Two simple tests predict mortality better than standard health checks
Grip strength and walking speed outperform traditional clinical risk factors in predicting who will die within a decade, according to analysis of over 8,000 older adults. The finding suggests hospitals and insurers could improve patient screening and resource allocation by adding these low-cost, quick assessments to routine evaluations.
Originaltitel: Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts
<p>Background</p><p>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.</p><p>Aim</p><p>We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.</p><p>Methods</p><p>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).</p><p>Results</p><p>Mean (SD) age of participants (<em>n</em> = 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.</p><p>Conclusions</p><p>Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.</p>