Older Mexican Americans with reduced handgrip strength at baseline demonstrated a statistically significant decline in cognitive function over a 7-year period. By contrast, participants in the highest handgrip strength quartile maintained a higher level of cognitive function.
Background:The association between obesity and mortality is reduced or eliminated in older subjects. In addition to mortality, disability is an important health outcome. The objectives of this study were to examine the association between body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, and subsequent disability and mortality among older Americans, as well as to estimate the effect of BMI on life expectancy and disability-free life expectancy among older Americans.
Methods:We studied 8359 non-Hispanic white Americans, 1931 African Americans, and 2435 Mexican Americans 65 years or older who were not disabled at baseline from 5 sites of the Established Populations for Epidemiologic Studies of the Elderly. Measures included BMI, medical conditions, activities of daily living, and demographic information. Cox proportional hazards regression analysis was used to estimate the hazard ratios (HRs) for subsequent disability and mortality during 7 years of follow-up. Total life expectancy and disability-free life expectancy were estimated using the interpolation of Markov chain approach.Results: The lowest HR (1.02; 95% confidence interval [CI], 0.94-1.10) for disability was at a BMI of 25 to less than 30. Subjects with BMIs of lower than 18.5 or 30 or higher at baseline were significantly more likely to experience disability during the follow-up period. In contrast, the lowest HRs for mortality were seen among subjects with BMIs of 25 to less than 30 (HR, 0.78; 95% CI, 0.72-0.85) and 30 to less than 35 (HR, 0.80; 95% CI, 0.72-0.90), with subjects with BMIs of lower than 25 or 35 or higher experiencing higher hazards for mortality. Disability-free life expectancy is greatest among subjects with a BMI of 25 to less than 30.
Conclusion:Assessments of the effect of obesity on the health of older Americans should account for mortality and incidence of disability.
Hand grip strength is an independent predictor of ADL disability among older Mexican American men and women. The hand grip strength test is an easy, reliable, valid, inexpensive method of screening to identify older adults at risk of disability.
Handgrip strength (HGS) is often used as an indicator of overall muscle strength for aging adults, and low HGS is associated with a variety of poor health outcomes including chronic morbidities, functional disabilities, and all-cause mortality. As public health initiatives and programs target the preservation of muscle strength for aging adults, it is important to understand how HGS factors into the disabling process and the sequence of health events that connect low HGS with premature mortality. Such information will help to inform interventions designed to slow the disabling process and improve health outcomes for those at risk for muscle weakness. Further, unraveling the disabling process and identifying the role of weakness throughout the life course will help to facilitate the adoption of HGS measurements into clinical practice for healthcare providers and their patients. The purposes of this article were to (1) highlight evidence demonstrating the associations between HGS and clinically relevant health outcomes, (2) provide directions for future research in HGS and health, and (3) propose a sequence of health-related events that may better explain the role of muscle weakness in the disabling process.
The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms, functional limitations, diabetes, and urinary incontinence.
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