Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults
Open accessAbstract
INTRODUCTION: Recent studies suggested that muscle mass and muscle strength may independently or synergistically affect aging-related health outcomes in older adults; however, prospective data on mortality in the general population are sparse. METHODS: We aimed to prospectively examine individual and joint associations of low muscle mass and low muscle strength with all-cause mortality in a nationally representative sample. This study included 4449 participants age 50 yr and older from the National Health and Nutrition Examination Survey 1999 to 2002 with public use 2011 linked mortality files. Weighted multivariable logistic regression models were adjusted for age, sex, race, body mass index (BMI), smoking, alcohol use, education, leisure time physical activity, sedentary time, and comorbid diseases. RESULTS: Overall, the prevalence of low muscle mass was 23.1% defined by appendicular lean mass (ALM) and 17.0% defined by ALM/BMI, and the prevalence of low muscle strength was 19.4%. In the joint analyses, all-cause mortality was significantly higher among individuals with low muscle strength, whether they had low muscle mass (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.27-3.24 for ALM; OR, 2.53; 95% CI, 1.64-3.88 for ALM/BMI) or not (OR, 2.66; 95% CI, 1.53-4.62 for ALM; OR, 2.17; 95% CI, 1.29-3.64 for ALM/BMI). In addition, the significant associations between low muscle strength and all-cause mortality persisted across different levels of metabolic syndrome, sedentary time, and LTPA. CONCLUSIONS: Low muscle strength was independently associated with elevated risk of all-cause mortality, regardless of muscle mass, metabolic syndrome, sedentary time, or LTPA among US older adults, indicating the importance of muscle strength in predicting aging-related health outcomes in older adults.
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Low muscle mass is associated with adverse health outcomes and higher all-cause mortality in older adults.
“as low muscle mass is associated with adverse health outcomes and higher all-cause mortality in older adults [112]”
From Dual and Triple Incretin-Based Co-agonists: Novel Therapeutics for Obesity and Diabetes (2024) · cites this paper as [112]
The Baseline characteristics section reports that older adults with low muscle mass, when defined relative to BMI, were more likely to have cardiovascular disease, diabetes, and adverse metabolic measures. But the Results section reports no significant overall mortality association for low muscle mass defined by appendicular lean mass; mortality was significantly higher for the BMI-adjusted definition and for those who also had low muscle strength. The claim omits these qualifications. (LLM, conf=0.89)
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Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
Levey, A. S., Coresh, J., Greene, T., Stevens, L. A., Zhang, Y., Hendriksen, S. M., Kusek, J. W., & Lente, F. V. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-4-200608150-00004 · Cited by 5,726 · see citing works
Levey, A., Eckardt, K., Tsukamoto, Y., Levin, A., Coresh, J., Rossert, J., de Zeeuw, D., Hostetter, T., Lameire, N., & Eknoyan, G. (2005) · Kidney International · doi:10.1111/j.1523-1755.2005.00365.x · Cited by 3,963 · see citing works
Goodpaster, B. H., Park, S. W., Harris, T. B., Kritchevsky, S. B., Nevitt, M., Schwartz, A. V., Simonsick, E. M., Tylavsky, F. A., Visser, M., Newman, A. B., et al. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.10.1059 · Cited by 3,083 · see citing works
Trends in Obesity Among Adults in the United States, 2005 to 2014
Flegal, K. M., Kruszon-Moran, D., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2016) · JAMA · doi:10.1001/jama.2016.6458 · Cited by 2,803 · see citing works
Studenski, S. A., Peters, K. W., Alley, D. E., Cawthon, P. M., McLean, R. R., Harris, T. B., Ferrucci, L., Guralnik, J. M., Fragala, M. S., Kenny, A. M., et al. (2014) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glu010 · Cited by 2,545 · see citing works
Sarcopenia: origins and clinical relevance
Rosenberg, I. H. (1997) · The Journal of Nutrition · doi:10.1093/jn/127.5.990s · Cited by 2,399 · see citing works
Obesity and Kidney Disease: Hidden Consequences of the Epidemic
Kovesdy, C. P., Furth, S. L., & Zoccali, C. (2017) · American Journal of Nephrology · doi:10.1159/000458467 · Cited by 2,239 · see citing works
Newman, A. B., Kupelian, V., Visser, M., Simonsick, E. M., Goodpaster, B. H., Kritchevsky, S. B., Tylavsky, F. A., Rubin, S. M., Harris, T. B., & on Behalf of the Health, A. A. B. C. S. I. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.1.72 · Cited by 1,692 · see citing works
Clark, B. C., & Manini, T. M. (2008) · The Journals of Gerontology Series A · doi:10.1093/gerona/63.8.829 · Cited by 876 · see citing works
Dynapenia and aging: an update
Manini, T. M., & Clark, B. C. (2012) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glr010 · Cited by 875 · see citing works
Association between muscular strength and mortality in men: prospective cohort study
Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N. (2008) · BMJ · doi:10.1136/bmj.a439 · Cited by 815 · see citing works
Young, D. R., Hivert, M.-F., Alhassan, S., Camhi, S. M., Ferguson, J. F., Katzmarzyk, P. T., Lewis, C. E., Owen, N., Perry, C. K., Siddique, J., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000440 · Cited by 791 · see citing works
Sarcopenia: origins and clinical relevance
Rosenberg, I. H. (2011) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2011.03.003 · Cited by 786 · see citing works
Measurement of Adults' Sedentary Time in Population-Based Studies
Healy, G. N., Clark, B. K., Winkler, E. A. H., Gardiner, P. A., Brown, W. J., & Matthews, C. E. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.05.005 · Cited by 628 · see citing works
Reflections on Physical Activity and Health: What Should We Recommend?
Warburton, D. E. R., & Bredin, S. S. D. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.01.024 · Cited by 557 · see citing works
Atkins, J. L., Whincup, P. H., Morris, R. W., Lennon, L. T., Papacosta, O., & Wannamethee, S. G. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12652 · Cited by 509 · see citing works
Frailty in Older Men: Prevalence, Progression, and Relationship with Mortality
Cawthon, P. M., Marshall, L. M., Michael, Y., Dam, T.-T. L., Ensrud, K. E., Barrett-Connor, E. L., & ORWOLL, E. S. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01259.x · Cited by 500 · see citing works
Schoene, D., Wu, S. M. ‐., Mikolaizak, A. S., Menant, J. C., Smith, S., Delbaere, K., & Lord, S. R. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12106 · Cited by 500 · see citing works
Batsis, J. A., Mackenzie, T. A., Barre, L. K., Lopez-Jimenez, F., & Bartels, S. J. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.117 · Cited by 479 · see citing works
Muscular strength as a strong predictor of mortality: A narrative review
Volaklis, K. A., Halle, M., & Meisinger, C. (2015) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2015.04.013 · Cited by 312 · see citing works
Matthews, C. E., Keadle, S. K., Troiano, R. P., Kahle, L., Koster, A., Brychta, R. J., Domelen, D. R. V., Caserotti, P., Chen, K. Y., Harris, T. B., et al. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.135129 · Cited by 304 · see citing works
Relation of muscle mass and fat mass to cardiovascular disease mortality
Srikanthan, P., Horwich, T. B., & Tseng, C. H. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.01.033 · Cited by 260 · see citing works
A Prospective Study of Muscular Strength and All-Cause Mortality in Men With Hypertension
Artero, E. G., Lee, D.-C., Ruiz, J. R., Sui, X., Ortega, F. B., Church, T. S., Lavie, C. J., Castillo, M. J., & Blair, S. N. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.12.025 · Cited by 236 · see citing works
Buch, A., Carmeli, E., Boker, L. K., Marcus, Y., Shefer, G., Kis, O., Berner, Y., & Stern, N. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.01.008 · Cited by 227 · see citing works
The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease
Kim, T. N., & Choi, K. M. (2015) · Journal of Cellular Biochemistry · doi:10.1002/jcb.25077 · Cited by 225 · see citing works
Batsis, J. A., Mackenzie, T. A., Lopez-Jimenez, F., & Bartels, S. J. (2015) · Nutrition Research · doi:10.1016/j.nutres.2015.09.003 · Cited by 203 · see citing works
Musculoskeletal fitness and risk of mortality
Katzmarzyk, P. T., & Craig, C. L. (2002) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200205000-00002 · Cited by 201 · see citing works
The associations of plant protein intake with all-cause mortality in CKD
Chen, X., Wei, G., Jalili, T., Metos, J., Giri, A., Cho, M. E., Boucher, R., Greene, T., & Beddhu, S. (2016) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2015.10.018 · Cited by 187 · see citing works
Physiological and Psychological Predictors of Walking Speed in Older Community-Dwelling People
Tiedemann, A., Sherrington, C., & Lord, S. R. (2005) · Gerontology · doi:10.1159/000088703 · Cited by 155 · see citing works
Evenson, K. R., Wen, F., & Herring, A. H. (2016) · American Journal of Epidemiology · doi:10.1093/aje/kww070 · Cited by 151 · see citing works
Menant, J. C., Weber, F. P., Lo, J. C. M., Sturnieks, D. L., Close, J., Sachdev, P. S., Brodaty, H., & Lord, S. R. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3691-7 · Cited by 149 · see citing works
Is strength training associated with mortality benefits? A 15 year cohort study of US older adults
Kraschnewski, J. L., Sciamanna, C., Poger, J. M., Rovniak, L. S., Lehman, E. B., Cooper, A. B., Ballentine, N. H., & Ciccolo, J. T. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.02.038 · Cited by 126 · see citing works
Corrigan, D., & Bohannon, R. W. (2001) · Archives of Physical Medicine and Rehabilitation · doi:10.1053/apmr.2001.26811 · Cited by 106 · see citing works
Shintakuya, R., Uemura, K., Murakami, Y., et al. (2016) · Pancreatology · doi:10.1016/j.pan.2016.10.005 · Cited by 106 · see citing works
Giacomantonio, N., Bredin, S. S. D., Foulds, H. J. A., & Warburton, D. E. R. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.07.003 · Cited by 77 · see citing works
Carty, C. P., Barrett, R., Cronin, N. J., Lichtwark, G. A., & Mills, P. (2012) · The Journals of Gerontology Series A · doi:10.1093/gerona/gls149 · Cited by 77 · see citing works
Adiposity measures, lean body mass, physical activity and mortality: NHANES 1999–2004
Navaneethan, S. D., Kirwan, J. P., Arrigain, S., & Schold, J. D. (2014) · BMC Nephrology · doi:10.1186/1471-2369-15-108 · Cited by 69 · see citing works
Suzuki, M., Kirimoto, H., Inamura, A., Yagi, M., Omori, Y., & Yamada, S. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2011.593678 · Cited by 32 · see citing works
Edwards, M. K., & Loprinzi, P. D. (2016) · The Physician and Sportsmedicine · doi:10.1080/00913847.2016.1221751 · Cited by 24 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [28]Plowman SA Smith DL Exercise physiology for health, fitness, and performance 3rd Philadelphia Lippincott Williams & Wilkins 2011 726
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Sorted by citations
Zhang, X., Xie, X., Dou, Q., Liu, C., Zhang, W., Yang, Y., Deng, R., & Cheng, A. S. K. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1195-y · Cited by 209 · see citing works
Self-citationDo Non-Responders to Exercise Exist—and If So, What Should We Do About Them?
Pickering, C., & Kiely, J. (2019) · Sports Medicine · doi:10.1007/s40279-018-01041-1 · Cited by 165 · see citing works
Weight loss strategies and the risk of skeletal muscle mass loss
McCarthy, D., & Berg, A. (2021) · Nutrients · doi:10.3390/nu13072473 · Cited by 163 · see citing works
Lim, M. T., Pan, B. J., Toh, D. W. K., Sutanto, C. N., & Kim, J. E. (2021) · Nutrients · doi:10.3390/nu13020661 · Cited by 164 · see citing works
“Similarly, low muscle strength was shown to be a significant and independent predictor of mortality risk [4,5].”
BackgroundLocatelli, J. C., Costa, J. G., Haynes, A., Naylor, L. H., Fegan, P. G., Yeap, B. B., & Green, D. J. (2024) · Diabetes Care · doi:10.2337/dci23-0100 · Cited by 152 · see citing works
Schumann, M., Feuerbacher, J. F., Sünkeler, M., Freitag, N., Rønnestad, B. R., Doma, K., & Lundberg, T. R. (2022) · Sports Medicine · doi:10.1007/s40279-021-01587-7 · Cited by 156 · see citing works
Messina, M., Lynch, H., Dickinson, J. M., & Reed, K. E. (2018) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2018-0071 · Cited by 120 · see citing works
Can High-Intensity Interval Training Promote Skeletal Muscle Anabolism?
Callahan, M. J., Parr, E. B., Hawley, J. A., & Camera, D. M. (2021) · Sports Medicine · doi:10.1007/s40279-020-01397-3 · Cited by 106 · see citing works
Shaughnessy, K. A., Hackney, K. J., Clark, B. C., Kraemer, W. J., Terbizan, D. J., Bailey, R. R., & McGrath, R. (2020) · Journal of Alzheimer’s Disease · doi:10.3233/jad-190856 · Cited by 90 · see citing works
The prevalence of low muscle mass associated with obesity in the USA
Murdock, D. J., Wu, N., Grimsby, J. S., Calle, R. A., Donahue, S., Glass, D. J., Sleeman, M. W., & Sanchez, R. J. (2022) · Skeletal Muscle · doi:10.1186/s13395-022-00309-5 · Cited by 73 · see citing works
Dual and Triple Incretin-Based Co-agonists: Novel Therapeutics for Obesity and Diabetes
Gutgesell, R. M., Nogueiras, R., Tschöp, M. H., & Müller, T. D. (2024) · Diabetes Therapy · doi:10.1007/s13300-024-01566-x · Cited by 61 · see citing works
“However, as low muscle mass is associated with adverse health outcomes and higher all-cause mortality in older adults [112]”
BackgroundVan Aller, C., Lara, J., Stephan, B. C. M., Donini, L. M., Heymsfield, S., Katzmarzyk, P. T., Wells, J. C. K., Prado, C. M., & Siervo, M. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.01.022 · Cited by 56 · see citing works
Nuzzo, J. L., Pinto, M. D., Kirk, B. J. C., & Nosaka, K. (2024) · Sports Medicine · doi:10.1007/s40279-024-02009-0 · Cited by 56 · see citing works
Petermann-Rocha, F., Ho, F. K., Welsh, P., Mackay, D., Brown, R., Gill, J. M. R., Sattar, N., Gray, S. R., Pell, J. P., & Celis-Morales, C. A. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.04.017 · Cited by 52 · see citing works
Vieira, F. T., de Oliveira, G. S., Gonçalves, V. S. S., Neri, S. G. R., de Carvalho, K. M. B., & Dutra, E. S. (2022) · PLOS ONE · doi:10.1371/journal.pone.0269699 · Cited by 36 · see citing works
Dungan, C. M., Wells, J. M., & Murach, K. A. (2023) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00553.2022 · Cited by 21 · see citing works
Langer, H. T., Gilmore, N. K., Hayden, C. M. T., Roux, J., Bariohay, B., Rouquet, T., Awada, M., Marcotorchino, J., Bournot, L., Nunn, E., et al. (2026) · Cell Reports Medicine · doi:10.1016/j.xcrm.2026.102665 · Cited by 21 · see citing works
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Toselli, S., Campa, F., Matias, C. N., de Alencar Silva, B. S., dos Santos, V. R., Maietta Latessa, P., & Gobbo, L. A. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111393 · Cited by 12 · see citing works
- Authors
- LI, R., XIA, J., ZHANG, X., GATHIRUA-MWANGI, W. G., GUO, J., LI, Y., MCKENZIE, S., & SONG, Y.
- Affiliations
- China Institute of Sport Science (CN)
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2018-03
- Volume
- 50
- Issue
- 3
- Pages
- 458-467
- ISSN
- 0195-9131 (ISSN-L)
- PMC
- PMC5820209
- OpenAlex
- W2762920249
- Cited by
- 398
- References
- 42
- Citations by year
- 2026: 39 · 2025: 71 · 2024: 60 · 2023: 46 · 2022: 47 · 2021: 72 · 2020: 34 · 2019: 20 · 2018: 8 · 2012: 1
- FWCI
- 12.55
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL113056)
- National Cancer Institute (K05CA175048)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- muscle mass, muscle strength, all-cause mortality, older adults, appendicular lean mass, muscle weakness, metabolic syndrome, sedentary time, leisure-time physical activity, aging, mortality risk
- MeSH terms
- Aged, Body Composition, Female, Humans, Male, Middle Aged, Mortality, Nutrition Surveys, Organ Size, Risk Factors, Exercise, Body Mass Index, Muscle, Skeletal, Metabolic Syndrome, Muscle Strength, Sedentary Behavior
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