Midlife hand grip strength as a predictor of old age disability
Midlife hand grip strength as a predictor of old age disability
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DOI：
10.1001/jama.281.6.558
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发表时间：
1999-02-10
影响因子：
120.7
通讯作者：
White, L
中科院分区：
文献类型：
--
作者：
Rantanen, T;Guralnik, JM;White, L
背景 肌肉力量差、功能限制和残疾常常并存，但中年时的肌肉力量是否可以预测老年功能能力尚不清楚。 目的 确定中年期间测量的握力是否可以预测最初健康男性的老年功能限制和残疾，设计和设置 一项为期 25 年的前瞻性队列研究，檀香山心脏计划，于 1965 年开始在居住在瓦胡岛的日裔美国男性中， 夏威夷. 参与者 共有 6089 名基线健康的 45 至 68 岁男性，从 1965 年到 1970 年测量了他们的最大握力，总共有 2259 名男性在随访期间死亡，3218 名幸存者参加了 1991 年到 1993 年的残疾评估。等于 0.4 m/s）并且无法从 不使用手臂的坐姿，以及多种自我报告的上肢、活动能力和自理残疾结果，结果在对多种潜在混杂因素进行调整后，25 年后功能限制和残疾的风险随着基线握力的增加而增加。分为三分位，下降。与握力最高三分之一的人相比，握力最低三分之一的人步行速度为 0.4 m/s 或更慢的优势比 (OR) 为 2.87（95% 置信区间 [CI]，1.76-4.67），中间三分之一的人为 1.79（95% CI，1.14-2.81）。握力最低的三分位与握力最高的三分位的人相比，自理能力障碍的风险高出 2 倍多。将随访中发现的慢性疾病添加到预测残疾的模型中，仅最小程度地降低了与握力相关的 OR。 结论 在 45 至 68 岁的健康男性中，握力对 25 年后的功能限制和残疾具有高度预测作用。中年时良好的肌肉力量可以通过提供高于残疾阈值的更大安全裕度来保护人们免受老年残疾的影响。
Context Poor muscle strength, functional limitations, and disability often coexist, but whether muscle strength during midlife predicts old age functional ability is not known.Objective To determine whether hand grip strength measured during midlife predicts old age functional limitations and disability in initially healthy men,Design and Setting A 25-year prospective cohort study, the Honolulu Heart Program, which began in 1965 among Japanese-American men living on Oahu, Hawaii.Participants A total of 6089 45- to 68-year-old men who were healthy at baseline and whose maximal hand grip strength was measured from 1965 through 1970, Altogether, 2259 men died over the follow-up period and 3218 survivors participated in the disability assessment in 1991 through 1993,Main Outcome Measures Functional limitations including slow customary walking speed (less than or equal to 0.4 m/s) and inability to rise from a seated position without using the arms, and multiple self-reported upper extremity, mobility, and self-care disability outcomes,Results After adjustment for multiple potential confounders, risk of functional limitations and disability 25 years later increased as baseline hand grip strength. divided into tertiles, declined. The odds ratio (OR) of walking speed of 0.4 m/s or slower was 2.87 (95% confidence interval [CI], 1.76-4.67) in those in the lowest third and 1.79 (95% CI, 1.14-2.81) in the middle third of grip strength vs those in the highest third, The risk of self-care disability was more than 2 times greater in the lowest vs the highest grip strength tertile. Adding chronic conditions identified at follow-up to the models predicting disability reduced the ORs related to grip strength only minimally,Conclusions Among healthy 45- to 68-year-old men, hand grip strength was highly predictive of functional limitations and disability 25 years later. Good muscle strength in midlife may protect people from old age disability by providing a greater safety margin above the threshold of disability.