Linear association between grip strength and all-cause mortality among the elderly: results from the SHARE study

Background Grip strength had become a potential tool for clinical assessments, while the predictive value of the grip strength of community-based populations had some limitations. Aims To identify the shapes of the association between grip strength and all-cause mortality in the Survey of Health, Ageing and Retirement in Europe (SHARE) cohort. Methods Based on the SHARE cohort, 13,231 subjects aged 65 years and older were included in this study. Cox models with penalized splines (P-splines) were employed to characterize the shapes of the association between grip strength and all-cause mortality with the adjustment of covariates including sociodemographic characteristics, health characteristics, behavioral habits, and illness status. Then grip strength was analyzed as a categorical variable in quintile to examine the impact of low grip strength on all-cause mortality. Results Inversely linear associations were found between grip strength and mortality both in males and females after adjustment for covariates. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for each 5 kg decrease in grip strength to all-cause mortality were 1.11 (1.06-1.18) in males and 1.17 (1.08-1.28) in females. In comparison with subjects in the fifth quintile, the adjusted HRs and 95% CIs of all-cause mortality in the first quintile was 2.39 (1.79-3.19) in males and 1.84 (1.34-2.51) in females. Which were statistically significant in the second quintile compared with the fifth quintile [Males: 2.06 (1.56, 2.74), Females: 1.83 (1.35, 2.48)]. Conclusions Grip strength is inversely linear association with all-cause mortality and the low grip strength at the first and second quintile are a robust predictor of all-cause mortality.

Automated summary

The study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) cohort showed an inverse linear association between grip strength and all-cause mortality, with low grip strength in the first and second quintile being a strong predictor of all-cause mortality.