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Handgrip Strength and Timed Up-And-Go (TUG) Test are Predictors of Short-Term Mortality Among Elderly in a Population-Based Cohort in Singapore

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Abstract

Objectives

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.

Design

Prospective cohort study.

Setting

Community-dwelling Chinese elderly in Singapore.

Participants

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.

Measurements

Subjects underwent assessment for handgrip strength and TUG. They were followed for mortality via linkage with nationwide death registry through 2018.

Results

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).

Conclusion

Among elderly in a Chinese population, handgrip strength and TUG test were strong and independent predictors of short-term mortality.

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Acknowledgments

We thank Siew-Hong Low of the National University of Singapore for supervising the fieldwork in the Singapore Chinese Health Study.

Funding

Funding Sources: This work was supported by the Singapore National Medical Research Council (NMRC/CSA/0055/2013) and the United States National Cancer Institute, National Institutes of Health (UM1 CA182876 and R01 CA144034), and the Saw Swee Hock School of Public Health, National University of Singapore. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Author Contributions: W-P Koh designed and conducted the study, W-P Koh, X Lin and KY Chua analyzed data, W-S Lim and J-M Yuan assisted in interpreting the data, KY Chua wrote the first draft and all authors critically edited the manuscript; W-P Koh had primary responsibility for final content. All authors read and approved the final manuscript.

Correspondence to Woon-Puay Koh.

Ethics declarations

Disclosure Statement: The authors declare no conflict of interest.

Statement of Ethics: The study was approved by the Institutional Review Board at the National University of Singapore and written informed consent was obtained from all study participants.

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Chua, K.Y., Lim, W.S., Lin, X. et al. Handgrip Strength and Timed Up-And-Go (TUG) Test are Predictors of Short-Term Mortality Among Elderly in a Population-Based Cohort in Singapore. J Nutr Health Aging (2020). https://doi.org/10.1007/s12603-020-1337-0

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Key words

  • Chinese
  • handgrip strength
  • mortality
  • sarcopenia
  • gait speed