Ageing; Epidemiology; Mortality; Osteoporosis; Sarcopenia; Humans; Male; Aged; Female; Cohort Studies; Risk Factors; Predictive Value of Tests; Aged, 80 and over; Sarcopenia/mortality; Sarcopenia/physiopathology; Hand Strength/physiology; Walking Speed/physiology
Abstract :
[en] [en] BACKGROUND: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.
AIM: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.
METHODS: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell's Concordance Index (C-index).
RESULTS: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.
CONCLUSIONS: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Westbury, Leo D ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Harvey, Nicholas C ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK. nch@mrc.soton.ac.uk ; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. nch@mrc.soton.ac.uk
Beaudart, Charlotte ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie générale ; Department of Biomedical Sciences, Clinical Pharmacology and Toxicology Research Unit, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, 5000, Namur, Belgium
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Cauley, Jane A ; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
Cawthon, Peggy ; Research Institute, California Pacific Medical Center, San Francisco, California, USA ; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
Cruz-Jentoft, Alfonso J ; Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
Curtis, Elizabeth M ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
Ensrud, Kristine ; Medicine and Epidemiology & Community Health, University of Minnesota, Minnesota, USA ; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
Fielding, Roger ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center On Aging, Tufts University, Boston, USA
Johansson, Helena; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ; Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
Kanis, John A ; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ; Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
Karlsson, Magnus K ; Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo, Lund University and Department of Orthopedics, Skane University Hospital, Malmo, Sweden
Lane, Nancy E ; Division of Rheumatology, Department of Internal Medicine, UC Davis Health, 4625 Second Avenue, Sacramento, CA, 95917, USA
Lengele, Laetitia ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, 1200 Sint-Lambrechts-Woluwe, Belgium
Lorentzon, Mattias ; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ; Center for Osteoporosis Research, Institute of Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, Mölndal, Sweden
McCloskey, Eugene ; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ; Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
Mellström, Dan ; Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Newman, Anne B ; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
Ohlsson, Claes ; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ; Region Västra Götaland, Sahlgrenska University Hospital, Department of Drug Treatment, Gothenburg, Sweden
Orwoll, Eric ; Oregon Health & Science University, Portland, Oregon, USA
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique ; Protein Research Chair, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
Ribom, Eva ; Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
Rosengren, Björn E ; Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo, Lund University and Department of Orthopedics, Skane University Hospital, Malmo, Sweden
Schousboe, John T ; Park Nicollet Clinic and HealthPartners Institute, Bloomington, Minnesota, USA ; University of Minnesota, Minneapolis, Minnesota, USA
Dennison, Elaine M ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK ; Victoria University of Wellington, Wellington, New Zealand
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