Physical-strength tests and mortality among visitors to health-promotion centers in Japan

doi:10.1016/0895-4356(95)00533-1

Journal of Clinical Epidemiology

Volume 48, Issue 11, November 1995, Pages 1349-1359

https://doi.org/10.1016/0895-4356(95)00533-1 Get rights and content

Abstract

A follow-up study was conducted to clarify the relationship between physicalstrength level and risk of death from all causes and from cancer and cardiovascular disease. The 7286 persons who were examined at seven health-promotion centers throughout Japan between 1982 and 1987 were followed up. By January 1992, 6259 persons (85.9%) had been contacted by questionnaire. They included 3117 men (49.8% of all subjects studied) (average age 53.6 years at baseline, SD = 9.0 years, range 40–84 years), and 3142 women (50.2%) (average age 54.5 years at baseline, SD = 8.5 years, range 40–85 years). The follow-up period for each person averaged 6.1 years, for a total of 38,253 person-years. During this period, 155 deaths were reported. At baseline, five physical-strength tests (grip strength, side step, vertical jump, standing trunk flexion, and sit-ups) were performed. Five clinical laboratory tests (thickness of skinfold, blood sugar, total serum cholesterol, percent vital lung capacity, and blood pressure) were also conducted. The examinees were questioned about smoking status (current smoker, nonsmoker, and ex-smoker). Men with thicker skinfold [relative risk (RR) = 2.11] and higher levels of blood sugar (RR = 1.89) had an excess risk of death from all causes. Men with higher serum cholesterol (RR = 5.08), thicker skinfold (RR = 4.54), and elevated blood pressure (RR = 2.33) had an excess risk of death from cardiovascular disease. In women, no relationship was seen between clinical laboratory tests and an excess risk of death. Men exhibiting lower values for side step (RR = 2.43), vertical jump (RR = 2.37), sit-ups (RR = 1.93) and grip strength (RR = 1.92) also had an excess risk of death from all causes. Furthermore, men with lower heights for vertical jump (RR = 5.51) had an excess risk of death from cardiovascular disease. After adjustment for skinfold thickness, blood sugar, total serum cholesterol, blood pressure, percent vital lung capacity and smoking status, men with a lower level of side step, vertical jump, and grip strength had an excess risk of death from all causes. No such relationship was seen between physical-strength level and an excess risk of death in women. It is concluded that a low level of physical strength might be significantly correlated with subsequent health outcomes in men.

References (28)

RS Paffenbarger et al.
Exercise in the prevention of coronary heart disease
Prev Med
(1984)
JA Cauley et al.
The relationship of physical activity to high density lipoprotein cholesterol in postmenopausal women
J Chron Dis
(1986)
GA Arraiz et al.
Risk assessment of physical activity and physical fitness in the Canada Health Survey Mortality Follow-up Study
J Clin Epidemiol
(1992)
KD Lindsted et al.
Self-report of physical activity and patterns of mortality in Seventh-Day Adventist men
J Clin Epidemiol
(1991)
JA Cauley et al.
The decline of grip strength in the menopause: relationship to physical activity, estrogen use and anthropometric factors
J Chron Dis
(1987)
M Okamoto et al.
Health and physical fitness indices. (Report I). Health characteristics of users of health promotion centers in Japan
Jpn J Public Health
(1989)
JD Potter et al.
Colon cancer: A review of the epidemiology
Epidemiol Rev
(1993)
S Oda
DL Preston et al.

Cited by (129)

Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis
2022, Ageing Research Reviews
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.
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.
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.
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.
Handgrip strength measurement protocols for all-cause and cause-specific mortality outcomes in more than 3 million participants: A systematic review and meta-regression analysis
2022, Clinical Nutrition
Citation Excerpt :
Table 2 summarises the standard measurement protocol for measuring handgrip strength based on the most common characteristics reported in the included studies. Thirty of the 48 studies were included in the meta-regression analysis, with a total of 1,836,464 participants [11,13,14,28,29,31,37–43,47,50–53,55,57–59,62,63,67,68,71–74]. Eighteen studies that measured handgrip strength in units other than kilograms and where conversion to that unit was not possible were excluded.
Handgrip strength is a strong predictor of the risk of mortality. The objective of this systematic review was to analyse handgrip strength measurement protocols used in all-cause and cause-specific mortality studies.
A systematic search of PubMed/MEDLINE, Web of Science and Scopus was conducted from inception to February 2022. Prospective cohort studies with objective measures of handgrip strength were included. Studies had to report at least one all-cause, cancer, or cardiovascular mortality outcome. The quality of the included studies was assessed using the Newcastle Ottawa Scale. Meta-regression was used to quantify the bias associated with handgrip strength values in relation to the use of different measurement protocols.
Forty-eight studies with a total of 3,135,473 participants (49.6% women) were included. Half of the studies controlled body position, 39.6% arm position, 33.3% elbow position, 12.5% wrist position, 13% handgrip duration, 23% hand-adjustment to dynamometer and 12.5% verbal encouragement. The number of measurements, the laterality of the hand tested, and the estimation method of the handgrip strength value varied considerably between the study protocols. The spline regression model showed a non-linear inverse association between the values of handgrip strength and the number of protocol items controlled. Handgrip strength was higher when the number of measurements per hand or arm position was not controlled. Conversely, handgrip strength was lower when elbow position was not controlled or verbal encouragement were not provided.
In general, the protocols used to assess handgrip strength in mortality studies are incomplete and highly heterogeneous. Handgrip strength values were higher when studies controlled fewer handgrip strength measurement protocol variables. There is a need to improve the controlling of handgrip strength measurement protocols and to standardise the method to enhance the accuracy of mortality risk estimates associated with handgrip strength.
CRD42022334929.
Five-year change in maximum tongue pressure and physical function in community-dwelling elderly adults
2020, Journal of Dental Sciences
Citation Excerpt :
Therefore, biomarkers are needed to estimate individual biological age and determine aging speed. Previous studies have shown that physical function is related to mortality.10–12 Kimura et al. developed an index to define physical fitness age (fitness age score, FAS), calculated from 5 fitness markers (one-leg standing time with eyes open, vertical jump height, grip strength, functional reach, and 10-m walk time).13
To identify age-related changes in maximum tongue pressure (MTP), it is necessary to determine individual biological age. The fitness age score (FAS) is used to calculate the biological age, based on the one-leg standing time with eyes open, vertical jump height, grip strength, functional reach, and 10-m walk time.
The study included 112 community-dwelling elderly adults (42 males and 70 females). We investigated MTP, FAS, and body mass index (BMI) at baseline and 5 years later. MTP was determined with a pressure measurement device.
A significant reduction in MTP, FAS, and BMI in both male and female subjects was observed at 5 years. A negative correlation between change in MTP and baseline MTP was observed, but there was no correlation between MTP change and baseline FAS, BMI, and change in FAS and BMI.
Age-related decline in MTP might be associated with high MTP, reflecting decreased reserve. Additionally, age-related decline in tongue function might be different from that of physical function.
Association of health empowerment and handgrip strength with intention to participate in physical activity among community-dwelling older adults
2019, Experimental Gerontology
Health empowerment is an individual's perceived control and competence related to health and health care. The projected increased growth of the older adult population calls for a health-related empowerment movement in health education that targets older adults. Using the theory of planned behavior, the purpose of this study was to investigate the association of health empowerment and handgrip strength with intention to participate in physical activity among older adults.
The Korean Health Empowerment Scale (K-HES) was used as a measure of health empowerment. Handgrip strength was used as a measure of muscle strength. Intention to participate in physical activity was measured using five items. Participants of this study included 103 community-dwelling older adults (Mage = 76.45 ± 9.395; Male = 42, Female = 61). Results: Statistical analyses revealed all participants were knowledgeable about the health benefits of exercise and most participated in regular physical activity (n = 84.5%). The majority had normal handgrip strength (n = 60.7%) and most indicated strong intentions to participate in regular physical activity (n = 85%). A stepwise multiple regression revealed health empowerment significantly and positively (F(1,101) = 30.511, p < .001, R² = 0.232, R²_Adjusted = 0.224) associated intention to participate in physical activity. Health empowerment explained 23.2% of the variance in intentions. There was no significant contribution of muscle strength on intention.
Findings suggest overall health empowerment may be affected by a variety of subscales such as problem-solving, obtaining support, motivation, psychosocial coping, and decision making. Conclusion: Future research should explore potential associations between health empowerment and intention to participate in physical activity.
Physical performance and negative events in very old adults: a longitudinal study examining the ilSIRENTE cohort
2024, Aging Clinical and Experimental Research
Association between physical fitness tests and neuromuscular properties
2024, European Journal of Applied Physiology

View all citing articles on Scopus

View full text

Original articlePhysical-strength tests and mortality among visitors to health-promotion centers in Japan

Abstract

Prev Med

J Chron Dis

J Clin Epidemiol

J Clin Epidemiol

J Chron Dis

Health and physical fitness indices. (Report I). Health characteristics of users of health promotion centers in Japan

Jpn J Public Health

Colon cancer: A review of the epidemiology

Epidemiol Rev

Original article
Physical-strength tests and mortality among visitors to health-promotion centers in Japan