capacity and grip strength in elderly people.
However, it is interesting to highlight the limitation found and make possible
recommendations for future studies that involve the theme, such as: the
non-homogeneity of sex distribution, where there was predominance of females in
relation to males, restricting greater results. Thus, this study addresses new
issues that could be adopted in future studies, such as a more similar number
of individuals of both sexes and the correlation of HGF and functional capacity
among them.
CONCLUSION
Functional
capacity is a health predictor of the elderly population, so factors that
correlate with it are of great importance for evaluation in this population.
Added to this, the grip strength of the hand reflects the overall strength,
being a form of easy evaluation and reliability.
This
study presented as a sample, elderly people who were mostly female, aged
between 60 and 89 years, self-declared white, attended elementary school in an
incomplete way, retired, with income between 1 to 2 salaries, widows, and most
of them had some type of comorbidity, especially systemic arterial
hypertension. In reference to the grip strength of the hand, the elderly
presented adequate grip strength in relation to the standard of normality. On the
functional capacity, the largest proportion of participants in the research
showed functional independence, according to the Barthel index. There was a
statistically weak positive correlation (r of pearson=0.2146; p=0.05) between
them. Thus, the greater the grip strength of the hand, the greater the
functional capacity.
The
results of this study showed that the grip strength of the hand is associated
with an increase in the functional capacity of elderly people attending a
Community Center in the interior of Maranhão. Where there was a prevalence of
active elderly able to carry out their daily activities, which demonstrates the
importance of the assistance offered by this type of institution.
Finally,
this study fulfilled the proposed objective, allowing to know the
sociodemographic profile and the correlation between the functional capacity
and grip strength of the elderly people attending the Center for Coexistence
and Strengthening of Ties in the city of Imperatriz do Maranhão. Therefore, the
knowledge of these data can serve as a support to health professionals, facing
the prevention of possible functional limitations and disabilities, favoring
the maintenance of the functional capacity of the elderly living in this
center.
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