Associations of handgrip strength with all-cause and cancer mortality in older adults: a prospective cohort study in 28 countries

Abstract

Background: mixed evidence exists on the association between muscle strength and mortality in older adults, in particular for cancer mortality.

Aim: to examine the dose-response association of objectively handgrip strength with all-cause and cancer mortality.

Study design and setting: data from consecutive waves from the Survey of Health, Ageing and Retirement in Europe comprising 27 European countries and Israel were retrieved. Overall, 54,807 men (45.2%; 128,753 observations) and 66,576 women (54.8%; 159,591 observations) aged 64.0 (SD 9.6) and 63.9 (SD 10.2) years, respectively, were included. Cox regression and Fine-Grey sub-distribution method were conducted.

Results: during the follow-up period (896,836 person-year), the fully adjusted model showed the lowest significant risk estimates for the highest third of handgrip strength when compared with the first third (reference) in men (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.34-0.50) and women (HR, 0.38; 95% CI, 0.30-0.49) for all-cause mortality. We identified a maximal threshold for reducing the risk of all-cause mortality for men (42 kg) and women (25 kg), as well as a linear dose-response association in participants aged 65 or over. No robust association for cancer mortality was observed.

Conclusion: these results indicate an inverse dose-response association between incremental levels of handgrip and all-cause mortality in older adults up to 42 kg for men and 25 kg for women, and a full linear association for participants aged 65 years or over. These findings warrant preventive strategies for older adults with low levels of handgrip strength.

Keywords: ageing; longevity; longitudinal; older people; physical activity; physical exercise.

Figure 1

Study profile.

Figure 2

Prospective associations between handgrip strength and mortality by sex. (A) All-cause mortality. (B) Cancer mortality Model A adjusted for age. Model B Adjusted for age, education, country, body mass index, drug and alcohol consumption.

Figure 3

Dose–response association (Adjusted HRs and associated 95% confidence interval band) between handgrip strength (kg) and all-cause mortality in men and women. Adjusted for Model B (age, education, country, body mass index, drug and alcohol consumption) and exclusion of all-cause deaths of two first years of follow-up.

Figure 4

Dose–response association (Adjusted SHRs and associated 95% confidence interval band) between handgrip strength (kg) and cancer mortality in men and women. Adjusted for Model B (age, education, country, body mass index, drug and alcohol consumption) and exclusion of cancer deaths of two first years of follow-up.