Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism
Abstract
OBJECTIVES: To examine the association between muscle strength and total and cause-specific mortality and the plausible contributing factors to this association, such as presence of diseases commonly underlying mortality, inflammation, nutritional deficiency, physical inactivity, smoking, and depression. DESIGN: Prospective population-based cohort study with mortality surveillance over 5 years. SETTING: Elderly women residing in the eastern half of Baltimore, Maryland, and part of Baltimore County. PARTICIPANTS: Nine hundred nineteen moderately to severely disabled women aged 65 to 101 who participated in handgrip strength testing at baseline as part of the Women's Health and Aging Study. MEASUREMENTS: Cardiovascular disease (CVD), cancer, respiratory disease, other measures (not CVD, respiratory, or cancer), total mortality, handgrip strength, and interleukin-6. RESULTS: Over the 5-year follow-up, 336 deaths occurred: 149 due to CVD, 59 due to cancer, 38 due to respiratory disease, and 90 due to other diseases. The unadjusted relative risk (RR) of CVD mortality was 3.21 (95% confidence interval (CI) = 2.00-5.14) in the lowest and 1.88 (95% CI = 1.11-3.21) in the middle compared with the highest tertile of handgrip strength. The unadjusted RR of respiratory mortality was 2.38 (95% CI = 1.09-5.20) and other mortality 2.59 (95% CI = 1.59-4.20) in the lowest versus the highest grip-strength tertile. Cancer mortality was not associated with grip strength. After adjusting for age, race, body height, and weight, the RR of CVD mortality decreased to 2.17 (95% CI = 1.26-3.73) in the lowest and 1.56 (95% CI = 0.89-2.71) in the middle, with the highest grip-strength tertile as the reference. Further adjustments for multiple diseases, physical inactivity, smoking, interleukin-6, C-reactive protein, serum albumin, unintentional weight loss, and depressive symptoms did not materially change the risk estimates. Similar results were observed for all-cause mortality. CONCLUSION: In older disabled women, handgrip strength was a powerful predictor of cause-specific and total mortality. Presence of chronic diseases commonly underlying death or the mechanisms behind decline in muscle strength in chronic disease, such as inflammation, poor nutritional status, disuse, and depression, all of which are independent predictors of mortality, did not explain the association. Handgrip strength, an indicator of overall muscle strength, may predict mortality through mechanisms other than those leading from disease to muscle impairment. Grip strength tests may help identify patients at increased risk of deterioration of health.
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Over 15% of older adults reported abnormal sleep patterns and also reported limitations in ambulatory function.
“Abnormal sleep patterns were reported by over 15% of older adults who also reported limitations in ambulatory function. (Rantanen, Volpato, Ferrucci, Heikkinen, Fried, and”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Rantanen et al. 2003
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- Authors
- Rantanen, T., Volpato, S., Luigi Ferrucci, M., Eino Heikkinen, M., Fried, L. P., & Guralnik, J. M.
- Affiliations
- National Institutes of Health (US)
- Johns Hopkins University (US)
- Corresponding author
- Rantanen, Taina
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2003-04-29
- Volume
- 51
- Issue
- 5
- Pages
- 636-641
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2037986780
- Cited by
- 661
- References
- 27
- Citations by year
- 2026: 17 · 2025: 24 · 2024: 17 · 2023: 18 · 2022: 32 · 2021: 32 · 2020: 31 · 2019: 42 · 2018: 39 · 2017: 36 · 2016: 30 · 2015: 42 · 2014: 38 · 2013: 37 · 2012: 31
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- grip strength, muscle strength, mortality, cardiovascular mortality, respiratory mortality, women's health, interleukin-6, inflammation, physical inactivity, smoking, nutritional deficiency, unintentional weight loss, depressive symptoms, C-reactive protein, serum albumin, mortality risk factors, Women's Health and Aging Study, Baltimore County, Maryland, Baltimore
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Persons with Disabilities, Health Status Indicators, Humans, Lung Diseases, Mortality, Neoplasms, Predictive Value of Tests, Prospective Studies, Risk Factors, Baltimore, Geriatric Assessment, Interleukin-6, Comorbidity, Chi-Square Distribution, Proportional Hazards Models, Risk Assessment, Hand Strength
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