Patterns of muscle strength loss with age in the general population and patients with a chronic inflammatory state

Abstract

Background: There is growing recognition of the serious consequences of sarcopenia on the functionality and autonomy in old age. Recently, the age-related changes in several inflammatory mediators have been implicated in the pathogenesis of sarcopenia. The purposes of this systematic review were two-fold: (1) to describe the patterns of muscle strength loss with age in the general population, and (2) to quantify the loss of muscle strength in rheumatoid arthritis as representative for an underlying inflammatory state. Handgrip strength was used as a proxy for overall muscle strength.

Results: Results from 114 studies (involving 90,520 subjects) and 71 studies (involving 10,529 subjects) were combined in a meta-analysis for the general and rheumatoid arthritis population respectively and standardized at an equal sex distribution. For the general population we showed that between the ages of 25 years and 95 years mean handgrip strength declined from 45.5 kg to 23.2 kg for males and from 27.1 kg to 12.8 kg for females. We noted a steeper handgrip strength decline after 50 years of age (rate of 0.37 kg/year). In the rheumatoid arthritis population handgrip strength was not associated with chronological age between the ages of 35 years and 65 years and was as low as 20.2 kg in male and 15.1 in female. Rheumatoid arthritis disease duration was inversely associated with handgrip strength.

Conclusions: This meta-analysis shows distinct patterns of age-related decrease of handgrip strength in the general population. Handgrip strength is strongly associated with the presence and duration of an inflammatory state as rheumatoid arthritis. The putative link between age-related inflammation and sarcopenia mandates further study as it represents a potential target for intervention to maintain functional independence in old age.

Fig. 1

Summary of article selection process.

Fig. 2

Handgrip strength in the general population dependent on age. Scatter plot of study groups from the general population (n = 330) and meta-regression lines with 95% confidence band (standardized at 50% females) with a change point at the age of 50 years.

Fig. 3

Grip strength in rheumatoid arthritis (RA) population dependent on age (n = 102) and RA disease duration (n = 88). (A) Scatter plot of study groups in the RA population dependent on chronological age and meta-regression line with 95% confidence band (standardized at 50% females). (B) Scatter plot of study groups in the RA population dependent on disease duration and meta-regression curve with 95% confidence band standardized at 50% females at median chronological age 55.1 years.