Association between muscular strength and mortality in men: prospective cohort study
Open accessAbstract
OBJECTIVE: To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men. DESIGN: Prospective cohort study. SETTING: Aerobics centre longitudinal study. PARTICIPANTS: 8762 men aged 20-80. MAIN OUTCOME MEASURES: All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill. RESULTS: During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10,000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0.01 for linear trend). After adjusting for age, physical activity, smoking, alcohol intake, body mass index, baseline medical conditions, and family history of cardiovascular disease, hazard ratios across incremental thirds of muscular strength for all cause mortality were 1.0 (referent), 0.72 (95% confidence interval 0.58 to 0.90), and 0.77 (0.62 to 0.96); for death from cardiovascular disease were 1.0 (referent), 0.74 (0.50 to 1.10), and 0.71 (0.47 to 1.07); and for death from cancer were 1.0 (referent), 0.72 (0.51 to 1.00), and 0.68 (0.48 to 0.97). The pattern of the association between muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness. CONCLUSION: Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.
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Elderly individuals with low strength have a 50% higher likelihood of all-cause mortality than those with normal strength at the same age.
“Elderly individuals classified as having low strength have a 50% higher likelihood of death from all-cause mortality compared with those with normal strength at the same age (44).”
From Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition? (2024) · cites this paper as [44]
The Results report that men in the lowest strength third had an all-cause mortality rate 1.50 times that of men in the middle third, but that figure is for the cohort overall, not specifically older men. In the age-stratified Results, the lowest-to-highest strength comparison ranges from 1.4-fold to 2.2-fold across age groups. The study included only men, so it does not establish the stated figure for elderly individuals generally. Page numbers are unavailable in our copy. (LLM, conf=0.87)
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References 69 · Cited by 815
- Authors
- Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N.
- Affiliations
- Universidad de Granada (ES)
- University of South Carolina (US)
- University of North Texas (US)
- Corresponding author
- Ruiz, J. R
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2008-08-13
- Volume
- 337
- Issue
- jul01 2
- Pages
- a439-a439
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2453303
- OpenAlex
- W2107150305
- Cited by
- 815
- References
- 69
- Citations by year
- 2026: 16 · 2025: 27 · 2024: 37 · 2023: 33 · 2022: 52 · 2021: 54 · 2020: 61 · 2019: 55 · 2018: 81 · 2017: 53 · 2016: 63 · 2015: 54 · 2014: 49 · 2013: 52 · 2012: 37
- FWCI
- 20.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- European Commission
- National Institutes of Health
- National Institute on Aging (AG06945)
- National Heart, Lung, and Blood Institute (HL62508, R01HL062508)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- muscle strength, mortality, cardiovascular mortality, cancer mortality, cardiorespiratory fitness, men, one-repetition maximum, leg press, bench press, physical activity
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Humans, Male, Middle Aged, Texas, Cohort Studies, Exercise, Body Mass Index, Survival Rate, Muscle Strength
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