Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands.
CMAJ. 2010 Mar 23;182(5):429-35. doi: 10.1503/cmaj.091278. Epub 2010 Feb 8.
Poor muscular strength has been shown to be associated with increased morbidity and mortality in diverse samples of middle-aged and elderly people. However, the oldest old population (i.e., over 85 years) is underrepresented in such studies. Our objective was to assess the association between muscular strength and mortality in the oldest old population.
We included 555 participants (65% women) from the Leiden 85-plus study, a prospective population-based study of all 85-year-old inhabitants of Leiden, Netherlands. We measured the handgrip strength of participants at baseline and again at age 89 years. We collected baseline data on comorbidities, functional status, levels of physical activity, and adjusted for potential confounders. During the follow-up period, we collected data on mortality.
During a follow-up period of 9.5 years (range 8.5-10.5 years), 444 (80%) participants died. Risk for all-cause mortality was elevated among participants in the lowest tertile of handgrip strength at age 85 years (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.00-1.82, p = 0.047) and the lowest two tertiles of handgrip strength at age 89 years (HR 2.04, CI 1.24-3.35, p = 0.005 and HR 1.73, CI 1.11-2.70, p = 0.016). We also observed significantly increased mortality among participants in the tertile with the highest relative loss of handgrip strength over four years (HR 1.72, CI 1.07-2.77, p = 0.026).
Handgrip strength, a surrogate measurement of overall muscular strength, is a predictor of all-cause mortality in the oldest old population and may serve as a convenient tool for prognostication of mortality risk among elderly people.
在不同年龄段和不同人群的中年和老年人样本中，肌肉力量较弱与发病率和死亡率的增加有关。然而，在这些研究中，最年长的老年人（即 85 岁以上）的代表性不足。我们的目的是评估最年长老年人的肌肉力量与死亡率之间的关系。
我们纳入了来自莱顿 85 岁以上研究的 555 名参与者（65%为女性），这是一项对荷兰莱顿所有 85 岁居民的前瞻性人群基础研究。我们在基线和 89 岁时测量了参与者的握力。我们在基线时收集了合并症、功能状态、身体活动水平的数据，并进行了潜在混杂因素的调整。在随访期间，我们收集了死亡率的数据。
在 9.5 年的随访期间（范围 8.5-10.5 年），有 444 名（80%）参与者死亡。在握力最低的 tertile 参与者中，全因死亡率风险升高（风险比 [HR] 1.35，95%置信区间 [CI] 1.00-1.82，p = 0.047），在握力最低的两个 tertile 参与者中，全因死亡率风险升高（HR 2.04，CI 1.24-3.35，p = 0.005 和 HR 1.73，CI 1.11-2.70，p = 0.016）。我们还观察到，在握力相对损失最高的 tertile 参与者中，死亡率显著增加（HR 1.72，CI 1.07-2.77，p = 0.026）。
握力是整体肌肉力量的替代测量指标，是最年长老年人全因死亡率的预测指标，可能成为预测老年人死亡率风险的一种方便工具。
