Association Between Muscular Strength and Mortality in Clinical Populations: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prospective cohort studies
PubMed 31331825 · doi:10.1016/j.jamda.2019.05.015
What was done
A systematic review and random-effects meta-analysis was performed using Medline, Embase, Clinical Trial Register, and Cochrane Trial Register from inception through September 30, 2018. It evaluated the association between muscular strength measures and mortality across 39 prospective cohort studies involving 39,852 participants with cancer, chronic obstructive pulmonary disease, renal disease, metabolic and vascular diseases, or critical illness.
What was found
Comparing the lowest versus highest strength categories showed an increased risk of all-cause mortality (HR 1.80, 95% CI 1.54-2.10). Lower strength was associated with higher mortality in cancer (HR 2.40, 95% CI 1.57-3.69), critical illness (HR 2.06, 95% CI 1.33-3.21), renal disease (HR 1.84, 95% CI 1.37-2.47), metabolic and vascular diseases (HR 1.64, 95% CI 1.26-2.14), and chronic obstructive pulmonary disease (HR 1.36, 95% CI 1.16-1.61). Each 5-kg higher level of muscular strength was associated with reduced overall mortality (HR 0.72, 95% CI 0.59-0.89), as well as reduced mortality in metabolic and vascular diseases (HR 0.52, 95% CI 0.29-0.91), critical illness (HR 0.78, 95% CI 0.61-0.99), and renal disease (HR 0.82, 95% CI 0.73-0.91).
Why it matters
This meta-analysis demonstrates that low muscular strength is a consistent prognostic marker of mortality risk across diverse acute and chronic clinical populations.
Limits
The included studies were observational cohorts, which cannot establish causality. The abstract does not specify the specific strength testing protocols used across studies, and validated cut-points for low muscular strength are not yet established.
Cited by
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