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Influencing factors for the decline of limb muscle strength and the association with all-cause mortality: evidence from a nationwide population-based cohort study

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Abstract

Background

The decline of muscle strength, a typical characteristic of sarcopenia, greatly affects aging-related health outcomes; however, prospective data on influencing factors and mortality in the Chinese population are relatively sparse.

Aims

We investigated the influencing factors for the declined limb muscle strength and the association with all-cause mortality among the elderly Chinese individuals aged ≥ 65 years in a large long-term prospective cohort study.

Methods

We used data from the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression analyses were performed to investigate the influencing factors of declined limb muscle strength. Cox proportional hazard models were used to analyze the impact on all-cause mortality, whose performance was evaluated by train-test cross-validation.

Results

The prevalences of declined upper and lower limb strength, which were defined by low hand grip strength (HS) and gait speed (GS), respectively, were 34.4% and 59.7%. The declined HS was significantly associated with older age (p < 0.001), female (p < 0.001), lower educational level (p < 0.001), lower BMI (p < 0.001), and combined with chronic diseases (p = 0.001). Moreover, the declined limb muscle strength was correlated with all-cause mortality (HR: 1.13, 95% CI 1.03–1.21 for HS; HR: 1.09, 95% CI 1.04–1.15 for GS), according to a multi-adjusted model with moderate predictive ability (C-index: 0.714, AUC of 7 year follow-up: 0.716).

Conclusions

The decline of limb muscle strength was prevalent among elderly Chinese individuals and had a strong impact on all-cause mortality. Identification of key populations and tailored interventions on their influencing factors should be implemented in further research.

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Data availability

Details of how to access the CHARLS data and details of the data release schedule are available from http://charls.pku.edu.cn/pages/data/111/zh-cn.html.

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Acknowledgements

We would like to acknowledge the China Health and Retirement Longitudinal Study (CHARLS) team for providing high quality, nationally representative data, which make it possible for our study.

Funding

This work was supported by grants from the Major Project of Beijing Municipal Science and Technology Commission of China (No.D171100003217002, Z171100002717094), and the National Natural Science Foundation of China (81973606, 81501919).

Author information

Author notes

  1. Jiaxiang Gao and Yudian Qiu have contributed equally to this manuscript.

Authors and Affiliations

  1. Arthritis Clinic & Research Center, Peking University People’s Hospital, Peking University, Beijing, 100044, China

    Jiaxiang Gao, Yunfei Hou, Liyi Zhang, Kai Wang, Zhaoyu Chen, Qian Liu & Jianhao Lin

  2. Arthritis Institute, Peking University, Beijing, China

    Jiaxiang Gao, Yunfei Hou, Liyi Zhang, Kai Wang, Zhaoyu Chen, Qian Liu & Jianhao Lin

  3. Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Beijing, China

    Yudian Qiu

  4. Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China

    Yudian Qiu

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  1. Jiaxiang Gao
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Contributions

Study design: JXG and YDQ. Data collection/validation: JXG, YFH. Data analysis: JXG, QL, KW, and YDQ. Result interpretation: JXG, LYZ, and YDQ. Reporting & editing: JXG, YFH, ZYC, and JHL. Final approval of the version to be submitted: JXG, YDQ, and JHL. Project guarantor: JHL.

Corresponding author

Correspondence to Jianhao Lin.

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The authors declare that they have no conflict of interests.

Ethical approval

CHARLS study is an open dataset. The CHARLS was approved by the Ethics Review Committee of Peking University (IRB 00001052-11015).

Statement of human and animal rights

CHARLS study is an open dataset. All procedures performed in CHARLS study involving human participants were in accordance with the ethical standards of the Ethics Review Committee of Peking University (IRB 00001052–11015) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All participants signed an informed consent.

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Gao, J., Qiu, Y., Hou, Y. et al. Influencing factors for the decline of limb muscle strength and the association with all-cause mortality: evidence from a nationwide population-based cohort study. Aging Clin Exp Res 34, 399–407 (2022). https://doi.org/10.1007/s40520-021-01940-w

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