International Journal of COPD (Jul 2025)
Impact of Low Hand Grip Strength on Quality of Life, Utilization of Healthcare, and Mental Health in Individuals with Airflow Limitation
Abstract
Sang Hyuk Kim,1,2,* Sungmin Zo,3,* Sung A Kong,4 Ju hee Cho,5 Jong Geol Do,6 Sun Hye Shin,7 Hye Yun Park7 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea; 2Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; 3Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; 4Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; 5Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 6Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 7Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Sun Hye Shin; Hye Yun Park, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea, Email [email protected]; [email protected]: A higher prevalence of sarcopenia has been demonstrated in individuals with airflow limitation (AFL). However, data on the impact of sarcopenia on quality of life, utilization of healthcare, and mental health in individuals with AFL are limited.Patients and methods: We used data from the 2014– 2019 Korea National Health and Nutrition Examination Survey (KNHANES), and participants with AFL were included. Sarcopenia was assessed using hand grip strength (HGS). The outcomes were health-related quality of life (HRQoL), utilization of healthcare, and mental health. The impact of low HGS and outcomes was assessed using multivariable logistic regression analysis.Results: Among participants with AFL, 12.6% had low HGS and the median (interquartile range) of HGS was 22.5 (18.9– 26.1) kg for women and 37.7 (32.9– 42.6) kg for men. After adjusting for confounders, low HGS was associated with a decrease in HRQoL (usual activities: adjusted odds ratio [aOR], 1.70; 95% confidence interval [CI], 1.14– 2.54; pain/discomfort: aOR, 1.44; 95% CI, 1.02– 2.02, anxiety/depression: aOR, 1.59; 95% CI, 1.05– 2.41), and increased perceived stress (aOR, 1.77; 95% CI, 1.24– 2.53). In the subgroup analysis, the impact of low HGS on HRQoL, utilization of healthcare, and mental health was more evident in the reduced lung function and inactive physical activity groups.Conclusion: Overall, low HGS was associated with decreased quality of life and worsening mental health in participants with AFL. Our findings underscore the importance of muscle strength for HRQoL, particularly in those with impaired lung function and sedentary lifestyles, suggesting that regular physical activity including muscle-strengthening exercises may improve HRQoL.Plain Language Summary: People with chronic lung disease often have a higher prevalence of sarcopenia, but it is unclear how this affects their daily life and mental health. In this study, we analyzed national health data from Korea and found that among people with airflow limitation, low hand grip strength was more likely to be associated with poorer quality of life, higher stress levels, and increased use of healthcare services. These issues were more pronounced in people with reduced lung function and low physical activity. Our findings underscore the importance of muscle strength for better quality of life, particularly in those with impaired lung function and sedentary lifestyles, suggesting that regular physical activity including muscle-strengthening exercises may improve quality of life.Keywords: chronic obstructive pulmonary disease, lung diseases, obstructive, sarcopenia, muscle strength
