Abstract
Objectives
Quantifying the association between muscle weakness and mortality with carefully matched
cohorts will help to better establish the impact of weakness on premature death. We
used a matched cohort analysis in a national sample of older Americans to determine
if those who were weak had a higher risk for mortality compared with control groups
with incrementally higher strength capacities.
Design
Longitudinal panel.
Setting
Detailed interviews that included physical measures were conducted in person, whereas
core interviews were often performed over the telephone.
Participants
Data from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the
Health and Retirement Study were analyzed.
Measures
A handgrip dynamometer was used to assess handgrip strength (HGS) in each participant.
Men with HGS <26 kg were considered weak, ≥26 kg were considered not weak, and ≥32 kg
were considered strong. Women with HGS <16 kg were classified as weak, ≥16 kg were
classified as not-weak, and ≥20 kg were classified as strong. The National Death Index
and postmortem interviews determined the date of death. The greedy matching algorithm
was used to match cohorts.
Results
Of the 1077 weak and not-weak matched pairs, 401 weak (37.2%) and 296 not-weak (27.4%)
older Americans died over an average 4.4 ± 2.5-year follow-up. There were 392 weak
(37.0%) and 243 strong (22.9%) persons who died over a mean 4.5 ± 2.5-year follow-up
from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95%
confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality
relative to persons in the not-weak and strong control cohorts, respectively.
Conclusions and Implications
Our findings may indicate a causal association between muscle weakness and mortality
in older Americans. Health care providers should include measures of HGS as part of
routine health assessments and discuss the health risks of muscle weakness with their
patients.
Keywords
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Article info
Publication history
Published online: November 27, 2019
Footnotes
R.M.'s effort in this research was partially supported by funding from the College of Human Sciences and Education at North Dakota State University. B.C.C.'s effort in this research was supported, in part, by a grant from the National Institute on Aging (R01AG044424).
Identification
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© 2019 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
