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Strength, But Not Muscle Mass, Is Associated With Mortality in the Health, Aging and Body Composition Study Cohort

Published on Jan 1, 2006in Journals of Gerontology Series A-biological Sciences and Medical Sciences 4.90
· DOI :10.1093/gerona/61.1.72
A. B. Newman140
Estimated H-index: 140
(University of Pittsburgh),
Varant Kupelian3
Estimated H-index: 3
+ 6 AuthorsTamara B. Harris170
Estimated H-index: 170
(National Institutes of Health)
Background. Although muscle strength and mass are highly correlated, the relationship between direct measures of low muscle mass (sarcopenia) and strength in association with mortality has not been examined. Methods. Total mortality rates were examined in the Health, Aging and Body Composition (Health ABC) Study in 2292 participants (aged 70–79 years, 51.6% women, and 38.8% black). Knee extension strength was measured with isokinetic dynamometry, grip strength with isometric dynamometry. Thigh muscle area was measured by computed tomography (CT) scan, and leg and arm lean soft tissue mass were determined by dual energy x-ray absorptiometry (DXA). Both strength and muscle size were assessed as in gender-specific Cox proportional hazards models, with age, race, comorbidities, smoking status, level of physical activity, fat area by CT or fat mass by DXA, height, and markers of inflammation, including interleukin-6, C-reactive protein, and tumor necrosis factor-a considered as potential confounders. Results. There were 286 deaths over an average of 4.9 (standard deviation ¼ 0.9) years of follow-up. Both quadriceps and grip strength were strongly related to mortality. For quadriceps strength (per standard deviation of 38 Nm), the crude hazard ratio for men was 1.51 (95% confidence interval, 1.28–1.79) and 1.65 (95% confidence interval, 1.19–2.30) for women. Muscle size, determined by either CT area or DXA regional lean mass, was not strongly related to mortality. In the models of quadriceps strength and mortality, adjustment for muscle area or regional lean mass only slightly attenuated the associations. Further adjustment for other factors also had minimal effect on the association of quadriceps strength with mortality. Associations of grip strength with mortality were similar. Conclusion. Low muscle mass did not explain the strong association of strength with mortality, demonstrating that muscle strength as a marker of muscle quality is more important than quantity in estimating mortality risk. Grip strength provided risk estimates similar to those of quadriceps strength.
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  • Citations (788)
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Fredrik Eika2
Estimated H-index: 2
(Aalborg University),
Anders W Blomkvist (Aalborg University)+ 6 AuthorsMartin Grønbech Jørgensen9
Estimated H-index: 9
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Hui Wang4
Estimated H-index: 4
(Sichuan University),
Shan Hai5
Estimated H-index: 5
(Sichuan University)
+ 2 AuthorsBirong Dong20
Estimated H-index: 20
(Sichuan University)
This study aimed to evaluate the association between skeletal muscle mass and long-term all-cause mortality among nonagenarians and centenarians in China. We used data from the Project of Longevity and Aging in Dujiangyan (PLAD). A total of 738 community-dwelling people aged ≥ 90 years (mean age of 93.5 ± 3.2 years) were analyzed in this study. The appendicular skeletal muscle mass (ASM) was estimated using a previously validated anthropometric equation. The information on the survival status wa...
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Estimated H-index: 1
(Ewha Womans University),
You Jin Kim9
Estimated H-index: 9
(Ewha Womans University)
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Estimated H-index: 18
(Ewha Womans University)
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Mikko Björkman14
Estimated H-index: 14
(University of Helsinki),
Kaisu H. Pitkälä49
Estimated H-index: 49
(University of Helsinki)
+ 2 AuthorsReijo S. Tilvis53
Estimated H-index: 53
(University of Helsinki)
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Estimated H-index: 9
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Estimated H-index: 22
(Karolinska Institutet)
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Tanya M. Holloway1
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Stuart M. Phillips79
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Annemarie Dijkhuizen2
Estimated H-index: 2
(University of Groningen),
Aly Waninge8
Estimated H-index: 8
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+ 2 AuthorsWim P. Krijnen16
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Peggy M. Cawthon46
Estimated H-index: 46
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Estimated H-index: 91
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Laura A. Schaap18
Estimated H-index: 18
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