Prevalence of dynapenia and overlap with disability, depression, and executive dysfunction




Activities of Daily Living, Depression


OBJECTIVE: This study aims to investigate handgrip strength and dynapenia prevalence among older adults stratified by Brazilian macroregions. Additionally, we aim to evaluate the overlap between dynapenia and Instrumental Activities of Daily Living (IADL) disability, depression, and executive dysfunction on a national basis and by each Brazilian macroregion. METHODS: This cross-sectional analysis was based on data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). A multistage cluster sample design was used, with a representative population-based study of non-institutionalized community-dwelling Brazilians aged ≥ 50 years from 70 municipalities across all five macroregions of the country. The outcome variable was dynapenia. Covariables were IADL disability, depression, and executive dysfunction. The Brazilian macroregions were used for stratification. In addition, the following additional variables were included: age group, gender, education level, macroregions (North, Northeast, Southeast, South, and Midwest), self-reported health, multimorbidity, and falls. RESULTS: A total of 8,849 (94%) of the sample provided complete information for the handgrip strength assessment and were included in this analysis. Dynapenia prevalence was higher in North and Northeast regions (28.5% and 35.1%, respectively). We identified statistically significant differences between different macroregions for dynapenia, IADL disability, and verbal fluency, with worse values in the North and Northeast regions. In the North and Northeast macroregions, nearly half of the subjects that presented executive dysfunction and IADL disability also had dynapenia. There was a more significant overlap in the prevalence of all four conditions in the North and Northeast regions (4.8% and 5.5%, respectively), whereas the overlap was smaller in the South (2.3%). There was also a smaller overlap in the prevalence of dynapenia and depression in the South (5.8%) compared with other macroregions. CONCLUSIONS: Macroregions in Brazil exhibit marked differences in the prevalence of dynapenia and in its overlap with IADL disability, depression, and executive dysfunction.


Clark BC, Manini TM. What is dynapenia? Nutrition. 2012 May;28(5):495-503.

Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis. Geriatr Gerontol Int. 2016 Jan;16(1):5-20.

Montes MC, Bortolotto CC, Tomasi E, Gonzalez MC, Barbosa-Silva TG, Domingues MR, et al. Strength and multimorbidity among community-dwelling elderly from southern Brazil. Nutrition. 2020 Mar;71:110636.

Noh HM, Park YS. Handgrip strength, dynapenia, and mental health in older Koreans. Sci Rep. 2020 Mar;10(1):4004.

Arrieta H, Rezola-Pardo C, Echeverria I, Iturburu M, Gil SM, Yanguas JJ, et al. Physical activity and fitness are associated with verbal memory, quality of life and depression among nursing home residents: preliminary data of a randomized controlled trial. BMC Geriatr. 2018 Mar;18(1):80.

Kobayashi-Cuya KE, Sakurai R, Suzuki H, Ogawa S, Takebayashi T, Fujiwara Y. Observational Evidence of the Association Between Handgrip Strength, Hand Dexterity, and Cognitive Performance in Community-Dwelling Older Adults: A systematic Review. J Epidemiol. 2018 Sep;28(9):373-81.

Scott D, Daly RM, Sanders KM, Ebeling PR. Fall and fracture risk in sarcopenia and dynapenia with and without obesity: the role of lifestyle interventions. Curr Osteoporos Rep. 2015 Aug;13(4):235-44.

Hamasaki H, Kawashima Y, Katsuyama H, Sako A, Goto A, Yanai H. Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Sci Rep. 2017 Aug;7(1):7041.

Kang SY, Lim J, Park HS. Relationship between low handgrip strength and quality of life in Korean men and women. Qual Life Res. 2018 Oct;27(10):2571-80.

Smith L, Yang L, Hamer M. Handgrip strength, inflammatory markers, and mortality. Scand J Med Sci Sports. 2019 Aug;29(8):1190-6.

Uchida S, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Nakamura T, et al. Prognostic utility of dynapenia in patients with cardiovascular disease. Clin Nutr. 2021 Apr;40(4):2210-8.

Borges VS, Lima-Costa MF, Andrade FB. A nationwide study on prevalence and factors associated with dynapenia in older adults: ELSI-Brazil. Cad Saude Publica. 2020 Apr;36(4):e00107319.

Yang M, Ding X, Luo L, Hao Q, Dong B. Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults. J Am Med Dir Assoc. 2014 Feb;15(2):150.e11-6. PMID:24291347

Iwamura M, Kanauchi M. A cross-sectional study of the association between dynapenia and higher-level functional capacity in daily living in community-dwelling older adults in Japan. BMC Geriatr. 2017 Jan;17(1):1.

Alexandre TD, Scholes S, Ferreira Santos JL, Duarte YA, Oliveira C. The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults. Clin Nutr. 2018 Dec;37(6 6 Pt A):2045-53.

Teixeira IA, Silva FO, Ferreira JVA, Plácido J, Marinho V, Camaz Deslandes A. Utility of handgrip strength cut-offs for identification of weakness and disability in community-dwelling older people with mild cognitive impairment and Alzheimer’s disease [Internet]. J Bras Psiquiatr. 2019;68(4):208-14.

Firth J, Firth JA, Stubbs B, Vancampfort D, Schuch FB, Hallgren M, et al. Association between muscular strength and cognition in people with major depression or bipolar disorder and healthy controls. JAMA Psychiatry. 2018 Jul;75(7):740-6.

Johnson JK, Lui LY, Yaffe K. Executive function, more than global cognition, predicts functional decline and mortality in elderly women. J Gerontol A Biol Sci Med Sci. 2007 Oct;62(10):1134-41.

Ikezaki H, Hashimoto M, Ishikawa T, Fukuhara R, Tanaka H, Yuki S, et al. Relationship between executive dysfunction and neuropsychiatric symptoms and impaired instrumental activities of daily living among patients with very mild Alzheimer’s disease. Int J Geriatr Psychiatry. 2020 Aug;35(8):877-87.

Marshall GA, Rentz DM, Frey MT, Locascio JJ, Johnson KA, Sperling RA. Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease. Alzheimers Dement. 2011 May;7(3):300-8.

Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med. 2014 Jul;44(10):2029-40.

Law TD, Clark LA, Clark BC. Resistance exercise to prevent and manage sarcopenia and dynapenia. Annu Rev Gerontol Geriatr. 2016;36(1):205-28.

de Mello RG, Dalla Corte RR, Gioscia J, Moriguchi EH. Effects of physical exercise programs on sarcopenia management, dynapenia, and physical performance in the elderly: a systematic review of randomized clinical trials. J Aging Res. 2019 Nov;2019:1959486.

Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc. 2014 Jun;46(6):1194-203.

Lima TR, Silva DA, Castro JA, Christofaro DG. Handgrip strength and associated sociodemographic and lifestyle factors: A systematic review of the adult population. J Bodyw Mov Ther. 2017 Apr;21(2):401-13.

Travassos C, Oliveira EX, Viacava F. Geographic and social inequalities in the access to health services in Brazil: 1998 and 2003. Cien Saude Colet. 2006;11(4):975-86.




How to Cite

Teixeira, I. A., Coutinho, E. S. F., Marinho, V., Castro-Costa, E., & Deslandes, A. C. (2023). Prevalence of dynapenia and overlap with disability, depression, and executive dysfunction. Revista De Saúde Pública, 57(1), 43.



Original Articles