Dataset Information

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing.

ABSTRACT: OBJECTIVE:To examine whether reduced handgrip strength, as a marker of muscle weakness, is linked with the risk of cardiovascular, cancer and all-cause mortality among older adults. DESIGN:We used data from the 2006 to 2014 Korean longitudinal study of ageing study. Estimates of handgrip strength were collected using a handheld dynamometer. Cox proportional hazard models with time-varying covariates were used to estimate HRs and their 95% CIs for all-cause mortality. The cause-specific hazards regression analysis was also used to model cardiovascular and cancer mortality, by treating deaths from the cause of interest as events and other causes of death as censored. PARTICIPANTS:5859 participants aged 50 years or older were followed up until death or until the date of censoring (31 December 2014). PRIMARY OUTCOME MEASURES:The study outcomes of interest were all-cause, cardiovascular and cancer mortality. RESULTS:Of the participants included in analyses, 515 individuals (8.8%) died, reflecting an overall crude mortality rate of 11.0 deaths per 1000 person-years. Participants in the lowest handgrip strength tertile showed an increased risk of all-cause and cardiovascular mortality evidenced by a multivariable adjusted HRs of 1.90 (95% CI 1.33 to 2.73) and 1.59 (95% Cl 1.08 to 2.34), respectively. However, there were no significant differences in the rates of cancer-related death, with HR of 1.29 (95% CI 0.92 to 1.81 [lowest vs highest tertile; p trend=0.21]). CONCLUSION:These results demonstrate that lower handgrip strength is an independent predictor of mortality among a population-based sample of Korean elderly; highlighting the importance of interventions targeted at enhancing muscle strength for improvements in survival at older ages.

SUBMITTER: Kim GR

PROVIDER: S-EPMC6527975 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing.

Kim Gyu Ri GR Sun Jiyu J Han Minkyung M Park Sohee S Nam Chung Mo CM

BMJ open 20190509 5

<h4>Objective</h4>To examine whether reduced handgrip strength, as a marker of muscle weakness, is linked with the risk of cardiovascular, cancer and all-cause mortality among older adults.<h4>Design</h4>We used data from the 2006 to 2014 Korean longitudinal study of ageing study. Estimates of handgrip strength were collected using a handheld dynamometer. Cox proportional hazard models with time-varying covariates were used to estimate HRs and their 95% CIs for all-cause mortality. The cause-spe ...[more]

PMID: 31072857

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Project description:Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction.Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61-74 years at baseline. Relative HS was obtained by dividing the absolute value by body weight.Results: During a median (interquartile range) follow-up of 17.3 (12.6-18.4) years, 116 fatal coronary heart diseases (CHDs), 195 fatal CVDs and 412 all-cause mortality events occurred. On adjustment for several risk factors, the hazard ratios (95% confidence intervals (CIs)) for fatal CHD, fatal CVD and all-cause mortality were 0.59 (0.37-0.95), 0.59 (0.41-0.86) and 0.66 (0.51-0.84), respectively, comparing extreme tertiles of relative HS. Adding relative HS to a CVD mortality risk prediction model containing established risk factors did not improve discrimination or reclassification using Harrell's C-index (C-index change: 0.0034; p = .65), integrated-discrimination-improvement (0.0059; p = .20) and net-reclassification-improvement (-1.31%; p = .74); however, there was a significant difference in -2 log likelihood (p < .001).Conclusions: Relative HS is inversely associated with CHD, CVD and all-cause mortality events. Adding relative HS to conventional risk factors improves CVD risk assessment using sensitive measures of discrimination.KEY MESSAGESHandgrip strength (HS) assessment is simple, inexpensive and it takes only a few minutes to measure in clinical practice; however, its prognostic role for fatal cardiovascular outcomes on top of traditional risk factors in apparently healthy populations is uncertain.In a population-based prospective cohort study, good HS adjusted for body weight was associated with lower risk of fatal cardiovascular outcomes and the associations remained consistent across several clinically relevant subgroups.Handgrip strength may be a useful prognostic tool for fatal CHD and CVD events, in the general population.

Project description:BackgroundFerritin constitutes a sensitive iron-storage index and multi-functional protein. Evidence on its association with mortality in general population is scarce and conflicting. We investigated the sex-specific associations of ferritin levels with all-cause and cardiovascular mortality in a population-based cohort.MethodsData came from the English Longitudinal Study of Ageing and the national mortality registry. The sample comprised 5,471 participants aged ?52 years. Blood concentration of ferritin was measured at baseline in 2004-05. Sex-specific Cox proportional hazards models were estimated with adjustment for age, major chronic diseases, marital status, educational attainment, total net household wealth, anemia, inflammatory markers, body mass index, smoking, and physical activity. Stratified analyses by chronic disease status were also performed.ResultsWe categorized ferritin in sex-specific quartiles. In men, we used, the following categorization: lowest (2-69ng/ml), second lowest (70-118ng/ml), second highest (reference category) (119-193ng/ml) and highest (194-598ng/ml) ferritin quartiles. In women, ferritin was categorized as follows: lowest (2-44ng/ml), second lowest (45-73ng/ml), second highest (reference category) (74-115ng/ml) and highest (116-341ng/ml) ferritin quartiles. 841 deaths of which 262 cardiovascular disease-related were recorded over a mean follow-up time of 7.7 years. Risk for all-cause mortality was found increased in men with hyperferritinemia (194-598ng/ml) and no history of major chronic diseases compared with the reference group [fully-adjusted HR: 1.49 (95%CI 1.03-2.16)]. Among women, those in the lowest ferritin quartile (2-44ng/ml) had increased risk for all-cause mortality [fully-adjusted HR: 1.59 (95%CI 1.18-2.13)] compared with the reference group after adjustment for all covariates. Regarding cardiovascular mortality, we observed a positive association with ferritin levels in men, which was blunted after adjustment for inflammatory markers and lifestyle parameters. Men with no major chronic diseases who were in the highest ferritin quartile had a significantly increased risk of cardiovascular mortality. No association between ferritin levels and cardiovascular mortality was detected in women.ConclusionCirculating ferritin levels showed sex-specific prognostic patterns. High ferritin levels in men with no major chronic disease and low ferritin levels in all women were associated with increased all-cause mortality after adjusting for covariates. High ferritin levels in men with no major chronic diseases were also independently associated with an increased risk of cardiovascular mortality. Future research is needed to clarify the prognostic role of ferritin.

Dataset Information

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing.

Publications

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing.

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