The association between walking pace and grip strength and all-cause mortality: A prospective analysis from the MAUCO cohort

OBJECTIVE

This study investigated the individual and combined association of walking pace and grip strength with all-cause mortality in Chilean adults.

STUDY DESIGN

8813 participants (54.6 % women) from the MAUCO population-based cohort were included in this prospective study.

MAIN OUTCOME MEASURES

Individual and combined associations of grip strength (normal or low grip) and walking pace (normal or slow walking) with all-cause mortality were investigated using Cox proportional-hazard models. Analyses were adjusted for sociodemographic, lifestyle, and health-related factors.

RESULTS

Over a median follow-up of 4.74 years, 151 and 206 participants included in the analyses of walking pace and grip strength died. Individuals with low grip strength had a risk of dying 2.40 times (95 % CI: 1.64 to 3.51) higher than their counterparts with normal grip strength. Similar results were identified for slow walkers (HR: 1.77 [95 % CI: 1.25 to 2.50]). When the two factors were combined and the associations investigated, individuals with normal walking pace but with low grip strength had a higher risk of all-cause mortality than those with normal walking pace and normal grip strength (HR: 3.56 [95 % CI: 1.99 to 6.36]). The associations remained even after including a 1- and 2-year landmark period in the analyses.

CONCLUSIONS

Slow walking pace and low grip strength were associated with a higher risk of mortality (both in isolation and combined). These factors might be early markers of all-cause mortality, and should be measured more frequently in middle-aged and older adults in clinical practice.

Clinical and serological profile of asymptomatic and non-severe symptomatic COVID-19 cases: Lessons from a longitudinal study in primary care in Latin America

BACKGROUND

Chile has one of the highest incidences of COVID-19 infection in the world. Primary care can play a key role in early detection and containment of the disease. There is a lack of information on the clinical profile of patients with suspected COVID-19 in primary care, and controversy on the effectiveness of rapid serologic tests in the diagnosis and surveillance of the disease.

AIM

To assess the effectiveness of rapid serologic testing in detection and surveillance of COVID-19 cases in primary care.

DESIGN & SETTING

A longitudinal study was undertaken, which was based on a non-random sample of 522 participants, including 304 symptomatic patients and 218 high-risk asymptomatic individuals. They were receiving care at four primary health clinics in an underserved area in Santiago, Chile.

METHOD

The participants were systematically assessed and tested for COVID-19 with reverse transcriptase-polymerase chain reaction (RT-PCR) and serology at baseline, and were followed clinically and serologically for 3 weeks.

RESULTS

The prevalence rate of RT-PCR confirmed COVID-19 cases were 3.5 times higher in symptomatic patients (27.5%; 95% confidence interval [CI] = 22.1 to 32.8) compared with asymptomatic participants (7.9%; 95% CI = 4.3 to 11.6). Similarly, the immune response was significantly different between both groups. Sensitivity of serologic testing was 57.8% (95% CI = 44.8 to 70.1) during the third week of follow-up and specificity was 98.4% (95% CI = 95.5 to 99.7).

CONCLUSION

Rapid serologic testing is ineffective for detecting asymptomatic or non-severe cases of COVID-19 at early stages of the disease, but can be of value for surveillance of immunity response in primary care. The clinical profile and immune response of patients with COVID-19 in primary care differs from those in hospital-based populations.

Processed meat eater profile in a Latin-American cohort

Background

We aim to describe the prevalence, distribution and factors associated to processed meat (e.g. sausages, bacon) consumption (PMC) in a Chilean population-based cohort. This is the first study to explore this exposure in Chile.

Methods

We studied 7841 participants of the Maule Cohort, 4358 women, 3483 men aged 37 to 77 years, who answered an epidemiological survey (diet, alcohol, health, socioeconomic), had a medical examination, and provided fasting blood. We stratified them in five groups by weekly frequency of PMC from (1) none, (2) <1/week, (3) 1/week, (4) 2-4/week to (5) >5/week. We analyzed MAUCO cohort baseline data in association with PMC. We estimated Prevalence ratios (PR) with Poisson regression (age, schooling & sex adjusted) and with multinomial logistic regression we modelled PMC using group 1 as reference.

Results

High consumers were 8% (7% women, 9% men). Binge drinking was more common among participants in groups 2, 3 & 4 (Relative Risk Ratio, RRR) 1.26, 95% confidence interval (CI) 1.04-1.52; 1.28, CI 1.0-1.55 & 1.32, CI 1.08-1.6). As for diet, participants consuming red meat (>4 /week, 2.79; CI 2.13-3.66), butter/cream (>4 times/week, 2.07; CI 1.62-2.64), sugary snacks/sweets (≥1 time/day, 2.26; 1.81-2.83) and sugary drinks (≥1 time/day, 1.85; CI 1.48-2.31) were more likely to be in the high PMC group. Cardiovascular diseases (1.72, 1.17-2.52) and large waist circumference (1.01, 1.0 - 1.02) were more common in participants in the high PMC group.

Conclusions

High consumption of processed meat is accompanied by other behaviors and risk factors that can potentiate adverse health effects in this population.

Key messages

In Chile, little attention has been given to potential health impacts of processed meat. This work aims to bring focus to this issue. High processed meat consumption was associated with other non-healthy foods, risky alcohol intake and unhealthy weight, all of which can increase the risk of chronic diseases.