PDF(Pubmed)
Abstract：
BACKGROUND: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.
OBJECTIVE: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.
METHODS: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell\'s Concordance Index (C-index).
RESULTS: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.
CONCLUSIONS: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.
OBJECTIVE: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.
METHODS: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell\'s Concordance Index (C-index).
RESULTS: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.
CONCLUSIONS: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.
摘要：
背景：低握力和步态速度与死亡率相关。然而,调查这些措施解释的额外死亡风险，超越其他因素，是有限的。
目的：我们研究了握力和步态速度是否提高了对死亡率的辨别能力，而不是更容易获得的临床危险因素。
方法：来自健康的参与者，衰老和身体成分研究，男性骨质疏松性骨折研究,和赫特福德郡队列研究进行了分析。使用DXA确定阑尾瘦体重（ALM）；通过握力测量法确定肌肉力量；通常的步态速度超过2.4-6m。记录了已确认的死亡。使用Cox回归分析了肌肉减少症成分与死亡率之间的关联，并将其作为随机效应；使用Harrell一致性指数（C指数）评估判别能力。
结果：参与者（n=8362）的平均（SD）年龄为73.8（5.1）岁；5231（62.6％）在中位随访时间为13.3年期间死亡。握力（每SD降低的危险比（95％CI）：1.14（1.10,1.19））和步态速度（1.21（1.17,1.26）），但不是ALM指数(1.01(0.95,1.06))，在考虑年龄后的相互调整模型中，与死亡率相关，性别,BMI,吸烟状况,酒精消费,身体活动,种族,教育,骨折和跌倒的历史，股骨颈骨密度（BMD），自我评估的健康，认知功能和合并症数量。然而,一个只包含年龄和性别作为暴露的模型给出了0.65(0.64,0.66)的C指数(95%CI)，在包含握力和步态速度后，仅增加到0.67（0.67,0.68）。
结论：与其他更容易获得的危险因素相比，握力和步态速度可能仅产生适度的死亡率辅助危险信息。
目的：我们研究了握力和步态速度是否提高了对死亡率的辨别能力，而不是更容易获得的临床危险因素。
方法：来自健康的参与者，衰老和身体成分研究，男性骨质疏松性骨折研究,和赫特福德郡队列研究进行了分析。使用DXA确定阑尾瘦体重（ALM）；通过握力测量法确定肌肉力量；通常的步态速度超过2.4-6m。记录了已确认的死亡。使用Cox回归分析了肌肉减少症成分与死亡率之间的关联，并将其作为随机效应；使用Harrell一致性指数（C指数）评估判别能力。
结果：参与者（n=8362）的平均（SD）年龄为73.8（5.1）岁；5231（62.6％）在中位随访时间为13.3年期间死亡。握力（每SD降低的危险比（95％CI）：1.14（1.10,1.19））和步态速度（1.21（1.17,1.26）），但不是ALM指数(1.01(0.95,1.06))，在考虑年龄后的相互调整模型中，与死亡率相关，性别,BMI,吸烟状况,酒精消费,身体活动,种族,教育,骨折和跌倒的历史，股骨颈骨密度（BMD），自我评估的健康，认知功能和合并症数量。然而,一个只包含年龄和性别作为暴露的模型给出了0.65(0.64,0.66)的C指数(95%CI)，在包含握力和步态速度后，仅增加到0.67（0.67,0.68）。
结论：与其他更容易获得的危险因素相比，握力和步态速度可能仅产生适度的死亡率辅助危险信息。
