title: Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old.
abstract: OBJECTIVE
  To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality; hospitalization; and the onset of disability, defined as a decline in activities of daily living (ADLs), independent of muscle mass, inflammatory markers, and comorbidities.
  
  
  METHODS
  A prospective, observational, population-based follow-up study.
  
  
  METHODS
  Three well-circumscribed areas of Belgium.
  
  
  METHODS
  Five hundred sixty participants aged 80 and older were followed for 33.5 months (interquartile range 31.1-35.6 months).
  
  
  METHODS
  Grip strength, Short Physical Performance Battery (SPPB) score, and muscle mass were measured at baseline; ADLs at baseline and after 20 months; and all-cause mortality and time to first hospitalization from inclusion onward. Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization. Logistic regression analysis was used to determine predictors of decline in ADLs.
  
  
  RESULTS
  Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score. The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization, independent of muscle mass, inflammatory markers, and comorbidity. A relationship was found between SPPB score and decline in ADLs, independent of muscle mass, inflammation, and comorbidity.
  
  
  CONCLUSIONS
  In people aged 80 and older, physical performance is a strong predictor of mortality, hospitalization, and disability, and muscle strength is a strong predictor of mortality and hospitalization. All of these relationships were independent of muscle mass, inflammatory markers, and comorbidity.
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Delphine
authors.initials: D
authors.lastname: Legrand
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.forename: Catharina
authors.initials: C
authors.lastname: Matheï
authors.forename: Wim
authors.initials: W
authors.lastname: Adriaensen
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D002423:Cause of Death; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D053580:Muscle Strength; D010809:Physical Fitness; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016019:Survival Analysis
keywords: functional decline; inflammatory markers; mortality; muscle strength; physical performance