title: Grip strength, postural control, and functional leg power in a representative cohort of British men and women: associations with physical activity, health status, and socioeconomic conditions.
abstract: BACKGROUND
  Understanding the health, behavioral, and social factors that influence physical performance in midlife may provide clues to the origins of frailty in old age and the future health of elderly populations. The authors evaluated muscle strength, postural control, and chair rise performance in a large representative prospective cohort of 53-year-old British men and women in relation to functional limitations, body size, health and activity, and socioeconomic conditions.
  
  
  METHODS
  Nurses interviewed 2984 men and women in their own homes in England, Scotland, and Wales and conducted physical examinations in 2956 of them. Objective measures were height, weight, and three physical performance tests: handgrip strength, one-legged standing balance time, and time to complete 10 chair rises. Functional limitations (difficulties walking, stair climbing, gripping, and falls), health status, physical activity, and social class were obtained using a structured questionnaire.
  
  
  RESULTS
  Those with the worst scores on the physical performance tests had higher rates of functional limitations for both upper and lower limbs. Women had much weaker handgrip strength, somewhat poorer balance time, and only slightly poorer chair rise time compared with men. In women, health problems and low levels of physical activity contributed to poor physical performance on all three measures. In men, physical activity was the predominant influence. Heavier weight and poorer socioeconomic conditions contributed to poorer balance and chair rise times.
  
  
  CONCLUSIONS
  In this representative middle-aged group, physical performance levels varied widely, and women were seriously disadvantaged compared with men. In general, physical performance was worse for men and women living in poorer socioeconomic conditions with greater body weight, poorer health status, and inactive lifestyles. These findings support recommendations for controlling excess body weight, effective health interventions, and the maintenance of active lifestyles during aging.
authors.affiliation: MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College Medical School, 1-19 Torrington Place, London, United Kingdom, WC1E 6BT. d.kuh@nshd.mrc.ac.uk
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: E Joan
authors.initials: EJ
authors.lastname: Bassey
authors.forename: Suzanne
authors.initials: S
authors.lastname: Butterworth
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.forename: Michael E J
authors.initials: ME
authors.lastname: Wadsworth
mesh_terms: D015331:Cohort Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006304:Health Status; D006801:Humans; D007866:Leg / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010808:Physical Examination; D011187:Posture / Q000502:physiology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D006113:United Kingdom