Handgrip strength and mortality in the oldest old population: the Leiden 85-plus study.
BACKGROUND
Poor muscular strength has been shown to be associated with increased morbidity and mortality in diverse samples of middle-aged and elderly people. However, the oldest old population (i.e., over 85 years) is underrepresented in such studies. Our objective was to assess the association between muscular strength and mortality in the oldest old population.


METHODS
We included 555 participants (65% women) from the Leiden 85-plus study, a prospective population-based study of all 85-year-old inhabitants of Leiden, Netherlands. We measured the handgrip strength of participants at baseline and again at age 89 years. We collected baseline data on comorbidities, functional status, levels of physical activity, and adjusted for potential confounders. During the follow-up period, we collected data on mortality.


RESULTS
During a follow-up period of 9.5 years (range 8.5-10.5 years), 444 (80%) participants died. Risk for all-cause mortality was elevated among participants in the lowest tertile of handgrip strength at age 85 years (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.00-1.82, p = 0.047) and the lowest two tertiles of handgrip strength at age 89 years (HR 2.04, CI 1.24-3.35, p = 0.005 and HR 1.73, CI 1.11-2.70, p = 0.016). We also observed significantly increased mortality among participants in the tertile with the highest relative loss of handgrip strength over four years (HR 1.72, CI 1.07-2.77, p = 0.026).


CONCLUSIONS
Handgrip strength, a surrogate measurement of overall muscular strength, is a predictor of all-cause mortality in the oldest old population and may serve as a convenient tool for prognostication of mortality risk among elderly people.
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands. c.h.y.ling@lumc.nl
Carolina H Y
CH
Ling
Diana
D
Taekema
Anton J M
AJ
de Craen
Jacobijn
J
Gussekloo
Rudi G J
RG
Westendorp
Andrea B
AB
Maier
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009026:Mortality; D053581:Muscle Strength Dynamometer; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests; D011446:Prospective Studies