Differences in musculoskeletal health due to gender in a rural multiethnic cohort: a Project FRONTIER study

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.

Musculoskeletal stiffness is common in healthy adults and increases with age

INTRODUCTION/OBJECTIVE

Musculoskeletal stiffness is a common feature in rheumatologic inflammatory diseases but little is known about background joint stiffness in the healthy population. The aim of this survey was to determine the variation in musculoskeletal stiffness with age in a cohort of healthy adults using a patient reported outcome instrument designed to assess stiffness in rheumatoid arthritis.

METHODS

Healthy subjects ≥18 years old were enrolled at two sites. Those with a diagnosis of rheumatological disease were excluded. Each subject completed a 21-item questionnaire designed to evaluate the severity of musculoskeletal stiffness, its physical impact and psychosocial impact, and to provide an overall stiffness score, expressed as a percentage. Scores were analyzed by age group.

RESULTS

Two hundred eighty-two subjects were included with a mean age of 42 years (±17, range 18-85). More than 50% of subjects reported stiffness in each age group but with a low median overall stiffness score of 5.4% (IQR 0, 12.6). Scores were markedly higher in those aged ≥60 years, median 10.0% (IQR 2.6, 21.9), and only in this age group did the majority of subjects report a physical or psychosocial impact of stiffness. Scores in males and females were similar.

CONCLUSION

The prevalence of musculoskeletal stiffness in healthy subjects of all ages is not negligible, and the high frequency of stiffness and greater severity in the upper age cohort suggest that the background joint stiffness amongst older subjects should be considered when interpreting stiffness in rheumatologic patients.

An Investigation of Short-Term Longitudinal Associations Between Handgrip Strength and Cardiovascular Disease Biomarkers Among Middle-Aged to Older Adults: A Project FRONTIER Study

The purpose of this study was to examine short-term longitudinal relationships between handgrip strength (HGS) and cardiovascular disease (CVD) biomarkers in middle-aged to older adults living in rural areas (N = 138). The association between HGS and CVD biomarkers was examined at baseline, with HGS as a predictor of the annual change in biomarkers, and in a parallel fashion between the annual change in HGS and CVD biomarkers over an average of 2.8 follow-up years. The results showed HGS to cross-sectionally associate with waist circumference and diastolic blood pressure at baseline, but HGS at baseline was not found to predict the annual change in any biomarker. The annual increase in HGS was significantly associated with favorable changes in high-density lipoprotein cholesterol, triglycerides, and systolic/diastolic blood pressures; yet, these associations varied by the baseline levels of biomarkers. The present findings suggest that improved muscle strength with aging is related to favorable changes in CVD biomarkers.