Gender differences in the association between grip strength and mortality in older adults: results from the KORA-age study

Abstract

BackgroundReduced muscular strength in the old age is strongly related to activity impairment and mortality. However, studies evaluating the gender-specific association between muscularity and mortality among older adults are lacking. Thus, the objective of the present study was to examine gender differences in the association between muscular strength and mortality in a prospective population-based cohort study.MethodsData used in this study derived from the Cooperative Health Research in the Region of Augsburg (KORA)-Age Study. The present analysis includes 1,066 individuals (mean age 76 ± 11 SD years) followed up over 3 years. Handgrip strength was measured using the Jamar Dynamometer. A Cox proportional hazard model was used to determine adjusted hazard ratios of mortality with 95% confidence intervals (95% CI) for handgrip strength. Potential confounders (i.e. age, nutritional status, number of prescribed drugs, diseases and level of physical activity) were pre-selected according to evidence-based information.ResultsDuring the follow-up period, 56 men (11%) and 39 women (7%) died. Age-adjusted mortality rates per 1,000 person years (95% CI) were 77 (59–106), 24 (13–41) and 14 (7–30) for men and 57 (39–81), 14 (7–27) and 1 (0–19) for women for the first, second and third sex-specific tertile of muscular strength, respectively. Low handgrip strength was significantly associated with all-cause mortality among older men and women from the general population after controlling for significant confounders. Hazard ratios (95% CI) comparing the first and second tertile to the third tertle were 3.33 (1.53–7.22) and 1.42 (0.61-3.28), respectively. Respective hazard ratios (95% CI) for mortality were higher in women than in men ((5.23 (0.67–40.91) and 2.17 (0.27–17.68) versus 2.36 (0.97–5.75) and 0.97 (0.36–2.57)).ConclusionsGrip strength is inversely associated with mortality risk in older adults, and this association is independent of age, nutritional status, number of prescribed drugs, number of chronic diseases and level of physical activity. The association between muscular strength and all-cause mortality tended to be stronger in women. It seems to be particularly important for the weakest to enhance their levels of muscular strength in order to reduce the risk of dying early.

Choice reaction time and grip strength as predictors of cardiovascular mortality in middle‐aged and elderly Japanese: from the Radiation Effects Research Foundation Adult Health study

“…***P < 0.001. 21 In our study, RT was significantly associated with heart disease and stroke mortalities in those aged 35-74 years at baseline, with greater HR in the younger birth cohort, and no clear gender difference was shown in the association between GS and CVD mortality. The multivariate model was adjusted for systolic blood pressure, diabetes mellitus, smoking habit, alcohol consumption, radiation dose, total cholesterol and reaction time/grip strength.…”

“…20 Although studies investigating an association of RT or GS with CVD mortality across different age and gender groups are limited, the Health and Lifestyle Survey showed the effect of different ages on associations between RT and all CVD and stroke mortalities, 5 and the Cooperative Health Research in the Region of Augsburg-Age study showed the effect of different genders on association between GS and CVD mortality. 21 In our study, RT was significantly associated with heart disease and stroke mortalities in those aged 35-74 years at baseline, with greater HR in the younger birth cohort, and no clear gender difference was shown in the association between GS and CVD mortality.…”

Association of lifestyle factors and inflammation with sarcopenic obesity: data from the PREDIMED‐Plus trial

“…Sarcopenia is an age‐associated process characterized by a progressive loss of skeletal muscle mass and strength . This condition is a major health concern in older adults because it has been associated with metabolic impairments, cardiovascular disease risk factors, and physical and functional disability and increases the likelihood/risk of early mortality . All these metabolic and physical alterations cause important healthcare costs and significantly affect quality of life .…”

Relationship between strength and muscle mass in middle-aged and elderly women: a cross-sectional study

“…In terms of hand grip strength, which is recognized as a method of predicting body muscularskeletal functioning 12 , it has been demonstrated that low grip strength may result in a greater probability of functional limitations and consequently death 13,14 . In addition, elderly persons with a history of frequent falls have lower levels of hand grip strength and, consequently, lower limb strength levels, than elderly individuals without a history of falls 13 .…”