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手握力不对称和减弱可能会加速美国老年人的死亡时间。

Handgrip Strength Asymmetry and Weakness May Accelerate Time to Mortality in Aging Americans.

机构信息

Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.

Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA; Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.

出版信息

J Am Med Dir Assoc. 2020 Dec;21(12):2003-2007.e1. doi: 10.1016/j.jamda.2020.04.030. Epub 2020 Jun 28.

Abstract

OBJECTIVES

Assessing handgrip strength (HGS) asymmetry may provide insights into HGS as a prognostic assessment of strength capacity and vitality. This study sought to determine the associations of HGS asymmetry and weakness on time to mortality in aging Americans.

DESIGN

Longitudinal panel.

SETTING

Secondary analyses of data from participants aged ≥50 years from the 2006‒2014 waves of the Health and Retirement Study.

PARTICIPANTS

The analytic sample included 19,325 Americans who identified hand dominance and had measures of HGS for both hands in a single wave.

MEASURES

A handgrip dynamometer was used to measure HGS. Men and women who were considered weak had HGS <26 kg and <16 kg, respectively. The highest HGS values from the dominant and nondominant hands were used to calculate HGS ratio: (nondominant HGS/dominant HGS). Those with HGS ratio <0.90 or >1.10 had any HGS asymmetry. Moreover, participants with HGS ratio <0.90 had dominant HGS asymmetry, whereas those with HGS ratio >1.10 had nondominant HGS asymmetry. The National Death Index and postmortem interviews verified date of death. Covariate-adjusted Cox models were used for analyses.

RESULTS

Those with any HGS asymmetry had a 1.10 [95% confidence interval (CI) 1.03‒1.17] higher hazard for mortality, while those with weakness had a 1.44 (CI 1.32‒1.58) higher hazard for mortality. Likewise, participants with dominant HGS asymmetry had a 1.11 (CI 1.03‒1.18) higher hazard for mortality, and those with weakness had a 1.45 (CI 1.32‒1.58) higher hazard for mortality; however, the association was not significant for those with nondominant HGS asymmetry (hazard ratio: 1.07; CI 0.96‒1.18).

CONCLUSIONS AND IMPLICATIONS

HGS asymmetry and weakness are markers of impaired strength capacity that independently accelerate time to mortality, but the magnitude of these associations was more prominent for weakness. Nevertheless, assessments of asymmetric HGS are a simple adjunct analysis that may show promise for increasing the prognostic value of handgrip dynamometers.

摘要

目的

评估握力(HGS)不对称性可能为 HGS 作为力量能力和活力的预后评估提供见解。本研究旨在确定衰老美国人中 HGS 不对称和减弱与死亡率之间的关联。

设计

纵向面板。

地点

对健康与退休研究 2006-2014 年各波次中年龄≥50 岁参与者的数据进行二次分析。

参与者

分析样本包括 19325 名美国人,他们在单个波次中确定了手优势,并对双手的 HGS 进行了测量。

测量方法

使用握力测力计测量 HGS。男性和女性中握力<26kg 和<16kg 被认为较弱。使用优势手和非优势手的最高 HGS 值计算 HGS 比值:(非优势手 HGS/优势手 HGS)。HGS 比值<0.90 或>1.10 的人存在任何 HGS 不对称。此外,HGS 比值<0.90 的参与者有优势手 HGS 不对称,而 HGS 比值>1.10 的参与者有非优势手 HGS 不对称。国家死亡指数和死后访谈核实了死亡日期。使用协变量调整的 Cox 模型进行分析。

结果

任何 HGS 不对称的人死亡的危险比为 1.10(95%置信区间 [CI],1.03-1.17),而 HGS 较弱的人死亡的危险比为 1.44(CI,1.32-1.58)。同样,优势手 HGS 不对称的参与者死亡的危险比为 1.11(CI,1.03-1.18),HGS 较弱的参与者死亡的危险比为 1.45(CI,1.32-1.58);然而,非优势手 HGS 不对称的参与者的相关性不显著(危险比:1.07;CI,0.96-1.18)。

结论和意义

HGS 不对称和减弱是力量能力受损的标志物,可独立加速死亡率,而这些关联的程度对于减弱更为明显。然而,不对称 HGS 的评估是一种简单的辅助分析,可能会提高握力计的预后价值。

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