Muscle Strength and Physical Performance as Predictors of Mortality, Hospitalization, and Disability in the Oldest Old

• Autores: Delphine Legrand, Bert Vaes, Catharina Mathei, Wim Adriaensen, Gijs Van Pottelbergh, Jan M. Degryse
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 6, 2014, págs. 1030-1038
• Idioma: inglés
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• Resumen

  • Objectives: To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality; hospitalization; and the onset of disability, defined as a decline in activities of daily living (ADLs), independent of muscle mass, inflammatory markers, and comorbidities.

    Design: A prospective, observational, population-based follow-up study.

    Setting: Three well-circumscribed areas of Belgium.

    Participants: Five hundred sixty participants aged 80 and older were followed for 33.5 months (interquartile range 31.1�35.6 months).

    Measurements: Grip strength, Short Physical Performance Battery (SPPB) score, and muscle mass were measured at baseline; ADLs at baseline and after 20 months; and all-cause mortality and time to first hospitalization from inclusion onward. Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization. Logistic regression analysis was used to determine predictors of decline in ADLs.

    Results: Kaplan�Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score. The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization, independent of muscle mass, inflammatory markers, and comorbidity. A relationship was found between SPPB score and decline in ADLs, independent of muscle mass, inflammation, and comorbidity.

    Conclusion: In people aged 80 and older, physical performance is a strong predictor of mortality, hospitalization, and disability, and muscle strength is a strong predictor of mortality and hospitalization. All of these relationships were independent of muscle mass, inflammatory markers, and comorbidity.