Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study

Abstract Background Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs. Methods We used data from 13,613 parti...

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Main Authors: Kevin Yiqiang Chua, Kelvin Bryan Tan, Rachel Tong, Jon Barrenetxea, Woon-Puay Koh, Cynthia Chen
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21489-x
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author Kevin Yiqiang Chua
Kelvin Bryan Tan
Rachel Tong
Jon Barrenetxea
Woon-Puay Koh
Cynthia Chen
author_facet Kevin Yiqiang Chua
Kelvin Bryan Tan
Rachel Tong
Jon Barrenetxea
Woon-Puay Koh
Cynthia Chen
author_sort Kevin Yiqiang Chua
collection DOAJ
description Abstract Background Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs. Methods We used data from 13,613 participants in the population-based Singapore Chinese Health Study who underwent assessment for handgrip strength and TUG time at a mean age of 74 years. Hospitalization costs for the subsequent year, among those who survived for at least one year thereafter, were ascertained via linkage with administrative healthcare finance data. We analyzed costs using a two-part model that contained a probit regression model in the first part, and a generalized linear regression model with gamma distribution and log link in the second. Results Handgrip strength showed a dose-dependent inverse relationship with hospitalization costs (P trend<0.001). Compared to the strongest quartile, participants in the weakest quartile experienced a 38.2% (95% CI: 18.0-58.5%) increase of US$599 (US$281-US$917) in mean costs. Conversely, TUG time demonstrated a dose-dependent positive association with hospitalization costs (P trend<0.001). Compared to the fastest quartile, participants in the slowest quartile had a 103.0% (72.1-133.9%) increase of US$1431 (US$1002-US$1859) in mean costs. We then examined combinations of handgrip strength and TUG time. Compared to participants who were both strong and fast, participants who were either weak or slow only had 12.9–48.7% higher mean costs. Meanwhile, participants who were both weak and slow experienced a 99.9% (68.5-131.4%) increase of US$1630 (US$1116-US$2144) in mean costs. Conclusions Weak handgrip strength and slow TUG time were independently associated with increased hospitalization costs among older adults.
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spelling doaj-art-c7e131af479c49239e384590f441e8c62025-01-26T12:56:20ZengBMCBMC Public Health1471-24582025-01-0125111210.1186/s12889-025-21489-xRelationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based studyKevin Yiqiang Chua0Kelvin Bryan Tan1Rachel Tong2Jon Barrenetxea3Woon-Puay Koh4Cynthia Chen5Integrative Sciences and Engineering Programme, NUS Graduate School, National University of SingaporeMinistry of HealthMinistry of HealthHealth Services and Systems Research, Duke-NUS Medical School SingaporeHealthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSaw Swee Hock School of Public Health, National University of SingaporeAbstract Background Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs. Methods We used data from 13,613 participants in the population-based Singapore Chinese Health Study who underwent assessment for handgrip strength and TUG time at a mean age of 74 years. Hospitalization costs for the subsequent year, among those who survived for at least one year thereafter, were ascertained via linkage with administrative healthcare finance data. We analyzed costs using a two-part model that contained a probit regression model in the first part, and a generalized linear regression model with gamma distribution and log link in the second. Results Handgrip strength showed a dose-dependent inverse relationship with hospitalization costs (P trend<0.001). Compared to the strongest quartile, participants in the weakest quartile experienced a 38.2% (95% CI: 18.0-58.5%) increase of US$599 (US$281-US$917) in mean costs. Conversely, TUG time demonstrated a dose-dependent positive association with hospitalization costs (P trend<0.001). Compared to the fastest quartile, participants in the slowest quartile had a 103.0% (72.1-133.9%) increase of US$1431 (US$1002-US$1859) in mean costs. We then examined combinations of handgrip strength and TUG time. Compared to participants who were both strong and fast, participants who were either weak or slow only had 12.9–48.7% higher mean costs. Meanwhile, participants who were both weak and slow experienced a 99.9% (68.5-131.4%) increase of US$1630 (US$1116-US$2144) in mean costs. Conclusions Weak handgrip strength and slow TUG time were independently associated with increased hospitalization costs among older adults.https://doi.org/10.1186/s12889-025-21489-xGripMuscleStrengthTimed-up-and-goTUGPhysical
spellingShingle Kevin Yiqiang Chua
Kelvin Bryan Tan
Rachel Tong
Jon Barrenetxea
Woon-Puay Koh
Cynthia Chen
Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
BMC Public Health
Grip
Muscle
Strength
Timed-up-and-go
TUG
Physical
title Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
title_full Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
title_fullStr Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
title_full_unstemmed Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
title_short Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study
title_sort relationship between handgrip strength and timed up and go test on hospitalization costs in older adults a population based study
topic Grip
Muscle
Strength
Timed-up-and-go
TUG
Physical
url https://doi.org/10.1186/s12889-025-21489-x
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