Association of Muscle Strength With All‐Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries
ABSTRACT Background Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold‐specific manner remains unclear. This study investigates the prospective association of...
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| Veröffentlicht in: | Journal of cachexia, sarcopenia and muscle sarcopenia and muscle, 2024-12, Vol.15 (6), p.2756-2764 |
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| creator | Andersen, Lars Louis López‐Bueno, Rubén Núñez‐Cortés, Rodrigo Cadore, Eduardo Lusa Polo‐López, Ana Calatayud, Joaquín |
| description | ABSTRACT
Background
Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold‐specific manner remains unclear. This study investigates the prospective association of muscle strength with all‐cause mortality in the oldest old.
Methods
We included 1890 adults aged ≥ 90 years (61.6% women, mean age 91.0 ± 1.5 years) from 27 European countries and Israel participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) study. Muscle strength was assessed using handgrip dynamometry (unit: kilogram). Using time‐varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with mortality, controlling for age, sex, smoking, BMI, marital status, education, geographical region and self‐perceived health.
Results
Over a mean follow‐up of 4.2 ± 2.4 years, more than half of the participants died (n = 971, 51.4%). The mean handgrip strength was 20.4 ± 8.0 kg for all participants, with men (26.7 ± 7.5 kg) showing significantly higher strength than women (16.4 ± 5.4 kg) (p |
| doi_str_mv | 10.1002/jcsm.13619 |
| format | Article |
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Background
Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold‐specific manner remains unclear. This study investigates the prospective association of muscle strength with all‐cause mortality in the oldest old.
Methods
We included 1890 adults aged ≥ 90 years (61.6% women, mean age 91.0 ± 1.5 years) from 27 European countries and Israel participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) study. Muscle strength was assessed using handgrip dynamometry (unit: kilogram). Using time‐varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with mortality, controlling for age, sex, smoking, BMI, marital status, education, geographical region and self‐perceived health.
Results
Over a mean follow‐up of 4.2 ± 2.4 years, more than half of the participants died (n = 971, 51.4%). The mean handgrip strength was 20.4 ± 8.0 kg for all participants, with men (26.7 ± 7.5 kg) showing significantly higher strength than women (16.4 ± 5.4 kg) (p < 0.001). Using the median level of muscle strength as reference (18 kg), lower and higher levels were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively. The 10th percentile of muscle strength (10 kg) showed a hazard ratio (HR) of 1.27 (95% CI 1.13–1.43, p < 0.001). The 90th percentile (31 kg) showed an HR of 0.69 (95% CI 0.58–0.82, p < 0.001). Stratified for sex, the median levels of muscle strength were 26 kg for men and 16 kg for women. The 10th percentile of muscle strength showed HRs of 1.33 (95% CI 1.10–1.61, p < 0.001) at 15 kg for men and 1.19 (95% CI 1.05–1.35, p < 0.01) at 10 kg for women. The 90th percentile of muscle strength showed HRs of 0.75 (95% CI 0.59–0.95, p < 0.01) at 35 kg for men and 0.75 (95% CI 0.62–0.90, p < 0.001) at 23 kg for women. Sensitivity analyses, which excluded individuals who died within the first 2 years of follow‐up, confirmed the main findings.
Conclusion
Rather than a specific threshold, muscle strength is gradually and inversely associated with mortality risk in the oldest old. As muscle strength at all ages is highly adaptive to resistance training, these findings highlight the importance of improving muscle strength in both men and women among the oldest old.]]></description><identifier>ISSN: 2190-5991</identifier><identifier>ISSN: 2190-6009</identifier><identifier>EISSN: 2190-6009</identifier><identifier>DOI: 10.1002/jcsm.13619</identifier><identifier>PMID: 39439054</identifier><language>eng</language><publisher>Germany: John Wiley & Sons, Inc</publisher><subject>Activities of daily living ; Age groups ; Aged, 80 and over ; ageing ; Body mass index ; Comorbidity ; Europe - epidemiology ; Female ; frailty ; Hand Strength - physiology ; Humans ; Interviews ; Life expectancy ; longevity ; Male ; Marital status ; Mortality ; Muscle strength ; Muscle Strength - physiology ; Musculoskeletal system ; Older people ; Original ; Physiology ; Proportional Hazards Models ; Prospective Studies ; Sample size ; sarcopenia</subject><ispartof>Journal of cachexia, sarcopenia and muscle, 2024-12, Vol.15 (6), p.2756-2764</ispartof><rights>2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3689-2e0f07fd7254079f60926ec0a15974a97f0d163dab02a8f4c2eee78da294f0b33</cites><orcidid>0000-0002-7865-3429</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634500/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634500/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,1412,2096,11543,27905,27906,45555,45556,46033,46457,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39439054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersen, Lars Louis</creatorcontrib><creatorcontrib>López‐Bueno, Rubén</creatorcontrib><creatorcontrib>Núñez‐Cortés, Rodrigo</creatorcontrib><creatorcontrib>Cadore, Eduardo Lusa</creatorcontrib><creatorcontrib>Polo‐López, Ana</creatorcontrib><creatorcontrib>Calatayud, Joaquín</creatorcontrib><title>Association of Muscle Strength With All‐Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries</title><title>Journal of cachexia, sarcopenia and muscle</title><addtitle>J Cachexia Sarcopenia Muscle</addtitle><description><![CDATA[ABSTRACT
Background
Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold‐specific manner remains unclear. This study investigates the prospective association of muscle strength with all‐cause mortality in the oldest old.
Methods
We included 1890 adults aged ≥ 90 years (61.6% women, mean age 91.0 ± 1.5 years) from 27 European countries and Israel participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) study. Muscle strength was assessed using handgrip dynamometry (unit: kilogram). Using time‐varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with mortality, controlling for age, sex, smoking, BMI, marital status, education, geographical region and self‐perceived health.
Results
Over a mean follow‐up of 4.2 ± 2.4 years, more than half of the participants died (n = 971, 51.4%). The mean handgrip strength was 20.4 ± 8.0 kg for all participants, with men (26.7 ± 7.5 kg) showing significantly higher strength than women (16.4 ± 5.4 kg) (p < 0.001). Using the median level of muscle strength as reference (18 kg), lower and higher levels were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively. The 10th percentile of muscle strength (10 kg) showed a hazard ratio (HR) of 1.27 (95% CI 1.13–1.43, p < 0.001). The 90th percentile (31 kg) showed an HR of 0.69 (95% CI 0.58–0.82, p < 0.001). Stratified for sex, the median levels of muscle strength were 26 kg for men and 16 kg for women. The 10th percentile of muscle strength showed HRs of 1.33 (95% CI 1.10–1.61, p < 0.001) at 15 kg for men and 1.19 (95% CI 1.05–1.35, p < 0.01) at 10 kg for women. The 90th percentile of muscle strength showed HRs of 0.75 (95% CI 0.59–0.95, p < 0.01) at 35 kg for men and 0.75 (95% CI 0.62–0.90, p < 0.001) at 23 kg for women. Sensitivity analyses, which excluded individuals who died within the first 2 years of follow‐up, confirmed the main findings.
Conclusion
Rather than a specific threshold, muscle strength is gradually and inversely associated with mortality risk in the oldest old. As muscle strength at all ages is highly adaptive to resistance training, these findings highlight the importance of improving muscle strength in both men and women among the oldest old.]]></description><subject>Activities of daily living</subject><subject>Age groups</subject><subject>Aged, 80 and over</subject><subject>ageing</subject><subject>Body mass index</subject><subject>Comorbidity</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>frailty</subject><subject>Hand Strength - physiology</subject><subject>Humans</subject><subject>Interviews</subject><subject>Life expectancy</subject><subject>longevity</subject><subject>Male</subject><subject>Marital status</subject><subject>Mortality</subject><subject>Muscle strength</subject><subject>Muscle Strength - physiology</subject><subject>Musculoskeletal system</subject><subject>Older people</subject><subject>Original</subject><subject>Physiology</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Sample size</subject><subject>sarcopenia</subject><issn>2190-5991</issn><issn>2190-6009</issn><issn>2190-6009</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks1uEzEQgFcIRKvQCw-ALHFBSCnj311zQVFES1GjIhXE0XK8s4mjzTrYu61y4xH6jDwJThMqygEf7JH96fPMaIriJYVTCsDerVxan1KuqH5SHDOqYawA9NNDLLWmR8VJSivISyiqJDwvjrgWXIMUx8XtJKXgvO196EhoyGxIrkVy3UfsFv2SfPd5m7Ttr593UzskJLMQe9v6fkt8R_olkqu2xtTvjvfkSwxpg673N0imYZnRbBrqLTmLYU1YlS-Hro8e04viWWPbhCeHc1R8O_v4dfppfHl1fjGdXI4dV5UeM4QGyqYumRRQ6kaBZgodWCp1KawuG6ip4rWdA7NVIxxDxLKqLdOigTnno-Ji762DXZlN9GsbtyZYb-4vQlwYG3ufazZaslKBE3OwSkhuNTLKKsG5bHKk5tn1Ye_aDPM11g5zKbZ9JH380vmlWYQbQ3OKQgJkw5uDIYYfQ26bWfvksG1th2FIhlOqc6ky_zoqXv-DrsIQu9yrTAkOrJJqR73dUy53PkVsHrKhYHbzYXbzYe7nI8Ov_s7_Af0zDRmge-DWt7j9j8p8nl7P9tLf4wPFgA</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Andersen, Lars Louis</creator><creator>López‐Bueno, Rubén</creator><creator>Núñez‐Cortés, Rodrigo</creator><creator>Cadore, Eduardo Lusa</creator><creator>Polo‐López, Ana</creator><creator>Calatayud, Joaquín</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7865-3429</orcidid></search><sort><creationdate>202412</creationdate><title>Association of Muscle Strength With All‐Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries</title><author>Andersen, Lars Louis ; López‐Bueno, Rubén ; Núñez‐Cortés, Rodrigo ; Cadore, Eduardo Lusa ; Polo‐López, Ana ; Calatayud, Joaquín</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3689-2e0f07fd7254079f60926ec0a15974a97f0d163dab02a8f4c2eee78da294f0b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Activities of daily living</topic><topic>Age groups</topic><topic>Aged, 80 and over</topic><topic>ageing</topic><topic>Body mass index</topic><topic>Comorbidity</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>frailty</topic><topic>Hand Strength - physiology</topic><topic>Humans</topic><topic>Interviews</topic><topic>Life expectancy</topic><topic>longevity</topic><topic>Male</topic><topic>Marital status</topic><topic>Mortality</topic><topic>Muscle strength</topic><topic>Muscle Strength - physiology</topic><topic>Musculoskeletal system</topic><topic>Older people</topic><topic>Original</topic><topic>Physiology</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Sample size</topic><topic>sarcopenia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersen, Lars Louis</creatorcontrib><creatorcontrib>López‐Bueno, Rubén</creatorcontrib><creatorcontrib>Núñez‐Cortés, Rodrigo</creatorcontrib><creatorcontrib>Cadore, Eduardo Lusa</creatorcontrib><creatorcontrib>Polo‐López, Ana</creatorcontrib><creatorcontrib>Calatayud, Joaquín</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of cachexia, sarcopenia and muscle</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersen, Lars Louis</au><au>López‐Bueno, Rubén</au><au>Núñez‐Cortés, Rodrigo</au><au>Cadore, Eduardo Lusa</au><au>Polo‐López, Ana</au><au>Calatayud, Joaquín</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Muscle Strength With All‐Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries</atitle><jtitle>Journal of cachexia, sarcopenia and muscle</jtitle><addtitle>J Cachexia Sarcopenia Muscle</addtitle><date>2024-12</date><risdate>2024</risdate><volume>15</volume><issue>6</issue><spage>2756</spage><epage>2764</epage><pages>2756-2764</pages><issn>2190-5991</issn><issn>2190-6009</issn><eissn>2190-6009</eissn><abstract><![CDATA[ABSTRACT
Background
Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold‐specific manner remains unclear. This study investigates the prospective association of muscle strength with all‐cause mortality in the oldest old.
Methods
We included 1890 adults aged ≥ 90 years (61.6% women, mean age 91.0 ± 1.5 years) from 27 European countries and Israel participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) study. Muscle strength was assessed using handgrip dynamometry (unit: kilogram). Using time‐varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with mortality, controlling for age, sex, smoking, BMI, marital status, education, geographical region and self‐perceived health.
Results
Over a mean follow‐up of 4.2 ± 2.4 years, more than half of the participants died (n = 971, 51.4%). The mean handgrip strength was 20.4 ± 8.0 kg for all participants, with men (26.7 ± 7.5 kg) showing significantly higher strength than women (16.4 ± 5.4 kg) (p < 0.001). Using the median level of muscle strength as reference (18 kg), lower and higher levels were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively. The 10th percentile of muscle strength (10 kg) showed a hazard ratio (HR) of 1.27 (95% CI 1.13–1.43, p < 0.001). The 90th percentile (31 kg) showed an HR of 0.69 (95% CI 0.58–0.82, p < 0.001). Stratified for sex, the median levels of muscle strength were 26 kg for men and 16 kg for women. The 10th percentile of muscle strength showed HRs of 1.33 (95% CI 1.10–1.61, p < 0.001) at 15 kg for men and 1.19 (95% CI 1.05–1.35, p < 0.01) at 10 kg for women. The 90th percentile of muscle strength showed HRs of 0.75 (95% CI 0.59–0.95, p < 0.01) at 35 kg for men and 0.75 (95% CI 0.62–0.90, p < 0.001) at 23 kg for women. Sensitivity analyses, which excluded individuals who died within the first 2 years of follow‐up, confirmed the main findings.
Conclusion
Rather than a specific threshold, muscle strength is gradually and inversely associated with mortality risk in the oldest old. As muscle strength at all ages is highly adaptive to resistance training, these findings highlight the importance of improving muscle strength in both men and women among the oldest old.]]></abstract><cop>Germany</cop><pub>John Wiley & Sons, Inc</pub><pmid>39439054</pmid><doi>10.1002/jcsm.13619</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7865-3429</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of cachexia, sarcopenia and muscle, 2024-12, Vol.15 (6), p.2756-2764 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wiley Online Library Open Access; PubMed Central |
| subjects | Activities of daily living Age groups Aged, 80 and over ageing Body mass index Comorbidity Europe - epidemiology Female frailty Hand Strength - physiology Humans Interviews Life expectancy longevity Male Marital status Mortality Muscle strength Muscle Strength - physiology Musculoskeletal system Older people Original Physiology Proportional Hazards Models Prospective Studies Sample size sarcopenia |
| title | Association of Muscle Strength With All‐Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries |
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