Handgrip strength, ageing and mortality in rural Africa

Abstract

Background: muscle strength measured as handgrip strength declines with increasing age and predicts mortality. While handgrip strength is determined by lifestyle through nutrition and physical activity, it has almost exclusively been studied in western populations with a sedentary lifestyle. This study aims to investigate the relation between handgrip strength, ageing and mortality in a population characterised by a predominance of malnutrition and manual labour.Design: a population-based longitudinal study.Setting: a traditional African rural population in Ghana.Subjects: nine hundred and twenty-three community-dwelling individuals aged 50 and older.Methods: demographic characteristics were registered. At baseline, height, body mass index (BMI) and handgrip strength were measured and compared with those in a western reference population. Survival of the participants was documented during a period of up to 2 years.Results: handgrip strength was dependent on age, sex, height and BMI. Compared with the western reference population, handgrip strength was lower due to a lower height and BMI but declined over age similarly. Risk of mortality was lower in participants having higher handgrip strength, with a hazard ratio of 0.94 per kg increase (P = 0.002). After adjustment for age, sex, tribe, socio-economic status, drinking water source, height and BMI, only handgrip strength remained predictive of mortality.Conclusion: in a traditional rural African population characterised by malnutrition and manual labour, handgrip strength declines over age and independently predicts mortality similar to western populations. Handgrip strength can be used as a universal marker of ageing.

The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study

“…[9][10][11][12][13] Our finding of similar associations between grip strength and all-cause mortality across age groups is in line with the few previous reports which have been able to stratify analyses by age. 14-16 19 22 23 Our finding of an equally strong inverse association between grip strength and all-cause mortality in men and women is also consistent with findings in other studies.…”

“…9 Since the publication of this review, subsequent studies have continued to find that weaker grip strength is associated with increased all-cause mortality rates in a range of settings. [10][11][12][13] Most studies of grip strength in middle and old age have investigated associations with all-cause mortality, and studies that have examined causespecific mortality are not as numerous. [14][15][16][17][18][19] Furthermore, often such studies are only powered to investigate broad groups of causes of death such as cardiovascular disease (CVD) and cancer, and have not been able to look at additional causes such as ischaemic heart disease (IHD), respiratory diseases and external causes.…”

Handgrip strength and depression among 34,129 adults aged 50 years and older in six low- and middle-income countries

“…States) and LMICs. For example, compared to age-and BMI-matched older people in high-income countries, it has been reported that women but not men in LMICs have higher handgrip strength (Koopman et al, 2014). Unlike Western populations, most old age people and in particular women in low-income countries engage in lifelong physical exercise (Koopman et al, 2014).…”

Age-related change in handgrip strength in men and women: is muscle quality a contributing factor?

“…Age-related decline in handgrip strength (HGS) is a simple and powerful predictor of future disability (Rantanen et al 1999;Giampaoli et al 1999) and mortality (Rantanen et al 2000;Metter et al 2002;Al Snib et al 2002;Newman et al 2006;Sasaki et al 2007;Ruiz et al 2008;Koopman et al 2015). Recently, Leong and Teo (2015) investigated the association between HGS, cause-specific mortality, and incident disease using a large sample (139,691 participants) from 17 different countries.…”