Sex Differences in the Level and Rate of Change of Physical Function and Grip Strength in the Danish 1905-Cohort Study

Abstract

Objectives-The study was conducted to examine sex differences in the initial level and rate of change in physical function and grip strength.Method-The baseline survey included 2,262 Danes born in 1905 and alive in 1998 and followedup in 2000, 2003, and 2005. Hence, the authors fully used the power of having a cohort with multiple assessments in late life and virtually complete follow-up of lifespan (through December 2008). Latent growth curve modeling was used.Results-Men had higher initial levels and rates of decline in strength score and grip strength. Lifespan was positively correlated with intercepts and slopes.Discussion-The Danish data suggested that the longest-living individuals have higher initial levels of strength score and grip strength and smaller rate of change. The data further suggested that the initial level of strength score and grip strength was more predictive of mortality than the rate of change was, and the predictive effects were similar in men and women. Keywords sex; activities of daily living; grip strength; oldest old; mortality; growth-curve analysis; Denmark Empirical evidence accumulated over recent decades revealed an apparent contradiction between health and survival of men and women (Case & Paxson, 2005;Nathanson, 1975;Waldron, 1985). Women enjoy a longer life than men in almost all countries of the world (Barford, Dorling, Smith, & Shaw, 2006), but women tend to report poorer self-rated health (Bambra et al., 2008;Olsen & Dahl, 2007), have higher disability levels at all ages (Arber & Cooper, 1999;Leveille, Penninx, Melzer, Izmirlian, & Guralnik, 2000), and perform more poorly on physical tests than men (Frederiksen et al., 2006;Jeune et al., 2006).It has been suggested that handgrip strength is better than chronological age in predicting the frailty of people (Syddall, Cooper, Martin, Briggs, & Sayer, 2003). Several studies have found that grip strength is predictive of disability among middle-aged men (Rantanen et al., 1999), as well as older persons (Giampaoli et al., 1999). Others have demonstrated that grip strength Corresponding Author: Anna Oksuzyan, Epidemiology, Institute of Public Health, J. B. Winslows Vej 9B, 5000 Odense C, Denmark, aoksuzyan@health.sdu.dk. Declaration of Conflicting InterestsThe authors declared no conflicts of interest with respect to the authorship and/or publication of this article. NIH Public AccessAuthor Manuscript J Aging Health. Author manuscript; available in PMC 2010 October 12. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript predicts all-cause, cardiovascular (CVD), and cancer mortality among men, but it ceased to predict mortality among elderly women in multivariate analyses (Fujita et al., 1995;Gale, Martyn, Cooper, & Sayer, 2007).Previous research proposed that many physiological functions begin to decline around 30 years (Sehl & Yates, 2001) and that the course of the decline accelerates with increasing age (Bassey, 1998;Forrest, Zmuda, & Cauley, 2005;Forrest, Zmuda, & Cauley, 2007;. The median loss ...

Sex Differences in Health and Survival

“…In one study that examined this apparent contradiction, the authors hypothesized that men and women differ not only in their initial grip strength levels, but also in the pace at which their grip strength declines with age. Thus, they suggested that the sex-specific associations of these parameters with lifespan may partially explain sex differences in health and mortality (Oksuzyan et al 2010c). The results of the study indicated that men have higher initial levels of and a steeper decline in grip strength, but that the initial level was more strongly associated with lifespan than the age-related decline.…”

“…This finding suggests that age-related declines in functional limitations are likely to be gender-specific. Although less research has been done on sex differences in age-related declines in physical functioning, there is some evidence that the rates of decline in physical functioning are higher among men than among women (Oksuzyan et al 2010c).…”

116Initial Level And Rate Of change In Grip strength Predict All-Cause Mortality In Very Old Adults

“…For both sexes, initial (absolute) GS was relevant for long-term survival irrespective of baseline physical activity and fat mass. The predictive value of baseline GS for longterm survival in older adults aged ≥85 has been observed previously [16,17]. Despite differences across the studies reviewed, including length of follow-up and selection of confounders, the importance of initial GS (muscle strength) for survival over 7-10 years have been seen in the Leiden 85-plus Study (35% increased risk for those in the lowest sex-specific tertile) [16], and in the Danish 1905-Cohort study (lifespan was positively correlated with the GS intercept in both sexes) [17].…”

“…Findings from the studies using the rate of change in muscle strength and physical performance as predictors of mortality have been mixed [13,[16][17][18][19][20][21][22][23]. For example, in the Baltimore Longitudinal Study (BLSA) the rate of change in GS in men aged < 60 was more important for long-term mortality than initial level, whilst for men aged ≥60 higher baseline GS but not slope predicted longer survival over a 40-year period [18].…”

Grip strength and healthy aging

“…The age-related decline in grip strength in adults has been reported in a number of previous longitudinal studies 2,20,[36][37][38][39] . However, the trajectory of grip strength with aging has been described as linear 36,40,41) or curved/quadratic 37,42,43) , and some studies have illustrated the slope with flexion points. Based on a Bayesian longitudinal plateau model of adult grip strength, Nahhas et al 44) described the trajectory of grip strength as peaking at 36 years of age for both men and women and then starting to decline at 56 years for men and 50 years for women.…”