Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care
Jotheeswaran Amuthavalli Thiyagarajan , Islene Araujo de Carvalho , Juan Pablo PeÃ±a-Rosas, Shelly Chadha, Silvio Paolo Mariotti, Tarun Dua, Emiliano Albanese, Olivier BruyÃ¨re, Matteo Cesari, Alan Dangour, Amit Dias, Mariella Guerra, Jill Keeffe, [ ... ], John R. Beard [ view all ]
Published: October 18, 2019https://doi.org/10.1371/journal.pmed.1002948
Hand Grip Strength and Evidence Based Medicine
Posted by Puliyel on 08 Nov 2019 at 04:33 GMT
Hand grip strength and gait speed are considered objective measures of the frailty syndrome which is associated with cardiovascular mortality (1). These are merely manifestations of the inexorable shortening of the telomeres and there is no suggestion that exercise induced improvements in hand grip can slow the â€˜muffled drums beating funeral marches to the graveâ€™.
We were therefore intrigued to note that the â€˜evidence-basedâ€™ WHO guidelines for the elderly, recommends multimodal exercises to those identified by slow gait speed and poor hand grip strength (2).
They say that those who live by the sword must be prepared to die by the sword. If one swears by evidence based medicine, then evidence needs to be provided that persons with poor hand grip strength are likely to benefit more from these exercises than those who are weak but have preserved hand grip strength.
Senior Resident, Holy Family Hospital, Delhi 110025
Paediatrician Holy Family Hospital, Delhi 110025
1. Chainani V, Shaharyar S, Dave K, Choksi V, Ravindranathan S, Hanno R, Jamal O, Abdo A, Abi Rafeh. (2016) Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: A systematic review. N. Int J Cardiol.;215:487-93. doi: 10.1016/j.ijcard.2016.04.068. Epub 2016 Apr 14.
2. Thiyagarajan JA, Araujo de Carvalho I, PeÃ±a-Rosas JP, Chadha S, Mariotti SP, Dua T, et al. (2019) Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care. PLoS Med 16(10): e1002948. https://doi.org/10.1371/j...
No competing interests declared.