title: Handgrip strength, ageing and mortality in rural Africa.
abstract: BACKGROUND
  muscle strength measured as handgrip strength declines with increasing age and predicts mortality. While handgrip strength is determined by lifestyle through nutrition and physical activity, it has almost exclusively been studied in western populations with a sedentary lifestyle. This study aims to investigate the relation between handgrip strength, ageing and mortality in a population characterised by a predominance of malnutrition and manual labour.
  
  
  METHODS
  a population-based longitudinal study.
  
  
  METHODS
  a traditional African rural population in Ghana.
  
  
  METHODS
  nine hundred and twenty-three community-dwelling individuals aged 50 and older.
  
  
  METHODS
  demographic characteristics were registered. At baseline, height, body mass index (BMI) and handgrip strength were measured and compared with those in a western reference population. Survival of the participants was documented during a period of up to 2 years.
  
  
  RESULTS
  handgrip strength was dependent on age, sex, height and BMI. Compared with the western reference population, handgrip strength was lower due to a lower height and BMI but declined over age similarly. Risk of mortality was lower in participants having higher handgrip strength, with a hazard ratio of 0.94 per kg increase (P = 0.002). After adjustment for age, sex, tribe, socio-economic status, drinking water source, height and BMI, only handgrip strength remained predictive of mortality.
  
  
  CONCLUSIONS
  in a traditional rural African population characterised by malnutrition and manual labour, handgrip strength declines over age and independently predicts mortality similar to western populations. Handgrip strength can be used as a universal marker of ageing.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, Leiden 2300 RC, The Netherlands Leyden Academy on Vitality and Ageing, Leiden 2333 AA, The Netherlands.
authors.forename: Jacob J E
authors.initials: JJ
authors.lastname: Koopman
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, Leiden 2300 RC, The Netherlands Leyden Academy on Vitality and Ageing, Leiden 2333 AA, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: van Bodegom
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, Leiden 2300 RC, The Netherlands Leyden Academy on Vitality and Ageing, Leiden 2333 AA, The Netherlands Netherlands Consortium for Healthy Ageing (NCHA), Leiden University Medical Center, Post Box 9600, Leiden 2300 RC, The Netherlands.
authors.forename: Diana
authors.initials: D
authors.lastname: van Heemst
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, Leiden 2300 RC, The Netherlands Leyden Academy on Vitality and Ageing, Leiden 2333 AA, The Netherlands.
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001827:Body Height; D015992:Body Mass Index; D005260:Female; D005869:Ghana / Q000453:epidemiology; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors
keywords: Africa; ageing; handgrip strength; mortality; older people