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

Autor(en)

Sergei Scherbov, Sonja Spitzer, Nadia Steiber

Abstrakt

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.

Organisation(en)

Institut für Soziologie, Institut für Demografie

Externe Organisation(en)

International Institute for Applied Systems Analysis, Österreichische Akademie der Wissenschaften (ÖAW)

Journal

BMJ Open

Band

12

Anzahl der Seiten

7

ISSN

2044-6055

DOI

https://doi.org/10.1136/bmjopen-2021-058489

Publikationsdatum

07-2022

Peer-reviewed

Ja

ÖFOS 2012

504006 Demographie

Schlagwörter

ASJC Scopus Sachgebiete

Medicine(all)

Link zum Portal

https://ucris.univie.ac.at/portal/de/publications/thresholds-for-clinical-practice-that-directly-link-handgrip-strength-to-remaining-years-of-life-estimates-based-on-longitudinal-observational-data(f145248c-36cb-4697-97e6-38d1b451bb05).html