Table 2 Details and HGS protocols of the studies that diagnose frailty, included in this systematic review

Multicentric prospective cohort study

Burgos, Albacete and Madrid, Spain

Abizanda et al. [92] ^(c)

Institutionalised older adults, in four nursing homes from the ACTIVNES study

≥70

Jamar hand dynamometer, Sammons Preston Rolyan, Bolingbrook, IL

3

–

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Neutral

2nd

–

–

–

Higher value

Fried’s criteria^*

Cross-sectional study

Alexandria, Egypt

Abou-Raya et al. [93]

Consecutive patients with congestive heart failure

≥65

Jamar hand dynamometer

2

Dominant

Sitting position

Adducted

90°

Between 0 and 30° dorsiflexion and 0 and 15° ulnar deviation

2nd

Yes

–

–

–

M: ≤21 kgf

W: ≤14 kgf

Cross-sectional study

USA

Bandeen-Roche et al. [94]

Older adults from the 2011 baseline of the National Health and Aging Trends Study

≥65

Jamar digital hand dynamometer

2

Dominant

Sitting position

Adducted

90°

Dynamometer or forearm resting on the table

2nd

Yes

–

–

Higher value

Lowest 20% within 8 sex and BMI categories

Cross-sectional study

The Netherlands

Bastiaanse et al. [56] ^(a)

Adults with intellectual disabilities from the HA-ID study

≥50

Jamar hand dynamometer, Sammons Preston Rolyan, USA

6

Both

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Neutral

2nd

–

–

1 min

Higher value

Fried’s criteria^*

Cross-sectional study

Liège, Belgium

Beaudart et al. [58] ^(d)

Community-dwelling older adults from the SarcoPhAge study

≥65

Hydraulic dynamometer Saehan Corporation, MSD Europe, Bvba, Belgium

(calibrated)

6

Both

Sitting position

–

Forearms resting on the arms of the chair

Neutral position, over the end of the arm of the chair, thumb facing upwards

Adjusted so that the thumb is round one side of the handle and the four fingers are around the other side

Yes

–

–

Higher value

Fried’s criteria^*

Cross-sectional study

England

Buttery et al. [95]

Consecutively patients from three elderly care wards of an urban teaching hospital

67–91

Jamar isometric hand dynamometer, Sammons Preston, Bolingbrook, Illinois, USA

6

Both

Sitting position

Adducted and neutrally rotated

90°

Between 0 and 30° dorsiflexion and 0 and 15° ulnar deviation

2nd

Yes

–

–

Higher value

Compared with normative data from Bohannon et al. [96]

Cross-sectional study

Germany

Buttery et al. [97]

Community-dwelling older adults from the DEGS1

65–79

Smedley hand dynamometer, Scandidact, Denmark, 100 kg

4

Both

Standing upright

–

–

–

–

–

–

–

Higher value

Fried’s criteria^*

Cross-sectional study

Urban administrative section of Taipei, Taiwan

Chang et al. [98]

Community-dwelling older adults

≥65

Handgrip dynamometer, Fabrication Enterprises, Inc., Irvington, NY

–

Both

–

Adducted

90°

–

–

Yes

–

–

–

Lowest 20% at baseline

Cross-sectional study

Saint Bruno,Québec, Canada and Santa Cruz, Rio Grande do Norte, Brazil

Da Camara et al. [99]

Community-dwelling older adults

65–74

Jamar hand dynamometer, Jamar, Irvington, NY, USA

3

–

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Neutral

Adjusted to a comfortable position between the 2nd or 3th handle

–

–

1 min

Mean value

Fried’s criteria^*

Cross-sectional study

Chicago, USA

Danilovich et al. [100] ^(b)

Convenience sample of older adults

≥65

Jamar hand hydraulic dynamometer

4

Both

Sitting position

Adducted and neutrally rotated

90°

Between 0 and 30° dorsiflexion

2nd

–

–

–

Higher value

M: <30 kgf

W: <20 kgf

Cross-sectional study

Denmark

Dato et al. [101]

Community-dwelling older adults

≥70

Smedley hand dynamometer TTM

3

Dominant

Sitting position

Adducted

–

–

–

–

–

–

Higher value

**

Cross-sectional study

The Netherlands

Evenhuis et al. [102]

Individuals with borderline to profound intellectual disabilities of three care provider services from the HA-ID Study

≥50

Jamar hand dynamometer, 5030 J1, Sammons Preston Rolyan, Dolgeville, NY

6

Both

Sitting position

Adducted and neutrally rotated

90°

Between 0 and 30° dorsiflexion and 0 and 15° ulnar deviation

2nd

Yes

–

–

–

Fried’s criteria^*

Prospective cohort study

USA

Fried et al. [10]

Community-dwelling older adults from the Cardiovascular Health study

≥65

Jamar hand dynamometer

3

Dominant

Sitting position

–

90°

–

2nd

Yes

–

–

Mean value

Fried’s criteria^*

Cross-sectional study

The Kolpino district, St. Petersburg, Russia

Gurina et al. [103]

Community-dwelling older adults from the “Crystal” Study

≥65

Carpal dynamometer (DK-50, Nizhni Tagil, Russian Federation)

6

Both

Standing upright

Arms hanging down at the sides

–

–

–

–

–

30 s

Mean value

Lowest 20%, adjusted for sex and BMI

Cross-sectional study

Vienna, Austria.

Haider et al. [104] ^(d)

Pre-frail and frail community-dwelling older adults

≥65

Jamar hydraulic hand

dynamometer, Lafayette, Louisiana

6

Both

Sitting position

–

Forearms resting on the arms of the chair

Neutral, over the end of the arm of the chair, thumb facing upwards

Adjusted so that the thumb is round one side of the handle and the four fingers are around the other side

Yes

–

1 min

Higher value

**

Cross-sectional and prospective cohort study

The Netherlands

Hoogendijk et al. [105]

Older adults from the Longitudinal Aging Study Amsterdam

≥65

Takei TKK 5001, Takei Scientific Instruments, Tokyo, Japan

4

Both

Standing upright or sitting position when the participant was not able to stand

–

180°

–

–

–

–

–

Sum of the highest values of each hand

Fried’s criteria^*

Cross-sectional study

Seoul, Korea

Kang et al. [106]

Female outpatients from the department of family medicine at Kangbuk Samsung Hospital

≥65

Lavisen electronic hand grip dynamometer KS 301, Lavisen Co.

Ltd., Namyangju, Korea

–

Right

–

Abducted

180°

–

Medial phalange of the third finger perpendicular to the handle

–

–

–

–

≤14.5 kgf

Cross-sectional study

Seoul and Gyeonggi province, Korea

Kim et al. [107]

Older adults who registered at six senior welfare centers

≥65

Jamar hydraulic hand dynamometer; Sammons Preston, Bolingbrook, IL, USA

2

–

–

Abducted

180°

–

–

–

–

–

Higher value

Lowest 20%, adjusted for sex and BMI

Cross-sectional study

Beaver Dam, Wisconsin

Klein et al. [108]

Adults and older adults from the Beaver Dam Eye Study

≥53

Lafayette hand dynamometer, Model 78,010, Lafayette Instrument Company, Lafayette, Indiana

4

Both

Standing upright

Abducted

180°

–

Adjusted to hand size

–

–

–

Mean value for the dominant hand

M: ≤ 34.5 kgf

W: ≤ 18.5 kgf

Randomised controlled trial

Itabashi Ward, Tokyo, Japan

Kwon et al. [109]

Pre-frail community-dwelling older women

≥70

Smedley hand dynamometer, Yagami, Tokyo, Japan

2

Dominant

Standing upright

Arms hanging naturally at their sides

–

–

–

–

–

–

Higher value

W: ≤23 kgf at baseline

Cohort study

Korea

Lee et al. [110]

Community-dwelling older adults from the Living profiles of Older People Survey

≥65

Tanita, No. 6103, Japan

4

Both

–

Elbow by the side of the body

90°

–

–

–

–

–

Higher value

Lowest 20%, adjusted for sex and BMI

Prospective cohort study

Boston, Massachusetts, USA

Mohr et al. [111]

Community-dwelling men from the Massachusetts Male Aging study

50–86

Jamar hydraulic hand dynamometer, Sammons Preston, Bolingbrook, IL

2

Dominant

Sitting position

Arms at their sides

90°

Forearm neutral

Neutral

Adjusted to hand size

–

3 s

1 min

Higher value

M: ≤28 kgf (BMI ≤ 24.9 kg/m²);

≤30 kgf (BMI 25.0–27.2 kg/m²); ≤32 kgf

(BMI > 27.2 kg/m²)

Prospective cohort study

Barcelona, Spain

Mora et al. [112]

Community-dwelling women from the Mataró Ageing Study

≥70

Jamar hand dynamometer

3

Non-dominant

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Between 0 and 30° dorsiflexion and between 0 and 15° ulnar deviation

–

Yes

–

–

Mean value

Fried’s criteria^*

Cross-sectional study

Belo Horizonte, Brazil

Moreira et al. [113] ^(b)

Community-dwelling older women with type 2 diabetes

65–89

Jamar hand dynamometer

3

Dominant

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Between 0 and 30° dorsiflexion

2nd

Yes

–

–

Mean value

Fried’s criteria^*

Double-blind, randomised, controlled trial

Rotterdam, The Netherlands

Muller et al. [114]

Community-dwelling older men

≥70

Jamar hand dynamometer, Horsham, PA

3

Non-dominant

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Between 0 and 30° dorsiflexion and between 0 and 15° ulnar deviation

–

Yes

–

–

Mean value

**

Cross-sectional study

Dimantina, Brasil

Parentoni et al. [115] ^(c)

Convenience sample of older women

≥65

Saehan dynamometer, SH5001

(calibrated)

3

Dominant

Sitting position

Adducted and neutrally rotated

90°

Forearm neutral

Neutral

2nd

Yes

–

1 min

Mean value

Fried’s criteria^*

Cross-sectional study

Calabria district, Italy

Passarino et al. [116]

Community-dwelling older adults

65–85

Smedley hand dynamometer TTM

3

Dominant

Sitting position

Adducted

–

–

–

–

–

–

Higher value

**

Cohort study

Texas, New Mexico, Colorado, Arizona and California, USA

Samper-Ternent et al. [117]

Non-institutionalised Mexican Americans from the Hispanic Established Population for the Epidemiological Study of the Elderly

≥65

Jamar hydraulic hand dynamometer, Model 5030 J1, J.A. Preston Corp., Clifton, NJ

2

Dominant

Sitting position

–

Resting on the table

Palm facing up

Adjusted to a comfortable position

Yes

–

–

Higher value

Lowest 20%, adjusted for sex and BMI

Cohort study

United States and Denmark

Sanders et al. [118]

Community-dwelling individuals from The Long Life Family Study

32–105

Jamar hydraulic hand Dynamometer, Lafayette, IN

2

Dominant

Sitting position

–

–

–

–

–

–

–

Mean value

Lowest 25%, adjusted for sex and BMI

Cross-sectional study

Saarland, Germany

Saum et al. [119] ^(d)

Community-dwelling adults from ESTHER study

≥59

Jamar hand dynamometer, Lafayette Instrument Company, Lafayette, IN

3

Dominant

Sitting position

–

Forearm resting on the arm of the chair

Neutral, over the end of the arm of the chair, thumb facing upwards

Adjusted so that the thumb is round one side of the handle and the four fingers are around the other side

Yes

–

–

Higher value

M: <30 kgf

W: <20 kgf

and

Fried’s criteria^*

Cross-sectional study

Lausanne, Switzerland

Seematter-Bagnoud et al. [120]

Community-dwelling older adults from the Lc65+ study

65–70

Baseline hydraulic dynamometer

3

Right

Sitting position

Adducted and neutrally rotated

90°

Between 0 and 30° dorsiflexion and 0 and 15° ulnar deviation

2nd

Yes

–

–

Higher value

Fried’s criteria^*

Randomised, Double-Blind, Placebo-Controlled Trial

The Netherlands

Tieland et al. [121]

Frail older adults

≥65

Jamar hand dynamometer, Jackson, MI, USA

6

Both

Sitting position

–

90°

–

–

–

–

–

–

Fried’s criteria^*

Cross-sectional study

Portugal

Vieira et al. [122] ^(c)

Institutionalised older adults from three urban residential homes

68–99

Jamar hydraulic hand dynamometer, J00105

3

Dominant

Sitting position

Adducted and in extension

90°

Forearm neutral

Extended between 0 and 30°

.

–

10 s

1 min

–

M:<30 kgf

W: <18 kgf

Cross-sectional study

Baltimore, Maryland, USA

Walston et al. [123]

Community-dwelling women from the Women’s Health and Aging Studies I and II

70–79

Jamar hand dynamometer, model BK-74978, Fred Sammons, Inc., Burr Ridge, IL

6

Both

Sitting position

Adducted

90°

–

.

Yes

–

–

Higher value of the non-dominant hand

Fried’s criteria^*

Cross-sectional study

Southern Taiwan

Wu et al. [124]

Community-dwelling older adults and outpatients from a hospital-based outpatient clinic

≥65

Jamar hand dynamometer, Sammons Preston, Bolingbrook, IL

–

Dominant

Sitting position

–

–

–

–

–

–

–

–

Fried’s criteria^*