Abstract
The prospective association of muscular weakness with the risk of all-cause and premature mortality in a general population remains unknown. The aim of this study was to investigate the prospective effects of handgrip strength and muscular weakness on risk for all-cause and premature mortality over 10 years using a large nationwide sample of Korean adults. The study participants included 9229 middle and older adults (4131 males and 5098 females), using data from the Korean Longitudinal Study of Ageing 2006–2016. Muscular strength was measured using handgrip strength. Muscle weakness was defined using the sex-specific handgrip strength index based on the Asian Working Group on Sarcopenia in Older People (AWGSOP). The primary outcome was all-cause and premature mortality assessed based on the death certificate. The hazard ratio (HR) for all-cause mortality was negatively associated with level of handgrip strength independent of potential confounding factors (HR: 2.06, 95% confidence interval [CI]: 1.62–2.63 for lowest quartile vs. highest quartile). When examined using muscle weakness defined using the AWGSOP diagnosis, the mortality was 1.56 times higher in the weak group (HR: 1.56, 95% CI: 1.36–1.78). We also found that risk of premature mortality was observed in the lowest quartile (HR: 2.34, 95% CI: 1.80–3.05) and the muscle weakness group (HR: 1.80, 95% CI: 1.52–2.13) in the fully adjusted model. Our 10-year prospective cohort study showed that handgrip strength and muscle weakness are strongly associated with an increased risk of all-cause and premature mortality in healthy middle-aged and older adults.
Highlights
Biological aging is characterized by changes in body composition and physical function
We found that risk of premature mortality was observed in the lowest quartile (HR: 2.34, 95% confidence interval (CI): 1.80–3.05) and the muscle weakness group (HR: 1.80, 95% CI: 1.52–2.13) in the fully adjusted model
Relative handgrip strength corrected by body weight was 49.63 (±0.16)% for male and 35.16 (±0.13)% for female
Summary
Biological aging is characterized by changes in body composition and physical function. Sarcopenia, the loss of muscle mass or strength as a result of aging, has been linked to an increased risk of chronic disease, physical impairment, cognitive dysfunction, hospitalization, and mortality [1,2,3,4,5,6]. Screening this population is an important intervention technique that promotes public health. Frequently used to evaluate muscle strength, reflects the strength of the whole body It has the advantage of being simple and safe to assess in older individuals [7]. Low handgrip strength was utilized as a surgical definition of sarcopenia by the Asian Working Group on Sarcopenia in Older People (AWGSOP) so that it may be a simple test to examine older people without evaluating muscle mass [12]
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