MRC Unit for Lifelong Health and Ageing at UCL, London WC1B 5JU, UK.
BMJ. 2014 Apr 29;348:g2219. doi: 10.1136/bmj.g2219.
To examine associations between three commonly used objective measures of physical capability assessed at age 53 and a composite score of these measures and all cause mortality; to investigate whether being unable to perform these tests is associated with mortality.
Cohort study.
MRC National Survey of Health and Development in England, Scotland, and Wales.
1355 men and 1411 women with data on physical capability at age 53 who were linked to the National Health Service (NHS) central register for death notification.
All cause mortality between ages 53 (1999) and 66 (2012).
For each of the three measures of physical capability (grip strength, chair rise speed, and standing balance time) those participants unable to perform the test and those in the lowest performing fifth were found to have higher mortality rates than those in the highest fifth. Adjustment for baseline covariates partially attenuated associations but in fully adjusted models the main associations remained. For example, the fully adjusted hazard ratio of all cause mortality for the lowest compared with the highest fifth of a composite score of physical capability was 3.68 (95% confidence interval 2.03 to 6.68). Those people who could not perform any of the tests had considerably higher rates of death compared with those people able to perform all three tests (8.40, 4.35 to 16.23). When a series of models including different combinations of the measures were compared by using likelihood ratio tests, all three measures of physical capability were found to improve model fit, and a model including all three measures produced the highest estimate of predictive ability (Harrell's C index 0.71, 95% confidence interval 0.65 to 0.77). There was some evidence that standing balance time was more strongly associated with mortality than the other two measures.
Lower levels of physical capability at age 53 and inability to perform capability tests are associated with higher rates of mortality. Even at this relatively young age these measures identify groups of people who are less likely than others to achieve a long and healthy life.
探讨 53 岁时三种常用的身体能力客观测量指标与这些指标的综合评分与全因死亡率之间的关联；研究无法进行这些测试是否与死亡率相关。
队列研究。
英国、苏格兰和威尔士的 MRC 国家健康与发展调查。
共有 1355 名男性和 1411 名女性，他们在 53 岁时的数据可用于身体能力测试，并与国民保健服务（NHS）的死亡通知中央登记处相关联。
53 岁（1999 年）至 66 岁（2012 年）期间的全因死亡率。
对于身体能力的三种测量指标（握力、椅子起身速度和站立平衡时间），无法进行测试的参与者和表现最低的五分之一参与者的死亡率高于表现最高的五分之一参与者。对基线协变量进行调整后，关联程度有所减弱，但在完全调整后的模型中，主要关联仍然存在。例如，身体能力综合评分最低五分位与最高五分位相比，全因死亡率的完全调整后的风险比为 3.68（95%置信区间 2.03 至 6.68）。与能够进行所有三项测试的人相比，无法进行任何测试的人死亡率要高得多（8.40，4.35 至 16.23）。当使用似然比检验比较包括不同组合的测试的一系列模型时，发现所有三种身体能力测量指标都可以改善模型拟合度，而包含所有三种测量指标的模型产生了最高的预测能力估计值（Harrell's C 指数为 0.71，95%置信区间为 0.65 至 0.77）。有证据表明，站立平衡时间与死亡率的关联比其他两项测量指标更强。
53 岁时身体能力水平较低且无法进行能力测试与较高的死亡率相关。即使在这个相对年轻的年龄，这些指标也能识别出比其他人更不可能长寿和健康的人群。
