Volaklis · European journal of internal medicine 2015 · narrative review · n=23 studies

Muscular strength as a strong predictor of mortality: A narrative review.

Cited 309 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review synthesizing observational cohort studies without meta-analysis.

PubMed 25921473 · doi:10.1016/j.ejim.2015.04.013 · record verified 2026-08-30

What was done

The authors conducted a search of EMBASE and MEDLINE (1980–2014) to investigate the association between muscular strength and all-cause and cause-specific mortality. The review selected and synthesized 23 publications, consisting of 15 epidemiological studies and 8 clinical studies.

What was found

The abstract reports no numerical effect estimates, confidence intervals, or p-values. It states that muscular strength was inversely and independently associated with all-cause mortality after adjustment for confounders including physical activity and cardiorespiratory fitness. An inverse association was also observed for cardiovascular mortality and in clinical cohorts (cardiovascular disease, peripheral artery disease, cancer, renal failure, chronic obstructive pulmonary disease, rheumatoid arthritis, and critical illness). Included studies failed to show an association between low muscular strength and cancer mortality.

Why it matters

This review highlights muscular strength as an independent prognostic marker for mortality risk that is not fully explained by cardiorespiratory fitness or activity level alone.

Limits

The abstract provides no numerical data, hazard ratios, or participant counts. The underlying studies are observational cohorts subject to residual confounding and reverse causation, and the review lacks quantitative meta-analytic pooling.

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