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Muscle Weakness and Physical Disability in Older Americans: Longitudinal Findings from the U.S. Health and Retirement Study

  • Published:
The journal of nutrition, health & aging

Abstract

Importance

Muscle weakness is an important indicator of disability, chronic disease and mortality. While we recently proposed sex/race specific grip strength cutpoints for clinical muscle weakness in a diverse, nationally representative sample of older Americans, the extent to which these cutpoints predict physical disability remains unknown.

Objective

To examine whether sex/race specific muscle weakness cutpoints predict physical disability status in a nationally representative sample of Americans age 65+.

Design

We used data from the 2006-2010 Health and Retirement Study. Fully-adjusted, weighted multinomial logistic regression models were used to quantify the odds of experiencing the onset, progression or persistence of disability in activities of daily living (ADL) among weak versus non-weak individuals over a 2-year period.

Setting

General community, nationally representative sample of older Americans.

Participants

Population-based, community dwelling sample of older American adults aged 65-years+; 57 percent were women, 91% were White and the mean age was 75 years.

Main Outcome(s) and Measure(s)

The primary outcome of interest was disability dynamics, defined by changes in ADL status across at 2- year period. The primary exposure was clinical muscle weakness as defined by previously identified cutpoints. Hypotheses were formulated before analyses were conducted.

Results

In this nationally representative sample (n= 8,725), 44% of individuals were classified as weak at baseline. At follow-up, 55% remained independent with no change in their ADL status, 11% had an onset of disability and 4% progressed in their disability status. The odds of experiencing an onset of ADL disability was 54% higher among weak individuals compared those who were not weak at baseline (OR= 1.54, 95% CI= 1.54, 1.5, p<.0001); the odds of experiencing a progression in physical disability status was 2.16 times higher among those who were weak at baseline compared to non-weak individuals (OR= 2.16, 95% CI= 2.15, 2.16, p<.0001).

Conclusions

This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life. Results underscore the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatest risk for adverse health outcomes.

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Authors and Affiliations

  1. University of Michigan School of Public Health, Department of Epidemiology, Center for Social Epidemiology and Population health, 1415 Washington Heights, 3rd Flower Tower, Ann Arbor, MI, 48109, USA

    Kate A. Duchowny & P. J. Clarke

  2. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    P. J. Clarke

  3. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA

    M. D. Peterson

Authors
  1. Kate A. Duchowny
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  2. P. J. Clarke
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Correspondence to Kate A. Duchowny.

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Duchowny, K.A., Clarke, P.J. & Peterson, M.D. Muscle Weakness and Physical Disability in Older Americans: Longitudinal Findings from the U.S. Health and Retirement Study. J Nutr Health Aging 22, 501–507 (2018). https://doi.org/10.1007/s12603-017-0951-y

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