Korean J Fam Pract 2019; 9(5): 438-447  https://doi.org/10.21215/kjfp.2019.9.5.438
Association of Grip Strength with All-Cause Mortality and Cause-Specific Mortality: Analysis of the Korean Longitudinal Study of Ageing (2006–2016)
Somi Kim, Songhwa Choi, Jungeun Yoo, Jungkwon Lee*
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Jungkwon Lee
Tel: +82-2-3410-2441, Fax: +82-2-3410-0388
E-mail: jklee@skku.edu
ORCID: http://orcid.org/0000-0001-5503-9605
Received: August 1, 2018; Accepted: September 2, 2019; Published online: October 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Grip strength has been found to be closely related to mortality and disease morbidity. In this study, we aimed to evaluate the relationship between grip strength and mortality in middle aged and elderly Koreans.
Methods: Study subjects were selected from the participants of the Korean Longitudinal Study of Ageing from 2006 to 2016. The Cox proportional hazards model was used to analyze the association between grip strength, all-cause mortality, and cause-specific mortality according to age and sex, after adjusting for covariates.
Results: The adjusted hazard ratio (HR) for all-cause mortality was decreased in the high grip strength group (male: HR=0.580, 95% confidence interval [CI]=0.478–0.704; female: HR=0.601, 95% CI=0.483–0.747) compared to the low grip strength group in both sexes. In male, cardiovascular mortality (middle group: HR=0.453, 95% CI=0.278–0.738; high group: HR=0.538, 95% CI=0.332–0.871) and cancer mortality (middle group: HR=0.697, 95% CI=0.514–0.945; high group: HR=0.589, 95% CI=0.427–0.812) were significantly lower in the middle and high grip strength groups compared to the low grip strength group. The HR for mortality due to stroke in male decreased significantly according to grip strength, but this became nonsignificant after adjusting for covariates. No association between cause-specific mortality and grip strength was found in female.
Conclusion: In this study, grip strength was inversely associated with all-cause mortality, with similar effects on cause-specific mortality due to heart disease and cancer in male. Grip strength is a useful predictor of health status, and further studies are needed to evaluate its clinical relevance in Koreans.
Keywords: Hand Strength; Mortality; Middle Aged, Aged; Korea
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