In a comprehensive study evaluating the predictive power of grip strength and gait speed on mortality, researchers found that these indicators offer only modest additional risk information compared to other easily obtainable clinical factors. Despite their known associations with mortality rates, the study suggests that their independent contribution to risk prediction is limited when other factors are considered.
Conducted among participants from the Health, Aging and Body Composition Study, the Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study, the research aimed to discern the added value of grip strength and gait speed in mortality risk assessment over more accessible clinical parameters. The study utilized appendicular lean mass (ALM) measured by DXA, grip strength assessed with dynamometry, and usual gait speed over distances ranging from 2.4 to 6 meters. Mortality data was verified and analyzed through Cox regression, with cohort considered as a random effect.
Key Findings
Participants, averaging 73.8 years of age, demonstrated that lower grip strength and slower gait speed were indeed associated with higher mortality. Specifically, each standard deviation decrease in grip strength yielded a hazard ratio of 1.14, and for gait speed, a hazard ratio of 1.21. Conversely, the ALM index did not show a significant link to mortality, with a hazard ratio of 1.01.
However, when grip strength and gait speed were included in models alongside age and sex, the improvement in the discriminative capacity for mortality was minimal. The C-index for a model with age and sex alone was 0.65, which only slightly increased to 0.67 with the addition of grip strength and gait speed.
Implications for Clinical Practice
The results indicate that while grip strength and gait speed are useful indicators, their incremental value in mortality prediction over basic clinical factors such as age and sex is limited. This finding suggests that clinicians might rely more on readily obtainable factors for mortality risk prediction.
The study underscores the importance of considering a broad range of clinical factors when assessing mortality risk, rather than overemphasizing these specific measures of physical capability.
User-Usable Inferences
- Lower grip strength and slower gait speed are associated with higher mortality but offer limited added predictive value when combined with age and sex.
- The ALM index does not significantly impact mortality risk prediction.
- Clinical assessments for mortality risk should prioritize easily obtainable factors like age and sex over more specific physical measures.
- Incorporating grip strength and gait speed into risk models provides only a marginal increase in discriminative capacity.
In conclusion, while grip strength and gait speed are important health indicators, their additional contribution to mortality risk assessment is modest when other clinical factors are already considered. This research highlights the necessity of a holistic approach in clinical evaluations to accurately predict mortality risks.
Original Article: Aging Clin Exp Res. 2024 Jun 6;36(1):126. doi: 10.1007/s40520-024-02783-x.
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