Handgrip Strength and Mortality in Older Mexican Americans

  • Snih S
  • Markides K
  • Ray L
 et al. 
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Abstract

OBJECTIVES: To examine the association between hand-grip strength and mortality in older Mexican American men and women. DESIGN: A 5-year prospective cohort study. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. MEASUREMENTS: Maximal handgrip strength, timed walk, and body mass index were assessed at baseline dur-ing 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. RESULTS: Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Aver-age handgrip strength Ϯ standard deviation was signifi-cantly higher in men (28.4 kg Ϯ 9.5) than in women (18.2 kg Ϯ 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quar-tile, the hazard ratio of death was 2.10 (95% confidence interval (CI) ϭ 1.31–3.38) compared with those in the highest handgrip strength quartile, after controlling for so-ciodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95% CI ϭ 1.05–2.93) compared with those in the highest hand-grip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. CONCLUSION: Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors. J Am Geriatr Soc 50:1250–1256, 2002. S tudies predicting mortality in older people aim to iden-tify risk factors enabling early intervention and effec-tive treatment and rehabilitation to help increase active life expectancy and improve quality of life. 1 These factors in-clude age, gender, physical and mental health, self-rated health, and lifestyle behaviors. 1–3 Decreased muscle strength in old age is related to functional limitations and upper and lower body disabil-ity. Factors associated with muscle weakness in upper and lower extremities in older people include decreased physi-cal activity, lower hormone levels, lower body weight, un-dernutrition, chronic disease, and more medications to treat disease. 4–19 Poor upper body muscle strength as mea-sured by handgrip strength has been associated with dis-ability in older people. 20–23 Poor lower body function, as measured by tests of walking, balance, and chair stands, is associated with poor health status, physiological alter-ations such as low albumin and hemoglobin levels, poor muscle strength, obesity, physical inactivity, and mortal-ity. 4,18,23–31 Nevertheless, only a limited number of studies have investigated the association of grip strength with mortal-ity. The grip strength test is commonly used to evaluate the integrated performances of muscles by determining maximal grip force that can be produced in one muscular contraction, 32 and grip strength has frequently been used as a marker for general muscle strength. 10,33 Laukkanen et al. 1 found a strong association between grip strength and mortality in a cohort of older people in Jyväskylä, Finland. Rantanen et al. 34 reported a gradient of decreasing mortality risk with increasing grip strength in a cohort of men living in Hawaii. Phillips et al. 35 found that reduced grip strength was associated with increased risk of mortality in women with acute illness. Fujita et al., 36 in health-promotion centers in Japan, found a

Author-supplied keywords

  • Mexican Americans
  • aging
  • grip strength
  • mortality
  • survival analy-sis

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Authors

  • Soham Al Snih

  • Kyriakos S Markides

  • Laura Ray

  • Glenn V Ostir

  • James S Goodwin

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