Department of Physical Medicine & Rehabilitation, University of Michigan, United States of America; Michigan Center on the Demography of Aging (MiCDA), United States of America; Michigan Institute for Health Policy and Innovation (IHPI), United States of America.
Department of Physical Medicine & Rehabilitation, University of Michigan, United States of America.
Exp Gerontol. 2021 Sep;152:111462. doi: 10.1016/j.exger.2021.111462. Epub 2021 Jul 2.
The objective of this study was to use nationally-representative data on Americans greater than 50 years of age to determine the association between grip strength and inflammation as independent predictors of incident disability, chronic multimorbidity and dementia.
Middle age and older adults (n = 12,618) from the 2006-2008 waves of the Health and Retirement Study with 8-years of follow-up were included. Longitudinal modeling was performed to examine the association between baseline grip strength (normalized to body mass: NGS) and high sensitivity C-reactive protein (hs-CRP) (≥3.0 mg/L) with incident physical disabilities (i.e., ≥2 limitations to activities of daily living), chronic multimorbidity (≥2 of chronic conditions), and dementia.
The odds of incident disability were 1.25 (95% CI: 1.20-1.30) and 1.31 (95% CI: 1.26-1.36) for men and women respectively, for each 0.05-unit lower NGS. The odds of incident chronic multimorbidity were 1.14 (95% CI: 1.08-1.20) and 1.14 (95% CI: 1.07-1.21) for men and women respectively for each 0.05-unit lower NGS. The odds of incident dementia were 1.10 for men (95% CI: 1.02-1.20) for each 0.05-unit lower NGS, but there was no significant association for women. Elevated hs-CRP was only associated with chronic multimorbidity among men (OR = 1.29; 95% CI: 1.00-1.73) and women (OR = 1.60; 95% CI: 1.26-2.02).
Our findings indicate a robust inverse association between NGS and disability and chronic, multimorbidity in older men and women, and dementia in men. Elevated hs-CRP was only associated with chronic multimorbidity in men and women. Healthcare providers should implement measures of grip strength in routine health assessments and discuss the potential dangers of weakness as well as interventions to improve strength with their patients.
本研究旨在利用具有代表性的美国 50 岁以上人群数据，确定握力与炎症作为残疾、慢性多种疾病和痴呆发生的独立预测因子之间的关系。
纳入了来自 2006-2008 年健康与退休研究中年龄较大的成年人（n=12618），随访 8 年。进行纵向建模以检查基线握力（标准化至体重：NGS）和高敏 C 反应蛋白（hs-CRP）（≥3.0mg/L）与新发身体残疾（即≥2 项日常生活活动受限）、慢性多种疾病（≥2 种慢性疾病）和痴呆之间的关联。
男性和女性的残疾发生率分别为 1.25（95%CI：1.20-1.30）和 1.31（95%CI：1.26-1.36），每降低 0.05 个 NGS 单位。男性和女性的新发慢性多种疾病发生率分别为 1.14（95%CI：1.08-1.20）和 1.14（95%CI：1.07-1.21），每降低 0.05 个 NGS 单位。男性的痴呆发生率为 1.10（95%CI：1.02-1.20），每降低 0.05 个 NGS 单位，但女性无显著相关性。hs-CRP 升高仅与男性（OR=1.29；95%CI：1.00-1.73）和女性（OR=1.60；95%CI：1.26-2.02）的慢性多种疾病相关。
我们的研究结果表明，在老年男性和女性中，NGS 与残疾和慢性、多种疾病以及男性痴呆之间存在强有力的反比关系。hs-CRP 升高仅与男性和女性的慢性多种疾病相关。医疗保健提供者应在常规健康评估中实施握力测量，并与患者讨论虚弱的潜在危险以及改善力量的干预措施。
