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Arch Phys Med Rehabil. 2018 Oct;99(10):2100-2113.e5. doi: 10.1016/j.apmr.2018.01.008. Epub 2018 Feb 7.

Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women.

Author information

1
Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile. Electronic address: antonio.garcia.h@usach.cl.
2
Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain.
3
Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia.
4
PROFITH (PROmoting FITness and Health through physical activity) research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain.
5
Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, USA.
6
Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile.

Abstract

OBJECTIVES:

The aims of the present systematic review and meta-analysis were to determine the relationship between muscular strength and all-cause mortality risk and to examine the sex-specific impact of muscular strength on all-cause mortality in an apparently healthy population.

DATA SOURCES:

Two authors systematically searched MEDLINE, EMBASE and SPORTDiscus databases and conducted manual searching of reference lists of selected articles.

STUDY SELECTION:

Eligible cohort studies were those that examined the association of muscular strength with all-cause mortality in an apparently healthy population. The hazard ratio (HR) estimates with 95% confidence interval (CI) were pooled by using random effects meta-analysis models after assessing heterogeneity across studies.

DATA EXTRACTION:

Two authors independently extracted data.

DATA SYNTHESIS:

Thirty-eight studies with 1,907,580 participants were included in the meta-analysis. The included studies had a total of 63,087 deaths. Higher levels of handgrip strength were associated with a reduced risk of all-cause mortality (HR=0.69; 95% CI, 0.64-0.74) compared with lower muscular strength, with a slightly stronger association in women (HR=0.60; 95% CI, 0.51-0.69) than men (HR=0.69; 95% CI, 0.62-0.77) (all P<.001). Also, adults with higher levels of muscular strength, as assessed by knee extension strength test, had a 14% lower risk of death (HR=0.86: 95% CI, 0.80-0.93; P<.001) compared with adults with lower muscular strength.

CONCLUSIONS:

Higher levels of upper- and lower-body muscular strength are associated with a lower risk of mortality in adult population, regardless of age and follow-up period. Muscular strength tests can be easily performed to identify people with lower muscular strength and, consequently, with an increased risk of mortality.

KEYWORDS:

Death; Hand strength; Leg strength; Muscles

PMID:
29425700
DOI:
10.1016/j.apmr.2018.01.008

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