Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prospective cohort studies
PubMed 36332759 · doi:10.1016/j.arr.2022.101778
What was done
A systematic review and dose-response meta-analysis was conducted across PubMed/MEDLINE, Web of Science, and Scopus from inception through February 8, 2022. Authors included prospective cohort studies of healthy adults aged 35 to 85 years with objective handgrip strength measurements. Outcomes evaluated were all-cause, cancer, and cardiovascular mortality. Study screening, data extraction, and risk of bias assessment were performed independently by two researchers. Data were synthesized using random forest models and two-stage random-effects hierarchical meta-regression.
What was found
Across 48 studies comprising 3,135,473 participants (49.6% women), random forest models demonstrated an inverse association between handgrip strength and all evaluated mortality outcomes. Dose-response meta-analyses identified significant risk reductions within specific strength ranges: all-cause mortality exhibited a close-to-linear inverse association between 26 and 50 kg (Higgin's I2 = 45.7%); cardiovascular mortality showed a close-to-linear inverse association between 24 and 40 kg (Higgin's I2 = 79.7%); and cancer mortality showed a trend toward a U-shaped association between 16 and 33 kg (Higgin's I2 = 77.4%). Numerical effect sizes and confidence intervals were not reported in the abstract.
Why it matters
This review identifies distinct dose-response patterns and strength thresholds across different causes of death, indicating that the mortality protection associated with muscular strength varies by specific disease outcome.
Limits
All included studies were prospective cohorts, precluding causal conclusions and leaving risk of residual confounding or reverse causation. Substantial statistical heterogeneity was observed for both cancer mortality (I2 = 77.4%) and cardiovascular mortality (I2 = 79.7%). Point estimates, confidence intervals, and sex-specific threshold analyses were not provided in the abstract.
Cited by
- supports Grip strength has been associated with longevity.