Predicting cause-specific mortality of older men living in the Veterans home by handgrip strength and walking speed: a 3-year, prospective cohort study in Taiwan.

OBJECTIVE

To determine prognostic value of handgrip strength (HGS) and walking speed (WS) in predicting the cause-specific mortality for older men.

DESIGN

Prospective cohort study.

SETTING

Banciao Veterans Care Home.

PARTICIPANTS

558 residents aged 75 years and older.

MEASUREMENTS

Anthropometric data, lifestyle factors, comorbid conditions, biomarkers, HGS, and WS at recruitment; all-cause and cause-specific mortality at 3 years after recruitment.

RESULTS

During the study period, 99 participants died and the baseline HGS and WS were significantly lower than survivors (P both <.001). Cox survival analysis showed that subjects with slowest quartile of WS were at significantly higher risk of all-cause mortality and cardiovascular mortality (hazard ratio [HR] 3.55, 95% confidence interval [CI] 1.69-7.43; HR 11.55, 95% CI 2.30-58.04, respectively), whereas the lowest quartile of HGS significantly predicted a higher risk of infection-related death (HR 5.53, 95% CI 1.09-28.09). Participants in the high-risk status with slowest quartile for WS but not those in the high-risk status with weakest quartile for HGS had similar high risk of all-cause mortality with the group with combined high-risk status (HR 2.96, 95% CI 1.68-5.23; HR 2.58, 95% CI 1.45-4.60, respectively) compared with the participants without high-risk status (reference group).

CONCLUSIONS

Slow WS predicted all-cause and cardiovascular mortality, whereas weak HGS predicted a higher risk of infection-related death among elderly, institutionalized men in Taiwan. Combining HGS with WS simultaneously had no better prognostic value than using WS only in predicting all-cause mortality.