Age-related changes in hand grip strength among rural and urban Haryanvi Jat females

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HOMO— Journal of Comparative

Human Biology 60 (2009) 441–450 www.elsevier.de/jchb

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Age-related changes in hand grip strength among rural and

urban Haryanvi Jat females

Maninder Kaur�

Department of Home Science, Kurukshetra University, Kurukshetra, Haryana, India

Received 23 October 2008; accepted 9 June 2009

Abstract

The aim of this study was to investigate the age-related changes in hand grip strength (both

right and left hand) among rural and urban Jat females and its correlation with various

anthropometric variables. The present cross-sectional study was based on a sample of 600 Jat

females (rural=300, urban=300), ranging in age from 40 to 70 years. Findings indicated that

rural and urban Jat females exhibit an age-related decline in the mean values of hand grip

strength (both right and left hand). The comparison suggested that rural Jat females had

significantly higher overall mean value of hand grip strength (kg) (right hand=20.35 vs 18.87,

po0.001 and left hand=17.05 vs 15.68, po0.001) than their urban counterparts. Mean values

for right hand grip strength were found to be higher than left hand grip strength in rural as

well as urban Jat females. Significant and positive correlation coefficients exist between hand

grip strength (both right and left hand) and various anthropometric variables (height, weight,

body mass index, biceps and triceps skinfold thickness) in both rural and urban Jat females.

An age-related decline in manual functioning of rural and urban Jat females may be attributed

to behavioral factors (reduced physical activity, sedentary lifestyle) and poor nutrition

(deteriorating quality and quantity of food intake with increasing age) associated with the

normal aging process.

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M. Kaur / HOMO— Journal of Comparative Human Biology 60 (2009) 441–450442

Introduction

The ability of older persons to carry out daily tasks independently is largelydependent on the maintenance of sufficient aerobic capacity and muscle strength.Hands undergo many physiological and anatomical changes associated with aging,though the effects of normal aging on adult hand function and dysfunction are stillpoorly understood (Carmeli et al., 2003). Numerous authors have previously studiedgrip strength with regard to nutritional status (Chilima and Ismail, 2001;Manandhar, 1999; Pieterse et al., 2002; Vaz et al., 1996; Watters et al., 1985),morbidity and mortality (Guo et al., 1996; Klidjian et al.,1980; Phillips, 1986),physical performance (Onder et al., 2002; Samson et al., 2000), falls and fractures(Lord et al., 1991; Wickham et al., 1989), but there is limited information regardingage-related changes in grip strength and its correlation with anthropometricvariables among aged females. Hence the present study aimed to assess this aspectamong Haryanvi Jat females residing in rural and urban areas of Haryana (NorthIndia) (Fig. 1).

Materials and methods

Land and people

Haryana is a state in northwest India between 271370 and 301350 latitude andbetween 741280 and 771360 longitude and with an altitude between 210 and 1000mabove sea level. The natural boundaries are the Shivalik hills in the North, RiverYamuna in the East and River Ghaggar in the West. The south-western boundary is

Fig. 1. Map indicating the location of study area (Haryana).

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M. Kaur / HOMO— Journal of Comparative Human Biology 60 (2009) 441–450 443

provided by the range of Aravalli hills, which run through southern Delhi and theGurgaon district up to Alwar. The people of Haryana belong to the Indo-Aryan typeand in parts to the Indo-Dravidian type. Haryana’s population is divided into anumber of castes (jatis): Brahmins, the Rajputs, the Jats and the Ahirs. The Jatsoccupy a prominent place in Haryana, being the single largest group in the region.All the subjects of the present study belonged to one endogamous group that is Jatsof Haryana. The main sub-castes (gotras) were Ahlawat, Dahiya, Dalal, Deswal,Dhanda, Hooda, Jaglian, Jakhar, Lamba, Kadian, Malik and Sahrawat. Both therural and urban sub-groups of the Jat population have the same broad geneticconstitution, but were exposed to different environmental settings. Jats in urban areawere engaged in trade, commerce, government, and private jobs, whereas their ruralcounterparts were mainly agriculturists. Most of the rural (95%) as well as urban(92%) Jat females of the present study were vegetarian. A non-vegetarian diet wasconsumed occasionally by the rest of females. Daily intakes of fruit, vegetables, milkand milk products were below the recommended level in both the rural as well as theurban Jat females. In the present study, the literacy rate was very low among rural(53%) and urban (70%) Jat females. Most of the elderly females were illiterate.Because of social, religious and economic factors a heavy sex bias in favour of boyswas witnessed in the area under study.

Participants

The current cross-sectional research is based on a sample of 600 Jat females(rural=300, urban=300), ranging in age from 40 to 70 years. The data werecollected from the year 2006 to 2007 from rural and urban areas of Haryana, NorthIndia. All the subjects were physically and mentally normal and were not sufferingfrom any chronic disease at the time of data collection. Subjects were excluded if theyhad a history of upper limb injury or deformity. All the rural and urban females ofthe present study had a middle socio-economic status.

All the rural and urban subjects were stratified in six age groups i.e. 40–45 years,46–50 years, 51–55 years, 56–60 years, 61–65 years and 66–70 years. Age in years hadbeen obtained from the date of birth, which most of the urban females could recall.In the majority of rural females and for some aged urban females age had to beascertained by association with some important events such as age at marriage, ageof the first child, any important festival, etc. With this cross-questioning, it waspossible to ascertain the approximate age of the subject. General informationregarding their socio-economic status, education, occupation, income, parity, familysize and structure was also recorded.

Hand grip strength (kg) was measured with a dynamometer (analogue model,range 0–100 kg, made in Japan). Subjects were encouraged to exert their maximalgrip. The subjects performed three hand grip tests with each hand. The best resultwas chosen for analysis. Height, weight, biceps and triceps skinfold thicknesses weremeasured by the standard techniques as recommended by Weiner and Lourie(1981). Body mass index was computed as weight in kg divided by height in meterssquared (m2).

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Data were analysed using the Statistical Package for Social Sciences (SPSS)version 14.0. The magnitude of rural and urban difference at all ages was assessed byStudent’s t-test at three levels of significance: po0.05 (*), po0.01 (**) and po0.001(***). Karl Pearson’s correlation coefficient (r) was employed to find the relationshipbetween two variables.

Results

Table 1 presents mean and standard deviation values of various anthropometricvariables of rural and urban Jat females.

Rural Jat females were lighter (56.07, sd 8.96 vs 57.36, sd 10.41) and significantlyshorter (1534.5mm, sd 59.8 vs 1553.3mm, sd 53.1) than their urban Jat counterparts.Biceps (16.24mm, sd 3.30 vs 16.34mm, sd 3.93) and triceps (20.22mm, sd 2.35 vs20.75mm, sd 2.60) skinfold thicknesses of rural females were lower as compared tourban females.

Age-wise mean and standard deviation values of right hand grip strength (kg) inrural and urban Jat females are shown in Table 2.

Right hand grip strength of rural Jat females had dropped from 26.36 kg at 40–45years to 14.66 kg at 66–70 years, showing a net decline of 11.7 kg during the entireage range under consideration. In urban Jat females maximum mean value for righthand grip strength was noted at 40–45 years (23.22 kg) and minimum value at agegroup 66–70 (14.70 kg), and a net loss of 8.52 kg from 40 to 70 years was observed.Rural females were found to have higher mean values of right hand grip strengththan their urban counterparts, although highly significant (po0.001) differences hadbeen obtained only at 40–45 years and 51–55 years.

Table 3 shows age-wise mean and standard deviation values of left hand gripstrength (kg) in rural and urban Jat females.

Left hand grip strength of rural females registered an average value of 23.42 kg forthe age group 40–45 years and a loss of 11.48 kg to attain a mean value of 11.58 kgfor the age group 66–70 years. In urban females, beginning with a mean value of21.08 kg for the age group 40–45 years, this variable decreased to 11.54 kg for the age

Table 1. General characteristics of the participants.

Anthropometric variables Rural Jat females (N=300) t-value Urban Jat females (N=300)

Mean Standard

deviation

Mean Standard

deviation

Height (mm) 1534.5 59.8 4.05*** 1553.3 53.1

Weight (kg) 56.07 8.96 1.63 57.36 10.41

Body mass index (kg/m2) 22.41 4.23 1.21 22.83 4.32

Biceps skinfold (mm) 16.24 3.30 0.34 16.34 3.93

Triceps skinfold (mm) 20.22 2.35 2.61** 20.75 2.60

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Table 2. Mean and standard deviation (SD) values for right hand grip strength (kg) in rural

and urban Jat females.

Age group (in years) Rural Jat females t-value Urban Jat females

N Mean SD N Mean SD

40–45 50 26.36 3.23 3.88*** 50 23.22 4.70

46–50 50 23.90 3.24 1.20 50 22.98 4.34

51–55 50 21.32 3.89 4.18*** 50 18.20 3.54

56–60 50 19.02 3.79 1.63 50 18.02 2.09

61–65 50 16.84 3.12 1.42 50 15.92 3.34

66–70 50 14.66 3.18 0.37 50 14.70 3.17

Total 300 20.35 5.25 3.58*** 300 18.87 4.82

Table 3. Mean and standard deviation (SD) values for left hand grip strength (kg) in rural and

urban Jat females.

Age group (in years) Rural Jat females t-value Urban Jat females

N Mean SD N Mean SD

40–45 50 23.42 3.48 2.90*** 50 21.08 4.50

46–50 50 19.60 3.23 0.52 50 19.22 3.93

51–55 50 18.76 3.33 4.91*** 50 15.38 3.53

56–60 50 15.26 3.44 1.69 50 14.20 2.77

61–65 50 13.68 3.23 1.64 50 12.66 2.96

66–70 50 11.58 2.94 0.07 50 11.54 2.75

Total 300 17.05 5.14 3.35*** 300 15.68 4.85


group 66–70 years. Rural females showed higher mean values of left hand gripstrength than their urban counterparts and differences were highly significant(po0.001) only at 40–45 years and 51–55 years.

Total correlation coefficient values, showing association between grip strength(both right and left hand) of rural and urban Jat females with variousanthropometric variables, are demonstrated in Table 4.

Right and left hand grip strength were highly correlated with each other in ruralJat females (r=0.841**) and urban Jat females (r=0.893**). Significant and positivetotal correlation coefficients were observed between right and left hand grip strengthand height (r=0.439** and r=0.445**, respectively, in rural females and r=0.193**and r=0.224**, respectively, in urban Jat females), weight (r=0.319** andr=0.234**, respectively, in rural females and r=0.168** and r=0.205**,respectively, in urban Jat females).

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Table 4. Total correlation coefficient (r) showing association of grip strength (right and left

hand) of rural and urban Jat females with anthropometric variables.

Anthropometric

variables

Rural Jat females Urban Jat females

Right hand

grip strength

Left hand grip

strength

Right hand

grip strength

Left hand grip

strength

Height 0.439** 0.445** 0.193** 0.224**

Weight 0.319** 0.234** 0.168** 0.205**

Body mass index 0.217** 0.130* 0.138* 0.169**

Biceps skinfold 0.482** 0.476** 0.507** 0.542**

Triceps skinfold 0.412** 0.415** 0.306** 0.361**


Body mass index also presented a positive association with right and left hand gripstrength (r=0.217** and r=0.130*, respectively, in rural females and r=0.138* andr=0.169**, respectively, in urban Jat females). Significant and positive totalcorrelation coefficients were observed between right and left hand grip strength andbiceps (r=0.482** and r=0.476**, respectively, in rural females and r=0.507** andr=0.542**, respectively, in urban Jat females) and triceps skinfold thickness(r=0.412** and r=0.415**, respectively, in rural females and r=0.306** andr=0.361**, respectively, in urban Jat females).

Discussion

Hand grip strength is the most common assessment method for upper extremitymuscle strength (Vespa, 1992). In the present study hand grip strength (both rightand left hand) of rural as well as urban Jat females showed a decline with increasingage. A similar pattern of age-related decrease in manual performance has beendemonstrated by a number of previous studies (Carmeli et al., 2003; Chong et al.,1994; Hussain, 1997; Jansen et al., 2008; Kaur, 2008). Grimby (1995) and Rantanenet al. (1998) in longitudinal and cross-sectional studies, reported a rapid decline inhand grip strength after 60 years of age by as much as 20% from peak levels. In amultiethnic and geographically vast country such as India, general health andparticularly physical performance of females should be analysed from the economicand socio-cultural point of view because the majority of the Haryanvi females werefacing gender discrimination, illiteracy, early and unregulated fertility along withpoor access to health services. In the present study most of the rural (95%) andurban (92%) Jat females were vegetarian and had a relatively monotonous diet. Sixtynine percent of rural and 35% of urban females ate twice a day. Daily dietary intakeof both the rural and urban females was below the recommended dietary allowances.Urban females had a more sedentary lifestyle as compared to their ruralcounterparts. Hence, this age-related decline in muscular strength among Haryanvi

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Jat females may be attributed to reduced physical activity and deteriorating qualityand quantity of food with advancing age associated with the normal aging process.Carmeli et al. (2003) and Ranganathan et al. (2001) also observed that decliningphysical activity, reduced exercise levels and sedentary lifestyle of elderly subjectsmay contribute to the deterioration of their hand function. Watters et al. (1985) andChilima and Ismail (2001) found that malnutrition may be a contributing factor toreduced manual functioning among elderly adults. Philips et al. (1992) observed thatlow post menopausal estrogen levels among women were associated with lowerstrength of the abductor pollicis muscle, thereby indicating that besides anthropo-metric factors, hormonal status also affects muscle strength. These findings clearlydepict that the ageing process is associated with progressive declines in musclestrength, resulting in functional disability and reduced quality of life (Forrest et al.,2007).

Rural and urban Jat females of the present study showed that grip strength of theright hand was greater than that of the left hand, which was also supported by earlierstudies (Hussain, 1997; Kaur, 2008). This may be probably because in the majorityof participants the right hand dominated over the left hand. Kamarul et al. (2006)reported that hand grip strength was significantly correlated with hand dominance.The present study also revealed that rural Jat females had a higher hand gripstrength (both right and left hand) than their urban counterparts. On the contraryHussain (1997) and Kaur (2008) previously reported that urban females had highermean values of hand grip strength (both right and left hand) than their ruralcounterparts. Higher grip strength of rural Haryanvi Jat females than their urbancounterparts may be attributed to their different lifestyles. Rural females wereengaged in physical work, whereas urban females had more sedentary lifestyle.Varakamin et al. (1998) also observed that lifestyle may influence both bodycomposition and muscular strength.

Table 5 shows the comparison of hand grip strength of Jat females of the presentstudy with Brahmin females (Kaur, 2008). Rural and urban Jat females showedgreater mean values of hand grip strength (both right and left hand) than rural andurban Brahmin females. Maximum mean values of hand grip strength (both rightand left hand) were reported in rural Jat females followed by urban Jat females andurban Brahmin females, respectively, whereas rural Brahmin females were reportedto have least mean values hand grip strength (both right and left hand). Thedifferences in the mean values of grip strength of Jat as well as Brahmin females maybe attributed to their different lifestyles. All the females showed a gradual decline inthe mean values of grip strength as age advances at all the age levels, therebydepicting a general trend of falling health and muscular strength with increasing age.

In the current cross-sectional study both rural and urban Jat females revealed apositive and significant correlation coefficient of hand grip strength with height,weight and body mass index. Chatterjee and Chowdhuri (1991) also observed thatright and left hand grip strength was positively correlated with weight, height andbody surface area. Similar findings were reported by a number of previous cross-sectional studies (Chilima and Ismail, 2001; Hanten et al., 1999; Koley and Singh,2009; Manandhar, 1999; Pieterse et al., 2002). Gale et al. (2007) also found a positive

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Table 5. Age group wise comparison of grip strength (right and left hand) of rural and urban

Jat females with rural, urban Brahmin females.

Age group

(in years)

Hand grip

strength

Rural Jat

females

Urban Jat

females

Rural

Brahmin

females

Urban

Brahmin

females

40–45 Right 26.36 23.22 20.92 21.20

Left 23.42 21.08 18.13 18.67

46–50 Right 23.90 22.98 19.26 20.08

Left 19.60 19.22 17.14 17.38

51–55 Right 21.32 18.20 16.33 16.82

Left 18.76 15.38 13.00 15.05

56–60 Right 19.02 18.02 13.54 14.74

Left 15.26 14.20 10.22 12.65

61–65 Right 16.84 15.92 12.84 13.45

Left 13.68 12.66 9.65 10.85

66–70 Right 14.66 14.70 10.08 11.08

Left 11.58 11.54 9.00 9.91


correlation of hand grip strength with height and body mass index among elderlywomen. Significant and positive correlations exist between hand grip strength (bothright and left hand) and biceps and triceps skinfold thicknesses in both rural andurban Jat females, thereby showing an association of manual performance with theanthropometric variables related to the upper extremities.

In conclusion, the present study confirms the previously reported age-relateddecline of hand grip strength. Carmeli et al. (2003) observed that deterioration ofhand function occurs as a result of both normal aging and established disordersfrequently encountered in older people such as osteoporosis, osteoarthritis andrheumatoid arthritis. Hence such studies can potentially be used in understandingage associated changes in muscle strength and functional mobility.

Acknowledgements

The author is thankful to the Department of Science and Technology (New Delhi)for financial support under Women Scientist Scheme (SR/WOS-A/LS-60/2005) tocarry out this work.

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Age-related changes in hand grip strength among rural and urban Haryanvi Jat females

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