Woon-Puay Koh, Health Services and Systems Research, Duke-NUS Medical School Singapore, 8 College Road Level 4, Singapore 169857, Singapore. Phone: (65) 6601 3147; Fax: (65) 6222 7453; Email:
J Nutr Health Aging. 2020;24(4):371-378. doi: 10.1007/s12603-020-1337-0.
Asian studies on how physical tests predict short-term mortality in elderly are scarce. We assessed handgrip strength and timed-up-and-go (TUG) as such predictors among elderly Chinese in Singapore.
Prospective cohort study.
Community-dwelling Chinese elderly in Singapore.
We used data from 13,789 subjects in the prospective, population-based Singapore Chinese Health Study, who had a mean age of 74 (range 63 to 97) years at time of measurements.
Subjects underwent assessment for handgrip strength and TUG. They were followed for mortality via linkage with nationwide death registry through 2018.
In multivariable analyses, handgrip strength was inversely associated with risk of mortality in a dose-dependent manner: the hazard ratio (HR) [95% confidence interval (CI)] comparing extreme quartiles was 2.05 (1.44-2.90) (Ptrend<0.001). TUG was positively associated with mortality in a stepwise manner: the HR (95% CI) comparing extreme quartiles was 3.08 (2.17-4.38) (Ptrend<0.001). Compared to those with stronger handgrip and faster TUG, participants who either had weaker handgrip or slower TUG had a significant 1.59 to 2.11 fold increase in risk of mortality; while the HR (95% CI) for those who had both weaker handgrip and slower TUG was 3.93 (3.06-5.05). In time-dependent receiver operating characteristic curves, adding handgrip strength and TUG time to a Cox model containing sociodemographic and lifestyle factors, comorbidities, and body measurements significantly improved the area under the curve for the prediction of mortality from 0.5 to 2 years (P≤0.001).
Among elderly in a Chinese population, handgrip strength and TUG test were strong and independent predictors of short-term mortality.
关于身体测试如何预测老年人短期死亡率的亚洲研究很少。我们评估了新加坡华人老年人的握力和计时起立行走(TUG)测试作为此类预测因素。
前瞻性队列研究。
新加坡的社区居住的华人老年人。
我们使用了前瞻性、基于人群的新加坡华人健康研究中 13789 名受试者的数据,这些受试者在测量时的平均年龄为 74 岁(63 至 97 岁)。
受试者接受握力和 TUG 测试。通过与全国死亡登记处的链接,对他们进行死亡率随访,截至 2018 年。
在多变量分析中,握力与死亡率呈负相关,呈剂量依赖性:比较极端四分位数的风险比(HR)[95%置信区间(CI)]为 2.05(1.44-2.90)(Ptrend<0.001)。TUG 测试与死亡率呈逐步相关:比较极端四分位数的 HR(95%CI)为 3.08(2.17-4.38)(Ptrend<0.001)。与握力较强且 TUG 较快的参与者相比,握力较弱或 TUG 较慢的参与者的死亡率风险显著增加 1.59 至 2.11 倍;而握力和 TUG 均较弱的参与者的 HR(95%CI)为 3.93(3.06-5.05)。在时间依赖性接收者操作特征曲线中,将握力和 TUG 时间添加到包含社会人口统计学和生活方式因素、合并症和身体测量值的 Cox 模型中,显著提高了死亡率预测的曲线下面积,从 0.5 年至 2 年(P≤0.001)。
在华人人群中,握力和 TUG 测试是短期死亡率的有力且独立的预测因素。