Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized cohort studies
PubMed 29425700 · doi:10.1016/j.apmr.2018.01.008
What was done
Authors systematically searched MEDLINE, EMBASE, and SPORTDiscus alongside reference lists for cohort studies evaluating muscular strength and all-cause mortality in an apparently healthy population. Hazard ratios (HR) and 95% confidence intervals (CI) were extracted independently by two authors and pooled using random-effects meta-analysis models.
What was found
The meta-analysis synthesized 38 cohort studies comprising 1,907,580 participants and 63,087 deaths. Higher handgrip strength was associated with a reduced risk of all-cause mortality (HR=0.69; 95% CI, 0.64-0.74; P<.001), with a slightly stronger association in women (HR=0.60; 95% CI, 0.51-0.69) than in men (HR=0.69; 95% CI, 0.62-0.77; P<.001). Higher knee extension strength was also associated with lower mortality risk (HR=0.86; 95% CI, 0.80-0.93; P<.001).
Why it matters
This large-scale synthesis confirms that both upper- and lower-body muscular strength independently predict all-cause mortality, reinforcing the clinical value of simple strength tests for risk stratification in general adult populations.
Limits
The findings derive exclusively from observational cohort studies, which cannot establish causality or exclude residual confounding. The abstract does not specify the exact strength cutoffs used across studies or the extent of statistical heterogeneity.
Cited by
- supports Grip strength has been associated with longevity.