Muscular strength as a predictor of all-cause mortality in apparently healthy population: a systematic review and meta-analysis of data from approximately 2 million men and women

Publication date: Available online 7 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Antonio García-Hermoso, Iván Cavero-Redondo, Robinson Ramírez-Vélez, Jonatan Ruiz, Francisco B. Ortega, Duck-Chul Lee, Vicente Martínez-Vizcaíno
ObjectiveThe aim of the present systematic review and meta-analysis was 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 apparently healthy population.Data SourcesTwo authors systematically searched MEDLINE, EMBASE and SPORTDiscus databases and conducted manual searching of reference lists of selected articles.Study SelectionEligible cohort studies were those that examined the association of muscular strength with all-cause mortality in 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 extractionTwo authors independently extracted data.Data SynthesisThirty-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 to 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<0.001). 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 < 0.001) compared to adults with lower muscular strength.ConclusionsHigher levels of upper- and lower-body muscular strength are associated with a lower risk of mortality in adult population, regardless of the age and follow-up period. Muscular strength tests can be easily performed to identify people with a lower muscular strength and, consequently, with an increased risk of mortality.



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