Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis

Rubén López-Bueno; Lars Louis Andersen; Ai Koyanagi; Rodrigo Núñez-Cortés; Joaquín Calatayud; José Casaña; Borja Del Pozo Cruz

doi:10.1016/j.arr.2022.101778

Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis

Ageing Res Rev. 2022 Dec:82:101778. doi: 10.1016/j.arr.2022.101778. Epub 2022 Nov 1.

Authors

Rubén López-Bueno¹, Lars Louis Andersen², Ai Koyanagi³, Rodrigo Núñez-Cortés⁴, Joaquín Calatayud⁵, José Casaña⁶, Borja Del Pozo Cruz⁷

Affiliations

¹ Department of Physical Medicine and Nursing, University of Zaragoza, Spain; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
² National Research Centre for the Working Environment, Copenhagen, Denmark.
³ Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, ICREA, Barcelona, Spain.
⁴ Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile. Electronic address: ronuez@alumni.uv.es.
⁵ Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
⁶ Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain.
⁷ Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Faculty of Education, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain; Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Seville, Spain.

PMID: 36332759
DOI: 10.1016/j.arr.2022.101778

Abstract

Background: While handgrip strength is associated with all-cause and cause-specific mortality, whether such associations are dose-dependent is largely unknown. Therefore, we conducted a systematic review on the dose-response relationship of handgrip strength with all-cause mortality, cancer, and cardiovascular mortality.

Methods: The data source included three electronic databases (PubMed/MEDLINE, Web of Science and Scopus) from inception to 8 February 2022. Prospective cohort studies of healthy adults with objective measures of handgrip strength were included. Two researchers independently screened studies, extracted data, and assessed risk of bias. We used estimates regarding handgrip strength categories to conduct a random forest model, and a two-stage random-effects hierarchical meta-regression model pooling study-specific estimates for dose-response relationship. Outcomes included all-cause, cancer, and cardiovascular mortality.

Reults: Forty-eight studies comprising 3,135,473 participants (49.6% women, age range 35-85 years) were included. Random forest models showed a significant inverse association between handgrip strength and all-cause and cause-specific mortality. Dose-response meta-analyses showed that higher levels of handgrip strength significantly reduced the risk of all-cause mortality within 26-50 kg (Higgin´s I² =45.7%) in a close-to-linear inverse fashion. Cancer and cardiovascular mortality displayed a trend towards a U-shaped association with a significant risk reduction between 16 and 33 kg (Higgin´s I² =77.4%), and a close-to-linear inverse shaped and significant risk reduction ranging from 24 to 40 kg (Higgin´s I² =79.7%) respectively.

Conclusion: There is strong evidence for an association between lower handgrip strength with higher all-cause, cancer, and cardiovascular mortality risk. The dose-response relationship of handgrip strength substantially varies depending on the cause of mortality.

Keywords: Longevity; Muscle strength dynamometer; Public health; Risk factors.

Publication types

Systematic Review
Meta-Analysis
Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Cardiovascular Diseases*
Cardiovascular System*
Female
Hand Strength
Humans
Male
Neoplasms*
Prospective Studies