Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

Unveiling significant risk factors for intensive care unit-acquired weakness:Advancing preventive care

In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.

Pioneering role of machine learning in unveiling intensive care unitacquired weakness

In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.

Predicting intensive care unit-acquired weakness:A multilayer perceptron neural network approach

In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.

Machine learning insights on intensive care unit-acquired weakness

Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies.

Clinical Effect of Modified Shengyang Yiwei Decoction in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome due to Spleen and Stomach Weakness

Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.

Eccentric exercise-induced muscle weakness abolishes sex differences in fatigability during sustained submaximal isometric contractions

Background:Females are typically less fatigable than males during sustained isometric contractions at lower isometric contraction intensities.This sex difference in fatigability becomes more variable during higher intensity isometric and dynamic contractions.While less fatiguing than isometric or concentric contractions,eccentric contractions induce greater and longer lasting impairments in force production.However,it is not clear how muscle weakness influences fatigability in males and females during sustained isometric contractions.Methods:We investigated the effects of eccentric exercise-induced muscle weakness on time to task failure(TTF)during a sustained submaximal isometric contraction in young(18-30 years)healthy males(n=9)and females(n=10).Participants performed a sustained isometric contraction of the dorsiflexors at 35°plantar flexion by matching a 30%maximal voluntary contraction(MVC)torque target until task failure(i.e.,falling below 5%of their target torque for>2 s).The same sustained isometric contraction was repeated 30 min after 150 maximal eccentric contractions.Agonist and antagonist activation were assessed using surface electromyography over the tibialis anterior and soleus muscles,respectively.Results:Males were~41%stronger than females.Following eccentric exercise both males and females experienced an~20%decline in maximal voliuntary contraction torque.TTF was-34%longer in females than males prior to eccentic exercise-induced muscle weakness.However,following eccentric exercise-induced muscle weakness,this sex-related difference was abolished,with both groups having an"45%shorter TTF.Notably,there was~100%greater antagonist activation in the female group during the sustained isometric contraction following exercise-induced weakness as compared to the males.Conclusion:This increase in antagonist activation disadvantaged females by decreasing their TTF,resulting in a blunting of their typical fatigability advantage over males.

Ankle and toe weakness caused by calcified ligamentum flavum cyst: A case report

BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is yet to be a documented case report of a calcified ligamentum flavum cyst.Herein,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks prior.Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion.Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level.Magnetic reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level.We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level.Intra-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum.Pathological examination suggested a calcified pseudocyst without a capsular lining.After the operation,the patient’s motor weakness in the ankle and great toe improved gradually.CONCLUSION The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.

Weaknesses of Chomsky's Theory of Language

As seemingly persuasive as Chomsky's theory is, it is significantly flawed in four aspects: 1. ignoring a much fundamental creative force in early infancy; 2. equation of first-language learning with second-language learning; 3. methodology; 4. employment of terms.

Azimuthal elastic impedance-based Fourier coefficient variation with angle inversion for fracture weakness

Quantitative inversion of fracture weakness plays an important role in fracture prediction.Considering reservoirs with a set of vertical fractures as horizontal transversely isotropic media,the logarithmic normalized azimuthal elastic impedance(EI)is rewritten in terms of Fourier coefficients(FCs),the 90°ambiguity in the azimuth estimation of the symmetry axis is resolved by judging the sign of the second FC,and we choose the FCs with the highest sensitivity to fracture weakness and present a feasible inversion workflow for fracture weakness,which involves:(1)the inversion for azimuthal EI datasets from observed azimuthal angle gathers;(2)the prediction for the second FCs and azimuth of the symmetry axis from the estimated azimuthal EI datasets;and(3)the estimation of fracture weakness combining the extracted second FCs and azimuth of the symmetry axis iteratively,which is constrained utilizing the Cauchy sparse regularization and the low-frequency regularization in a Bayesian framework.Tests on synthetic and field data demonstrate that the 90°ambiguity in the azimuth estimation of the symmetry axis has been removed,and reliable fracture weakness can be obtained when the estimated azimuth of the symmetry axis deviates less than 30°,which can guide the prediction of fractured reservoirs.

Intervention effect of neuromuscular electrical stimulation on ICU acquired weakness: A meta-analysis

Objective:The early use of neuromuscular electrical stimulation(NMES)to prevent intensive care unit-acquired weakness(ICU-AW)in critical patients is still a controversial topic.We conducted a systematic review to clarify the effectiveness of NMES in preventing ICU-AW.Methods:The Cochrane Library,PubMed,EMBASE,MEDUNE,Web of Science,Ovid,CNKI,Wanfang,VIP,China Biology Medicine disc(CBMdisc)and other databases were searched for randomized controlled trials on the influence of NMES on ICU-AW.The studies were selected according to the inclusion and exclusion criteria.After data and quality were evaluated,a meta-analysis was performed by RevMan 5.3 software.Results:A total of 11 randomized controlled trials with 576 patients were included.The meta-analysis results showed that NMES can improve muscle strength[MD=1.78,95%CI(0.44,3.12,P=0.009);shorten the mechanical ventilation(MV)time[SMD=-0.65,95%CI(-1.03,-0.27,P=0.001],ICU length of stay[MD=-3.41,95%CI(-4.58,-4.24),P<0.001],and total length of stay[MD=-3.97,95%CI(-6.89,-1.06,P=0.008];improve the ability of patients to perform activities of daily living[SMD=0.9,95%CI(0.45,1.35),P=0.001];and increase walking distance[MD=239.03,95%CI(179.22298.85),P<0.001].However,there is no evidence indicating that NMES can improve the functional status of ICU patients during hospitalization,promote the early awakening of patients or reduce mortality(P>0.05).Conclusion:Early implementation of the NMES intervention in ICU patients can prevent ICU-AW and improve their quality of life by enhancing their muscle strength and shortening the MV duration,length of stay in the ICU and total length of stay in the hospital.

Strengths, weaknesses, opportunities and threats (SWOT) analysis of reinitiation into methamphetamine abusers: qualitative findings from an exploration of methamphetamine abusers in Shanghai, China

Background Despite high relapse rate among methamphetamine (MA) abusers, there still have been little empirical data to date detecting the risk factors related to craving and relapse from the perspective of MA abusers. Therefore, the aim of this study was to use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors that could facilitate or impede individuals' abstinence in a real-life context from the perspectives of MA abusers. Aim To use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors relating to individuals' abstinence in a real-life context. Method Semistructured interviews were conducted with 32 MA abusers recruited in Shanghai guided by open-ended questions on narrating the real-life catalysts and inhibitors related to craving, initiation, relapse and abstinence. All data were transcribed verbatim and analysed using a strengths, weaknesses, opportunities and threats (SWOT) analysis. Results The results of the SWOT analysis revealed that contextual factors including peer influence, prevalence and availability of MA, familiar venue of MA use, discrimination, sexual behaviours, alcohol, emotional states and their attitudes towards smoking MA were important factors that contribute to reinitiation and relapse. Surveillance systems, antidrug social workers, vocational skills trainings, moving to another city and family responsibility might serve as counter measures targeti叩 those mentioned weaknesses and threats above. Conclusion This SWOT analysis highlights the complex nature of relapse. Comprehensive interventions strengtheni叩 coping skills such as virtual reality techniques are desperately needed to facilitate individuals1 sustained abstinence.

Missense mutation in DYNC1H1 gene caused psychomotor developmental delay and muscle weakness:A case report

BACKGROUND The DYNC1H1 gene encodes a part of the dynamic protein,and the protein mutations may further affect the growth and development of neurons,resulting in degeneration of anterior horn cells of the spinal cord,and a variety of clinical phenotypes finally resulting in axonal Charcot-Marie-Tooth disease type 20(CMT20),mental retardation 13(MRD13)and spinal muscular atrophy with lower extremity predominant 1(SMA-LED).The incidence of the disease is low,and it is difficult to diagnose,especially in children.Here,we report a case of DYNC1H1 gene mutation and review the related literature to improve the pediatrician’s understanding of DYNC1H1 gene-related disease to make an early correct diagnosis and provide better services for children.CASE SUMMARY A 4-mo-old Chinese female child with adducted thumbs,high arch feet,and epileptic seizure presented slow response,delayed development,and low limb muscle strength.Electroencephalogram showed abnormal waves,a large number of multifocal sharp waves,sharp slow waves,and multiple spasms with a series of attacks.High-throughput sequencing and Sanger sequencing identified a heterozygous mutation,c.5885 G>A(p.R1962H),in the DYNC1H1 gene(NM 001376)of the proband,which was not identified in her parents.Combined with the clinical manifestations and pedigree of this family,this mutation is likely pathogenic based on the American Academy of Medical Genetics and Genomics guidelines.The child was followed when she was 1 year and 2 mo old.The magnetic resonance imaging result was consistent with the findings of white matter myelinated dysplasia and congenital giant gyrus.The extensive neurogenic damage to the extremities was considered,as the results of electromyography showed that the motor conduction velocity and sensory conduction of the nerves of the extremities were not abnormal,and the degree of fit of the children with severe contraction was poor.At present,the child is 80 cm in length and 9 kg in weight,with slender limbs and low muscle strength,and still does not raise her head.She cannot sit or speak.Speech,motor,and mental development was significantly delayed.There is still no effective treatment for this disease.CONCLUSION We herein report a de novo variant of DYNC1H1 gene,c.5885 G>A(p.R1962H),leading to overlapping phenotypes(seizure,general growth retardation,and muscle weakness)of CMT20,MRD13,and SMA-LED,but there is no effective treatment for such condition.Our case enriches the DYNC1H1 gene mutation spectrum and provides an important basis for clinical diagnosis and treatment and genetic counseling.

Weakness Ranking Method for Subsystems of Heavy-Duty Machine Tools Based on FMECA Information

Heavy-duty machine tools are composed of many subsystems with different functions,and their reliability is governed by the reliabilities of these subsystems.It is important to rank the weaknesses of subsystems and identify the weakest subsystem to optimize products and improve their reliabilities.However,traditional ranking methods based on failure mode effect and critical analysis(FMECA)does not consider the complex maintenance of products.Herein,a weakness ranking method for the subsystems of heavy-duty machine tools is proposed based on generalized FMECA information.In this method,eight reliability indexes,including maintainability and maintenance cost,are considered in the generalized FMECA information.Subsequently,the cognition best worst method is used to calculate the weight of each screened index,and the weaknesses of the subsystems are ranked using a technique for order preference by similarity to an ideal solution.Finally,based on the failure data collected from certain domestic heavy-duty horizontal lathes,the weakness ranking result of the subsystems is obtained to verify the effectiveness of the proposed method.An improved weakness ranking method that can comprehensively analyze and identify weak subsystems is proposed herein for designing and improving the reliability of complex electromechanical products.

Hydro-mechanical fault reactivation modeling based on elasto-plasticity with embedded weakness planes

In this paper,an elasto-plastic constitutive model is employed to capture the shear failure that may occur in a rock mass presenting mechanical discontinuities,such as faults,fractures,bedding planes or other planar weak structures.The failure may occur in two modes:a sliding failure on the weak plane or an intrinsic failure of the rock mass.The rock matrix is expected to behave elastically or fail in a brittle manner,being represented by a non-associated Mohr-Coulomb behavior,while the sliding failure is represented by the evaluation of the Coulomb criterion on an explicitly defined plane.Failure may furthermore affect the hydraulic properties of the rock mass:the shearing of the weakness plane may create a transmissive fluid pathway.Verification of the mechanical submodel is conducted by comparison with an analytical solution,while the coupled hydro-mechanical behavior is validated with field data and will be applied within a model and code validation initiative.The work presented here aims at documenting the progress in code development,while accurate match of the field data with the numerical results is current work in progress.

Practical approach to the patient with acute neuromuscular weakness

Acute neuromuscular paralysis(ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks(less than 4 wk).Bulbar and respiratory muscle weakness may or may not be present.It is a common neurological emergency which requires immediateand careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis.Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia.Also,the arterial blood gas finding of severe hypoxemia,hypercapnia,and acidosis may not be apparent until respiratory failure is profound.Hence,the requirement for respiratory assistance should also be intensively and promptly investigated in all patients with neuromuscular disease.The disorder is classified based on the site of defect in motor unit pathway,i.e.,anterior horn cells,nerve root,peripheral nerve,neuromuscular junction or muscle.Identification of the cause is primarily based on a good medical history and detailed clinical examination supplemented with neurophysiologic investigations and sometimes few specific laboratory tests.Medical history and neurological examination should be focused on the onset,progression,pattern and severity of muscle weakness as well as cranial nerves testing and tests for autonomic dysfunction.Associated non neurological features like fever,rash or other skin lesions etc.should also be noted.Globally,Guillain-Barré syndrome is the most frequent cause of ANMP and accounts for the majority of cases of respiratory muscles weakness associated with neuromuscular disorders.Newly acquired neuromuscular weakness in intensive care unit patients consist of critical illness polyneuropathy,critical illness myopathy and drug induced neuromuscular weakness which may arise as a consequence of sepsis,multi-organ failure,and exposure to certain medications like intravenous corticosteroids and neuromuscular blocking agents.

Muscular atrophy and weakness in the lower extremities in Behçet’s disease: A case report and review of literature

BACKGROUND In Behçet’s disease(BD),very few cases of muscular involvement have been reported previously.The natural history and therapeutic protocol for muscular involvement in BD are obscure due to the low incidence of peripheral neuropathy or myopathy in BD.The purpose of our study was to report a rare case of BD with chronic,focal forms of neuromyopathy and review the relevant literature.CASE SUMMARY We herein report the case of a 54-year-old man who presented with progressive muscular atrophy and weakness of both thighs 2 years after the presentation of the cardinal symptoms of BD.The past medical history,electrophysiological study,neurological examination,blood tests,magnetic resonance imaging study,and histological exam were performed for the differential diagnosis.Relevant literature on muscular involvement in BD was reviewed.Neurological examination revealed that muscular involvement was predominantly localized in the proximal parts of the lower extremities.Heterogeneous enhancement of several thigh muscles was observed on magnetic resonance imaging,which corresponded with the clinical manifestations.Histological study of one of the enhanced muscles showed denervation atrophy of the muscle with superimposed myopathic changes,while electrophysiological studies only suggested denervation.CONCLUSION To our knowledge,this is the first case of neurogenic muscular atrophy with a specific set of clinical,radiological,electrophysiological,and histological findings reported in BD.

Early-onset ophthalmoplegia,cervical dyskinesia,and lower extremity weakness due to partial deletion of chromosome 16:A case report

BACKGROUND We explored the genotype-phenotype correlation of the novel deletion 16p13.2p12.3 in an 8-year-old child with progressive total ophthalmoplegia,cervical dyskinesia,and lower limb weakness by comparing the patient’s clinical features with previously reported data on adjacent copy number variation(CNV)regions.CASE SUMMARY Specifically,we first performed whole-exome sequencing,CNV-sequencing,and mitochondrial genome sequencing on the patient and his parents,then applied“MitoExome”(the entire mitochondrial genome and exons of nuclear genes encoding the mitochondrial proteome)analysis to screen for genetic mitochondrial diseases.We identified a de novo 7.23 Mb deletion,covering 16p13.2p12.3,by both whole-exome sequencing and CNV sequencing.We also detected 16p13.11 in the deleted region,which is the recurrent distinct region associated with neurodevelopmental disorder.However,the patient only displayed features of progressive total ophthalmoplegia,cervical dyskinesia,and weakness in his lower limbs without neurodevelopmental disorder.The“MitoExome”sequencing was negative.Brain magnetic resonance imaging revealed non-specific sporadic changes in the occipital parietal lobe and basal ganglia.CONCLUSION Taken together,these results indicated that 16p13.2p12.3 deletion causes a syndrome with the phenotype of early-onset total ophthalmoplegia.The“MitoExome”analysis is powerful for the differential diagnosis of mitochondrial diseases.We report a novel copy number variant in this case,but further confirmation is required.

Asymmetric limb weakness in Guillain-Barre syndrome:Three case reports

BACKGROUND Guillain-Barrésyndrome(GBS)is an autoimmune-mediated peripheral neuropathy characterized by symmetric weakness.Asymmetric weakness in GBS is uncommon and may be easily confused with other differential diagnoses.We herein present three cases of asymmetric GBS and review the literature on this atypical subtype of GBS in order to describe the characteristics of asymmetric GBS and to provide experience for clinicians.CASE SUMMARY Different from patients in the previous reports,our patients showed persistent asymmetric limb weakness from the onset to recovery phase.All three patients were serologically positive for antecedent infections.Two of the three cases had IgG antibodies against ganglioside GM1.Two patients received immunotherapy including intravenous immunoglobulin and plasma exchange,while one patient received only supportive treatment.Autoantibodies against gangliosides,asymmetry of congenital development of blood-nerve barrier and limb use may contribute to the development of asymmetric limb weakness in GBS.CONCLUSION Asymmetric GBS may be a rare clinical variant and should be considered when a patient develops acute and progressive asymmetric limb weakness.The differences in clinical features and prognosis between asymmetric GBS and classic GBS deserve further investigation in a large study.

Optimal Cutoffs of Grip Strength for Definition as Weakness in the Elderly

Objective:?To indentify Optimal cutoffs of grip strength for definition as weakness in the elderly. Methods: Our study population comprised 1317 subjects (mean ± SD age: 67.6 ± 6.0 years;44.3% men) from the Hangu area of Tianjin, China. Data collection includes general physical examination, biochemical indicators and questionnaire. Mobility limitation was defined as a 4-m walking speed < 0.8 m/s and grip strength represents muscle strength. According to the ROC curve model, the cut-off point of grip strength was calculated, when mobility limitation was selected as the target variables. Results: According to the results of ROC curve, In man, grip strength is lower than 32.45 kg, the strength is weaker, Sensitivity is 79.7% and Specificity is 64.9%, the AUC is 0.764 (p < 0.001);In women, grip strength is lower than 18.20 kg, the strength is weaker, Sensitivity is 53.3% and Specificity is78.1%, the AUC is 0.703 (p < 0.001). Conclusions: Cut points for weakness derived from this large, diverse sample of older adults may be useful to identify populations who may benefit from interventions to improve muscle strength and function.