Grasp Force Control in Older Adults

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Abstract
Diminished tactile sensibility and impaired hand dexterity have been reported for elderly individuals. Reports that younger adults with severely impaired tactile sensibility use excessive grasp force during routine grasp and manipulation tasks raise the possibility that elderly persons likewise produce large grasp forces that may contribute to impaired dexterity. Impaired sudomotor functioning also occurs in elderly subjects and may yield a slipperier skin surface that enhances the possibility for excessive grasp force. The present study measured grasp force in 10 elderly and 9 young adult individuals, during grasp and vertical lift of a small object, using a precision (pinch) grip of the thumb and index finger. The slipperiness of the object's gripped surfaces was unexpectedly varied. Skin slipperiness was estimated by also measuring the grasp force at which the object slipped from grasp. The older subjects employed grasp forces that were, on average, twice as large as those of the young subjects, with some producing forces many times greater than the young subjects' average grip force. Grip forces also were significantly more variable across trials in older subjects. This increased variability was not caused simply by the elderly subjects' increased grip force. A portion of the increased force was due to increased skin slipperiness. The grip force that the elderly subjects produced in excess of the slip force (the “margin of safety” against object slippage) was larger than would have been predicted from their skin slipperiness, however. It is suggested that, in part, the excessive grasp forces represent a strategic response to tactile sensibility impairment. Two-point discrimination limina in the older subjects averaged about four times greater than in the younger subjects. Increased grasp forces in elderly persons may result from other factors, such as increased variability in grip force production. The contributions of excessive grasp forces to impaired dexterity in older persons still need to be addressed experimentally.