{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:08:52Z","timestamp":1784812132847,"version":"3.55.0"},"reference-count":45,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Technology Development Program","award":["S2958399"],"award-info":[{"award-number":["S2958399"]}]},{"name":"Ministry of SMEs and Startups (MSS, Republic of Korea)","award":["S2958399"],"award-info":[{"award-number":["S2958399"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Hand grip strength (HGS) and osteoporosis are known to be closely related to the health condition of the elderly, respectively. Comprehensive studies including adults over middle age were insufficient. This study aimed to investigate the relationship between HGS with osteoporosis and health-related quality of life (HRQoL) in adults aged &gt;40 years. Materials and Methods: This cross-sectional analysis included data from 13,966 people aged &gt;40 years between 2015 to 2018 provided by the Korea National Health and Nutrition Examination Survey. The HGS was divided into strong and weak quartiles, defined as the highest and lowest quartiles, respectively. We used the European Quality of Life Scale-Five dimensions (EQ-5D) for HRQoL. We performed multiple logistic regression and post hoc analysis to confirm the relationship between the four groups and HRQoL. Results: Osteoporotic patients with weak HGS showed the lowest EQ-5D index (0.87 \u00b1 0.01) among all groups and had a significantly impaired HRQoL in all EQ-5D dimensions, at least 1.75 times more than healthy individuals with strong HGS (0.95 \u00b1 0.00). Osteoporotic patients with weak HGS showed, notably, 2.68 times more impaired mobility compared to healthy individuals with strong HGS among all five dimensions of the EQ-5D. In self-care, significant sex differences in impaired HRQoL were observed (males 6.03, 2.23\u201316.35; females 2.51, 1.70\u20133.71). Conclusions: Weak HGS and the presence of osteoporosis were associated with low HRQoL, respectively. Middle-aged and older adults with both weak HGS and osteoporosis showed poorer HRQoL compared to healthy middle-aged and older adults. This suggests that HGS is a possible factor for predicting poor HRQoL in adults aged &gt;40 years with or without osteoporosis. It is necessary to assess the risk of low HRQoL by measuring HGS and confirming whether osteoporosis is accompanied in adults over middle age.<\/jats:p>","DOI":"10.3390\/medicina59122148","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T06:56:00Z","timestamp":1702277760000},"page":"2148","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5420-930X","authenticated-orcid":false,"given":"Hyo Jin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byoungduck","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So-youn","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Yeouido St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ho","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Medical Device Industry, Dongguk University, Seoul 04620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Wook","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5614-4175","authenticated-orcid":false,"given":"Seok","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.2147\/CIA.S194543","article-title":"Grip Strength: An Indispensable Biomarker For Older Adults","volume":"14","author":"Bohannon","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"868","DOI":"10.3346\/jkms.2017.32.5.868","article-title":"Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI","volume":"32","author":"Yoo","year":"2017","journal-title":"J. Korean Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e122900","DOI":"10.5812\/intjssh.122900","article-title":"Is It Possible to Age Healthy Performing Ultra-endurance Exercises?","volume":"4","author":"Vancini","year":"2022","journal-title":"Int. J. Sport Stud. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e954","DOI":"10.52547\/aassjournal.954","article-title":"The Effects of Various Stimuli on Motivation and Physical Fitness of Physically Active and Non-Active Students","volume":"9","author":"Pacholek","year":"2021","journal-title":"Ann. Appl. Sport Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1007\/s11357-011-9297-2","article-title":"Low handgrip strength is a predictor of osteoporotic fractures: Cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study","volume":"34","author":"Cheung","year":"2012","journal-title":"Age"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jshs.2020.06.009","article-title":"Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies","volume":"10","author":"Soysal","year":"2021","journal-title":"J. Sport Health Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clnu.2010.09.010","article-title":"Hand grip strength: Outcome predictor and marker of nutritional status","volume":"30","author":"Norman","year":"2011","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.clnu.2004.10.007","article-title":"Handgrip dynamometry in healthy adults","volume":"24","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2022027","DOI":"10.4178\/epih.e2022027","article-title":"Association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019","volume":"44","author":"Ahn","year":"2022","journal-title":"Epidemiol. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"685","DOI":"10.2519\/jospt.2018.7851","article-title":"Hand-Grip Strength: Normative Reference Values and Equations for Individuals 18 to 85 Years of Age Residing in the United States","volume":"48","author":"Wang","year":"2018","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_11","first-page":"207","article-title":"Comparing the Effectiveness of Spirituality Therapy and Acceptance and Commitment Therapy on Sleep Quality, Resilience, and Death Anxiety in the Elderly: Spirituality therapy and ACT in the elderly","volume":"10","author":"Hajatnia","year":"2023","journal-title":"Int. J. Body Mind Cult."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.1016\/S1297-319X(10)70004-X","article-title":"Osteoporosis and mortality","volume":"77","author":"Leboime","year":"2010","journal-title":"Jt. Bone Spine"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Stanghelle, B., Bentzen, H., Giangregorio, L., Pripp, A.H., and Bergland, A. (2019). Associations between health-related quality of life, physical function and pain in older women with osteoporosis and vertebral fracture. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1268-y"},{"key":"ref_14","first-page":"e13261","article-title":"Dual-Energy X-Ray Absorptiometry (DEXA) Scan Versus Computed Tomography for Bone Density Assessment","volume":"13","author":"Alawi","year":"2021","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11657-020-00719-2","article-title":"Association between grip strength and bone mineral density in general US population of NHANES 2013\u20132014","volume":"15","author":"Luo","year":"2020","journal-title":"Arch. Osteoporos."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1007\/s00198-014-2655-z","article-title":"The clinical diagnosis of osteoporosis: A position statement from the National Bone Health Alliance Working Group","volume":"25","author":"Siris","year":"2014","journal-title":"Osteoporos. Int."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Musalek, C., and Kirchengast, S. (2017). Grip Strength as an Indicator of Health-Related Quality of Life in Old Age-A Pilot Study. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14121447"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"12897","DOI":"10.1038\/s41598-022-16373-2","article-title":"Association between changes in working status and hand-grip strength among Korean middle-aged and older adults: A longitudinal panel study","volume":"12","author":"Yun","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1093\/ageing\/afl024","article-title":"Is grip strength associated with health-related quality of life? Findings from the Hertfordshire Cohort Study","volume":"35","author":"Sayer","year":"2006","journal-title":"Age Ageing"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s11657-017-0339-y","article-title":"Hip fractures in young adults: A retrospective cross-sectional study of characteristics, injury mechanism, risk factors, complications and follow-up","volume":"12","author":"Wang","year":"2017","journal-title":"Arch. Osteoporos."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e10594","DOI":"10.1002\/jbm4.10594","article-title":"Dilemmas in the Management of Osteoporosis in Younger Adults","volume":"6","author":"Herath","year":"2022","journal-title":"JBMR Plus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/S0003-9993(95)80607-5","article-title":"Relation Between Grip Strength and Radial Bone Mineral Density in Young Athletes","volume":"76","author":"Tsuji","year":"1995","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/ije\/dyt228","article-title":"Data resource profile: The Korea National Health and Nutrition Examination Survey (KNHANES)","volume":"43","author":"Kweon","year":"2014","journal-title":"Int. J. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chang, S.Y., Han, B.D., Han, K.D., Park, H.J., and Kang, S. (2022). Relation between Handgrip Strength and Quality of Life in Patients with Arthritis in Korea: The Korea National Health and Nutrition Examination Survey, 2015\u20132018. Medicina, 58.","DOI":"10.3390\/medicina58020172"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1111\/jgs.15410","article-title":"Relationship Between Handgrip Strength and Pulmonary Function in Apparently Healthy Older Women","volume":"66","author":"Son","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/ageing\/afr051","article-title":"A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach","volume":"40","author":"Roberts","year":"2011","journal-title":"Age Ageing"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12955-020-01365-5","article-title":"Health-related quality of life measured using the EQ-5D-5 L: Population norms for the capital of Iran","volume":"18","author":"Emrani","year":"2020","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12955-018-1016-6","article-title":"Multimorbidity and health-related quality of life in Koreans aged 50 or older using KNHANES 2013-2014","volume":"16","author":"Park","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_29","first-page":"1","article-title":"A Study on the Application of the Korean Valuation Weights for EuroQoL-5 Dimension","volume":"26","author":"Lee","year":"2009","journal-title":"J. Korean Soc. Health Educ. Promot."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kim, C.R., Jeon, Y.J., Kim, M.C., Jeong, T., and Koo, W.R. (2018). Reference values for hand grip strength in the South Korean population. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195485"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/os.12360","article-title":"Low Grip Strength is a Strong Risk Factor of Osteoporosis in Postmenopausal Women","volume":"10","author":"Li","year":"2018","journal-title":"Orthop. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/MCO.0000000000000202","article-title":"Muscle strength: Clinical and prognostic value of hand-grip dynamometry","volume":"18","author":"Bohannon","year":"2015","journal-title":"Curr. Opin Clin. Nutr. Metab. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"926","DOI":"10.14740\/jocmr2361w","article-title":"Nutrition for Sarcopenia","volume":"7","author":"Yanai","year":"2015","journal-title":"J. Clin. Med. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/gerona\/56.suppl_2.54","article-title":"Nutrition and Quality of Life in Older Adults","volume":"56","author":"Eleni","year":"2001","journal-title":"J. Gerontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1007\/s12199-012-0267-9","article-title":"Association between gait speed and bone strength in community-dwelling postmenopausal Japanese women","volume":"17","author":"Sakazaki","year":"2012","journal-title":"Environ. Health Prev. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hayashida, I., Tanimoto, Y., Takahashi, Y., Kusabiraki, T., and Tamaki, J. (2014). Correlation between muscle strength and muscle mass, and their association with walking speed, in community-dwelling elderly Japanese individuals. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111810"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cooper, R., Hardy, R., Aihie Sayer, A., Ben-Shlomo, Y., Birnie, K., Cooper, C., Craig, L., Deary, I.J., Demakakos, P., and Gallacher, J. (2011). Age and gender differences in physical capability levels from mid-life onwards: The harmonisation and meta-analysis of data from eight UK cohort studies. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027899"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.jpain.2010.10.004","article-title":"Experimental knee pain reduces muscle strength","volume":"12","author":"Henriksen","year":"2011","journal-title":"J. Pain"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.3109\/09638288.2012.731469","article-title":"Higher pain sensitivity and lower muscle strength in postmenonpausal women with early rheumatoid arthritis compared with age-matched healthy women--a pilot study","volume":"35","author":"Friden","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zasadzka, E., Pieczynska, A., Trzmiel, T., Kleka, P., and Pawlaczyk, M. (2021). Correlation between Handgrip Strength and Depression in Older Adults-A Systematic Review and a Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.21203\/rs.3.rs-229479\/v1"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4004","DOI":"10.1038\/s41598-020-60835-4","article-title":"Handgrip strength, dynapenia, and mental health in older Koreans","volume":"10","author":"Noh","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.jad.2018.11.017","article-title":"Effect of grip strength on mental health","volume":"245","author":"Kim","year":"2019","journal-title":"J. Affect Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.3233\/JAD-190856","article-title":"A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory","volume":"73","author":"Shaughnessy","year":"2020","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1093\/ageing\/afv013","article-title":"Association between hand-grip strength and depressive symptoms: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS)","volume":"44","author":"Fukumori","year":"2015","journal-title":"Age Ageing"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1002\/cphy.c120033","article-title":"Muscle as a secretory organ","volume":"3","author":"Pedersen","year":"2013","journal-title":"Compr. Physiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2148\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:36:40Z","timestamp":1760132200000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":45,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["medicina59122148"],"URL":"https:\/\/doi.org\/10.3390\/medicina59122148","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]}}}