Objectively measured physical capability levels and mortality: systematic review and meta-analysis

Cooper, R., Kuh, D., Hardy, R. and Mortality Review Group on behalf of the FALCon and HALCyon study, (2010) Objectively measured physical capability levels and mortality: systematic review and meta-analysis. British Medical Journal, 341, c4467. (doi:10.1136/bmj.c4467)

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Abstract

<p><b>Objective</b> To do a quantitative systematic review, including published and unpublished data, examining the associations between individual objective measures of physical capability (grip strength, walking speed, chair rising, and standing balance times) and mortality in community dwelling populations.</p> <p><b>Design</b> Systematic review and meta-analysis.</p> <p><b>Data</b> sources Relevant studies published by May 2009 identified through literature searches using Embase (from 1980) and Medline (from 1950) and manual searching of reference lists; unpublished results were obtained from study investigators.</p> <p><b>Study</b> selection Eligible observational studies were those done in community dwelling people of any age that examined the association of at least one of the specified measures of physical capability (grip strength, walking speed, chair rises, or standing balance) with mortality.</p> <p><b>Data synthesis</b> Effect estimates obtained were pooled by using random effects meta-analysis models with heterogeneity between studies investigated.</p> <p><b>Results</b> Although heterogeneity was detected, consistent evidence was found of associations between all four measures of physical capability and mortality; those people who performed less well in these tests were found to be at higher risk of all cause mortality. For example, the summary hazard ratio for mortality comparing the weakest with the strongest quarter of grip strength (14 studies, 53 476 participants) was 1.67 (95% confidence interval 1.45 to 1.93) after adjustment for age, sex, and body size (I2=84.0%, 95% confidence interval 74% to 90%; P from Q statistic <0.001). The summary hazard ratio for mortality comparing the slowest with the fastest quarter of walking speed (five studies, 14 692 participants) was 2.87 (2.22 to 3.72) (I2=25.2%, 0% to 70%; P=0.25) after similar adjustments. Whereas studies of the associations of walking speed, chair rising, and standing balance with mortality have only been done in older populations (average age over 70 years), the association of grip strength with mortality was also found in younger populations (five studies had an average age under 60 years).</p> <p><b>Conclusions</b> Objective measures of physical capability are predictors of all cause mortality in older community dwelling populations. Such measures may therefore provide useful tools for identifying older people at higher risk of death.</p>

Item Type:Articles
Additional Information:<p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <a href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</a> and <a href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</a>.</p> <br>Glasgow staff member P.G. Shiels is part of the HALCyon study team.</br> <br>Members of the FALCon study team: Eleni Bakra, Michaela Benzeval, Fiona Matthews, and Graciela Muniz Terrera.</br> <br>Members of the HALCyon study team: Yoav Ben-Shlomo, Cyrus Cooper, Leone Craig, Ian Day, Richard Martin, Kate Tilling, Tamuno Alfred, Mike Gardner, John Gallacher, Ian Deary, John Starr, Paul Shiels, Thomas von Zglinicki, Humphrey Southall, Paula Aucott, Jane Elliott, Andrew Steptoe, Chris Power, Geraldine McNeill, Alison Lennox, Marcus Richards, Gita Mishra, Zeinab Mulla, Emily Lemelin, and James Goodwin.</br> <br>The following are members of the Mortality Review Group, all of whom contributed equally to this work: Rabiah Ahmad (Universiti Teknologi Malaysia), Avan Aihie Sayer (MRC Epidemiology Resource Centre, University of Southampton), Soham Al Snih (Sealy Center on Aging), Peter A Bath (University of Sheffield), Peggy M Cawthon (California Pacific Medical Center Research Institute), J David Curb (Kuakini Medical Center and University of Hawaii), Kristine E Ensrud (University of Minnesota), Luigi Ferrucci (National Institute on Aging), Catharine R Gale (MRC Epidemiology Resource Centre, University of Southampton), Jack M Guralnik (National Institute on Aging), Suzanne Ho (Chinese University of Hong Kong), Fumiyoshi Kasagi (Radiation Effects Research Foundation, Japan), Barbara E K Klein (University of Wisconsin-Madison), Valerie Lauwers-Cances (Service d’Epidémiologie, CHU Toulouse), Debbie A Lawlor (MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol), E Jeffrey Metter (National Institute on Aging), Kushang V Patel (National Institute on Aging), Taina Rantanen (University of Jyväskylä), Yves Rolland (University of Toulouse III), Hideo Sasaki (Hiroshima University School of Medicine), Holly Syddall (MRC Epidemiology Resource Centre, University of Southampton), Annewieke van den Beld (Erasmus Medical Center), Bradley Willcox (Kuakini Health System), Andrew K Wills (MRC Unit for Lifelong Health and Ageing), and Jean Woo (Chinese University of Hong Kong).</br>
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Shiels, Professor Paul
Authors: Cooper, R., Kuh, D., Hardy, R., and Mortality Review Group on behalf of the FALCon and HALCyon study,
College/School:College of Medical Veterinary and Life Sciences
Journal Name:British Medical Journal
Publisher:BMJ Publishing Group
ISSN:0959-535X
ISSN (Online):1468-5833
Copyright Holders:Copyright © 2010 The authors.
First Published:First published in BMJ 341 : c4467
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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