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Cited by 12Nutrition and Health in AgingFrailty in Older AdultsHormonal and reproductive studies

Thresholds for clinical practice that directly link handgrip strength to remaining years of life: estimates based on longitudinal observational data

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Scherbov, Sergei, Spitzer, Sonja, Steiber, Nadia·2022·BMJ Open
DOI 10.1136/bmjopen-2021-058489PMC PMC9315893
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Abstract

Objective: Muscle strength is a powerful predictor of mortality that can quickly and inexpensively be assessed by measuring handgrip strength (HGS). What is missing for clinical practice, however, are empirically meaningful cut-off points that apply to the general population and that consider the correlation of HGS with gender and body height as well as the decline in HGS during processes of normal ageing. This study provides standardised thresholds that directly link HGS to remaining life expectancy (RLE), thus enabling practitioners to detect patients with an increased mortality risk early on. Design: Relying on representative observational data from the Health and Retirement Study, the HGS of survey participants was z-standardised by gender, age and body height. We defined six HGS groups based on cut-off points in SD; we use these as predictors in survival analyses with a 9-year follow-up and provide RLE by gender based on a Gompertz model for each HGS group. Participants: 8156 US American women and men aged 50–80 years. Main outcome measures: Z-standardised HGS and all-cause mortality. Results: Even slight negative deviations in HGS from the reference group with [0.0 SD, 0.5 SD) have substantial effects on survival. RLE among individuals aged 60 years with standardised HGS of [−0.5 SD, 0.0 SD) is 3.0/1.4 years lower for men/women than for the reference group, increasing to a difference of 4.1/2.6 years in the group with HGS of [−1.0 SD, −0.5 SD). By contrast, we find no benefit of strong HGS related to survival. Conclusions: HGS varies substantially with gender, age and body height. This confirms the importance of considering these heterogeneities when defining reference groups and risk thresholds. Moreover, survival appears to decrease at much higher levels of muscle strength than is assumed in previous literature, suggesting that medical practitioners should start to become concerned when HGS is slightly below that of the reference group.

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  • Previous studies have shown similar results on lean and fat mass and inconclusive results on the continuous or dose-response effect of protein intake effect on HGS.

    “Previous studies have shown similar results on lean and fat mass and inconclusive results on the continuous or dose–response effect of protein intake effect on HGS [20, 23, 24, 39].”

    From Sarcopenic Obesity Phenotype Index (SOP <i>i</i> ): A Population‐Based Study (2025) · cites this paper as [39]

    The Introduction (page unavailable) mentions age-related changes in responsiveness to protein intake, but does not assess protein intake’s continuous or dose–response effect on HGS. The Discussion’s mixed evidence concerns HGS and mortality, not protein intake; the passages found also do not address comparable results for lean and fat mass. Searched for lean and fat mass and for a protein-intake dose–response effect on HGS. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Scherbov, S., Spitzer, S., & Steiber, N.
Affiliations
University of Vienna (AT)
Corresponding author
Steiber, Nadia
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2022-07
Volume
12
Issue
7
Pages
e058489
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-058489
PMC
PMC9315893
OpenAlex
W4286567614
Cited by
12
References
4
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 2
FWCI
1.55
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Repository (IHS Vienna) (acceptedVersion)
  • IIASA PURE (International Institute of Applied Systems Analysis) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Vienna
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
grip strength, remaining life expectancy, mortality risk, cut-off values, muscle strength, Gompertz model, aging, gender differences, body height, older adults, mortality prediction
MeSH terms
Aging, Body Height, Cross-Sectional Studies, Female, Humans, Male, Hand Strength, Muscle Strength

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