Background: The capacity to perceived vitality (CPV) ratio is a novel measure for intrinsic capacity or resilience based on grip work and self-perceived fatigue. CPV has been associated with pre-frailty in older adults and post-surgery inflammation in adults. To better understand the utility of this measure in a frail population, we examined the association between CPV and inflammation in geriatric inpatients. Methods: Data were obtained from 104 hospitalized geriatric patients. The average age of participants was 83.3 ± 7.5 years, and 55.8% of participants were women. In the cross-sectional analyses, associations between C-reactive protein (CRP), grip work (GW), self-perceived fatigue (SPF) and the CPV ratio (higher values indicate better capacity) were examined using linear regression adjusted for confounders. Results: The adjusted association between CRP (abnormal vs. normal) and the CPV ratio was not statistically significant (B = −0.33, 95% CI = −4.00 to 3.34). Associations between CRP and GW (B = 25.53, 95% CI = −478.23 to 529.30) and SPF (B = 0.57, 95% CI = −0.64 to 1.77) were also not statistically significant. Similar results were found in unadjusted models and analyses of cases with complete data. Conclusions: In this frail group of geriatric inpatients, inflammation, routinely assessed with CRP, was not associated with CPV or its components, GW and SPF. Further research is needed to explore whether CPV is a useful indicator of frailty or recovery capacity in hospitalized geriatric patients.

Hand grip measures offer potential indicators for recovery after hospitalization in older adults. We investigated prospective associations of the grip indicators maximal grip strength (GSmax), fatigue resistance (FR) and grip work (GW) with post-discharge functional limitations, health-related quality of life (HRQOL) and survival in older inpatients. Grip indicators were evaluated at admission in general geriatric inpatients (GGI, n = 149) and geriatric hip fracture inpatients (HIP, n = 109). Questionnaires on functional limitations (10-40, lower is better) were collected for two weeks pre-admission, admission, three months follow-up, and six months follow-up. HRQOL (-4-10, higher is better) was assessed at admission, three months follow-up and six months follow-up. With individual growth modeling, we established the associations between grip indicators and the outcome trajectories. Three-month survival was analyzed using Cox proportional hazards models. In GGI, higher FR and GW were associated with better functional recovery from admission to three months follow-up (FR: B = -1.0 points per 10s increase, 95 %CI -1.9, -0.14; GW: B = -0.33 points per 100 kPa × s increase, 95 %CI -0.59, -0.07). HIP with higher grip indicators showed a better functional recovery towards three months follow-up (GSmax: B = -2.4 per 10 kPa increase, 95 %CI -3.9, -0.89; FR: B = -1.1, 95 %CI -2.4, 0.20; GW: B = -0.31, 95 %CI -0.61, -0.02). No or weak associations were found between grip indicators and HRQOL recovery. Hazard ratios pointed towards a better survival for better scores on grip indicators, but associations were not statistically significant. Higher FR and GW at admission were associated with better recovery post-discharge in geriatric inpatients. Future research should examine the added clinical value of grip indicators in addition to known patient characteristics.

Background Hand grip measures are promising candidate markers for recovery in geriatric patients. Aims To advance interpretation of these measures, we examined: (1) the associations between grip measures at admission and measures of frailty, daily functioning and fatigue to understand the constructs they measure; (2) alternate operational definitions of grip measures. Methods 181 geriatric inpatients completed twice daily grip measurements using the Eforto^® vigorimeter, including maximum grip strength (GSmax), fatigue resistance (FR), grip work (GW) and capacity to perceived vitality ratio (CPV). Associations with each of these measures and the outcomes frailty index (range 0-100), functional limitations (10–40), and total (4–20) and physical (20–100) fatigue were examined using linear regression. Analyses were repeated for the baseline value, average of first two measurements, within-person standard deviation of all values, and the coefficient of variation of all values for each of the grip measures. Results Associations approached statistical significance for baseline GSmax and the outcomes frailty (B=-0.09, 99%CI=--0.21, 0.02), functional limitations (B=-0.10, 99%CI=-0.20, 0) and physical fatigue (B=-0.07, 99%CI=-0.14, 0). Baseline, average and standard deviation values for FR, GW and CPV showed trends towards associations with functional limitations, but not with frailty or fatigue. Conclusions GSmax and CPV constructs overlapped more strongly with the construct of frailty than FR and GW. FR, GW and CPV overlapped with functional limitations, supporting their potential as early markers of recovery. Average values are more reliable than single values and variance measures may add additional information.