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Abstract

To examine the association between handgrip strength and mortality in older Mexican American men and women. A 5-year prospective cohort study. Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. Maximal handgrip strength, timed walk, and body mass index were assessed at baseline during 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Average handgrip strength +/- standard deviation was significantly higher in men (28.4 kg +/- 9.5) than in women (18.2g +/- 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quartile, the hazard ratio of death was 2.10 (95% confidence interval (CI) = 1.31-3.38) compared with those in the highest handgrip strength quartile, after controlling for sociodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95%I = 1.05-2.93) compared with those in the highest handgrip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors.

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Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.

J M Guralnik, L Ferrucci, E Simonsick … (1995)

Functional assessment is an important part of the evaluation of elderly persons. We conducted this study to determine whether objective measures of physical function can predict subsequent disability in older persons. This prospective cohort study included men and women 71 years of age or older who were living in the community, who reported no disability in the activities of daily living, and who reported that they were able to walk one-half mile (0.8 km) and climb stairs without assistance. The subjects completed a short battery of physical-performance tests and participated in a follow-up interview four years later. The tests included an assessment of standing balance, a timed 8-ft (2.4-m) walk at a normal pace, and a timed test of five repetitions of rising from a chair and sitting down. Among the 1122 subjects who were not disabled at base line and who participated in the four-year follow-up, lower scores on the base-line performance tests were associated with a statistically significant, graduated increase in the frequency of disability in the activities of daily living and mobility-related disability at follow-up. After adjustment for age, sex, and the presence of chronic disease, those with the lowest scores on the performance tests were 4.2 to 4.9 times as likely to have disability at four years as those with the highest performance scores, and those with intermediate performance scores were 1.6 to 1.8 times as likely to have disability. Among nondisabled older persons living in the community, objective measures of lower-extremity function were highly predictive of subsequent disability. Measures of physical performance may identify older persons with a preclinical stage of disability who may benefit from interventions to prevent the development of frank disability.

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Predictors of skeletal muscle mass in elderly men and women.

R N Baumgartner, D. WATERS, D. Gallagher … (1999)

Elderly men and women lose muscle mass and strength with increasing age. Decreased physical activity, hormones, malnutrition and chronic disease have been identified as factors contributing to this loss. There are few data, however, for their multivariate associations with muscle mass and strength. This study analyzes these associations in a cross-sectional sample of elderly people from the New Mexico Aging Process Study. Data collected in 1994 for 121 male and 180 female volunteers aged 65-97 years of age enrolled in The New Mexico Aging Process Study were analyzed. Body composition was measured using dual energy X-ray absorptiometry; dietary intake from 3 day food records; usual physical activity by questionnaire; health status from annual physical examinations; and serum testosterone, estrone, sex-hormone binding globulin (SHBG), and insulin-like growth factor (IGF1) from radioimmunoassays of fasting blood samples. Statistical analyses included partial correlation and stepwise multiple regression. The muscle mass and strength (adjusted for knee height) decreased with increasing age in both sexes. The muscle mass was significantly associated with serum free-testosterone, physical activity, cardiovascular disease, and IGF1 in the men. In the women, the muscle mass was significantly associated with total fat mass and physical activity. Age was not associated significantly with muscle mass after controlling for these variables. Grip strength was associated with age independent of muscle mass in both sexes. Estrogen (endogenous and exogenous) was not associated with muscle mass or strength in women. Age-related loss of muscle mass and strength occurs in relatively healthy, well-nourished elderly men and women and has a multifactorial basis. Sex hormone status is an important factor in men but not in women. Physical activity is an important predictor of muscle mass in both sexes.

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Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population.

T. Rantanen, M Hirvensalo, E Heikkinen (2000)

In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality. A population-based, prospective study. The data were collected in structured interviews in the year 1988 and 8 years later in the year 1996 as part of the Evergreen Project. Subjects were 1109 independently living, at baseline 65- to 84-year-old people in the city of Jyvaskyla, in central Finland. Participants were ranked into four groups: (1) Intact mobility and physically active (Mobile-Active), (2) Intact mobility and sedentary (Mobile-Sedentary), (3) Impaired mobility and physically active (Impaired-Active), and (4) Impaired mobility and sedentary (Impaired-Sedentary). The confounders adjusted for in the models included age, marital status, education, chronic conditions, smoking, and physical exercise earlier in life. In men and women, the relative risk of death was two times greater in Impaired-Active and three times greater in Impaired-Sedentary groups than the risk of death in Mobile-Active groups. However, the risk of death did not differ between Mobile-Active and Mobile-Sedentary groups. The odds ratio for dependency (95% confidence interval) in Impaired-Sedentary men was 5.21 (1.44-18.70) and in Impaired-Sedentary women was 2.92 (1.52-5.60) compared to Mobile-Active groups. The risk of dependence did not differ significantly between Mobile-Active, Mobile-Sedentary, and Impaired-Active groups. Mobility impairments predicted mortality and dependence. However, among people with impaired mobility, physical activity was associated with lower risks, whereas the risk did not differ according to activity level among those with intact mobility. Despite of their overall greater risk, mobility-impaired people may be able to prevent further disability and mortality by physical exercise.

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PubMed ID:: 12133020

DOI:: 10.1046/j.1532-5415.2002.50312.x

ScienceOpen disciplines: Chemistry

Keywords: Aged,Aged, 80 and over,Aging,physiology,Disability Evaluation,Female,Geriatric Assessment,Hand Strength,Hispanic Americans,Humans,Male,Mexico,ethnology,Mortality,Predictive Value of Tests,Proportional Hazards Models,Prospective Studies,Survival Analysis,United States,epidemiology,Walking

Handgrip strength and mortality in older Mexican Americans.

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Most cited references 31

Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.

Predictors of skeletal muscle mass in elderly men and women.

Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population.

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