Abstract
The prevalence of chronic diseases has risen along with increased longevity. Co-occurrence of two or more chronic diseases in an individual (multimorbidity) is prevalent and poses a huge burden to individuals and the society. However, determinants of multimorbidity are largely unknown. Handgrip strength is a general indicator of muscle strength and linked with premature mortality. However, its role in multimorbidity has never been evaluated. To investigate the relationships between handgrip strength and multiple chronic diseases and multimorbidity, and to assess the usefulness of age and handgrip as a marker of chronic diseases and multimorbidity in a community dwelling sample of men and women, we analyzed a cross-sectional cohort with 1,145 subjects (748 men and 397 women) aged 50 years and older living in Hong Kong. Low handgrip strength was significantly associated with increased odds of having five and three chronic diseases in men and women, respectively, after controlling for age, body mass index, history of smoking, educational level, marital level and comorbidity. Multivariable-adjusted handgrip strength was significantly decreased with the number of chronic diseases in men (trend, P = 0.001), but the trend in women was marginal (trend, P = 0.06). Conversely, multivariable-adjusted age was significantly increased with the number of chronic diseases in women (trend, P = 0.033), but not in men (trend, P = 0.118). In conclusion, handgrip strength is associated with multiple chronic diseases and multimorbidity in men and women after adjustment of confounding factors. It shows a linear trend of association with the number of chronic diseases in men, but not in women. Since handgrip strength is a biomarker of multiple physiological systems, its augmentation may be a feasible strategy to improve general health and decrease likelihood of having multiple chronic diseases and hence, premature mortality.Electronic supplementary materialThe online version of this article (doi:10.1007/s11357-012-9385-y) contains supplementary material, which is available to authorized users.
Highlights
The prevalence of chronic diseases has risen along with longevity (Knottnerus et al 1992), and the prevalence is expected to rise further owing to an aging population
The associations between each chronic disease per each study. The mean (SD) decrease in handgrip strength in men and women are shown in Tables 2 and 3, respectively
In men, decreased handgrip strength was associated with increased odds of 12 chronic diseases
Summary
The prevalence of chronic diseases has risen along with longevity (Knottnerus et al 1992), and the prevalence is expected to rise further owing to an aging population. Previous studies have shown that multimorbidity increases the mortality risk (Marengoni et al 2011; Newman et al 2008), causes a decline of physical and mental functioning (Marengoni et al 2009, 2011), and adversely influences quality of life (Fortin et al 2006; Marengoni et al 2011; Tooth et al 2008). It is associated with needing help with activities of daily living, longer hospitalization, and higher overall health service utilization (Marengoni et al 2011; Tooth et al 2008)
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