Key points
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Grip strength is easy to assess, does not require specific environmental conditions, and the equipment involved is inexpensive and portable. Grip strength is also considered a reliable biomarker in older adults; Previous studies have reported declines in grip strength with aging at an annual rate of ∼1% after midlife, and greater handgrip strength in midlife has been suggested to increase resilience to aging.
A substantial loss of handgrip strength may indicate both declining health and premature aging, leading to increased risk of future disability and morbidity, especially among older adults.
There is evidence supporting an inverse association between handgrip strength and all-cause mortality. A meta-analysis with 2,000,000 participants found that higher levels of grip strength were associated with a lower risk of all-cause mortality, regardless of age and duration of follow-up. Studies also show consistent associations between handgrip strength and cardiovascular mortality. However, the association of handgrip strength with cancer mortality remains controversial.
This study aims to examine the association of handgrip strength with all-cause and cancer mortality in a large representative sample of older adults from 28 countries with repeated measurements of handgrip. A secondary objective was to determine the form of the dose-response association between grip strength and mortality.
Background
There is mixed evidence on the association between muscle strength and mortality in older adults, particularly for cancer mortality.
Aim
examine the dose-response association of objective grip strength with all-cause and cancer mortality.
Study Design and Setup
Data were retrieved from consecutive waves of the Survey of Health, Aging and Retirement in Europe comprising 27 European countries and Israel. Overall, 54,807 men (45.2%; 128,753 observations) and 66,576 women (54.8%; 159,591 observations) aged 64.0 (SD 9.6) and 63.9 (SD 10.2) years were included. respectively. Cox regression and Fine-Grey subdistribution method were performed.
Results
During the follow-up period (896,836 person-years), the fully adjusted model showed the lowest significant risk estimates for the highest third of handgrip strength compared to the first third (reference) in men (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.34–0.50) and women (HR, 0.38; 95% CI, 0.30–0.49) for mortality from all causes.
We identified a maximum threshold for reducing the risk of all-cause mortality for men (42 kg) and women (25 kg), as well as a linear dose-response association in participants aged 65 years or older. No strong association was observed for cancer mortality.
Dose-response association (adjusted HR and associated 95% confidence interval band) between grip strength (kg) and all-cause mortality in men and women. Adjusted for Model B (age, education, country, body mass index, drug and alcohol use) and exclusion of deaths from all causes from the first two years of follow-up.
Conclusion
These results indicate an inverse dose-response association between incremental levels of handgrip and all-cause mortality in older adults up to 42 kg for men and 25 kg for women, and a complete linear association for participants aged 65 years or older. further.
These findings justify preventive strategies for older adults with low levels of handgrip strength.
Discussion
The results of our study indicate the existence of an inverse linear association between incremental levels of handgrip and the risk of all-cause mortality in older adults up to 42 kg for men and 25 kg for women, and a dose-dependent association was observed. -full linear response for a subgroup of older men and women (≥65 years) within specific ranges of grip strength.
Unexpectedly, handgrip strength did not reduce the risk of cancer mortality after robust analyzes and a linear dose-response examination, which was observed in both men and women. As in previous studies, we were unable to confirm a consistent association between grip strength and cancer mortality.
Our results shed light on ongoing debates about the utility of handgrip strength as a biomarker of aging and could inform clinical guidelines to detect older men and women at risk for premature mortality. Despite differences between men and women in relation to grip strength values, we observed similar associations for both sexes with respect to all-cause and cancer mortality.
Furthermore, comparable trajectories were also observed in dose-response analyzes for the two outcomes examined among men and women, indicating the possibility of common pathways leading to reduced risk of all-cause mortality, regardless of levels of reference grip strength.
In contrast, previous research observed stronger associations among older women than those observed in men, a difference possibly attributed to hormonal factors related to muscle strength gains associated only with women.
Final message
- There is an inverse linear association between incremental levels of handgrip strength and the risk of all-cause mortality in older adults up to 42 kg for men and 25 kg for women.
- Such a linear association was observed for all values within a specific range of handgrip strength among people aged 65 years or older for both sexes.
- In contrast, there is no clear association of grip strength with cancer mortality, but future research considering different types of cancer is warranted.
