Mortality, bone density and grip strength: lessons from the past and hope for the future?

Leo D Westbury; Faidra Laskou; Harnish P Patel; Cyrus Cooper; Elaine M Dennison

doi:10.1093/rap/rkae046

Mortality, bone density and grip strength: lessons from the past and hope for the future?

Rheumatol Adv Pract. 2024 Mar 28;8(2):rkae046. doi: 10.1093/rap/rkae046. eCollection 2024.

Authors

Leo D Westbury¹, Faidra Laskou^{1

2}, Harnish P Patel^{1

2

3}, Cyrus Cooper^{1

2

4}, Elaine M Dennison^{1

2

5}

Affiliations

¹ MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
² NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
³ Medicine for Older People, University Hospital Southampton, Southampton, UK.
⁴ NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
⁵ Victoria University of Wellington, Wellington, New Zealand.

Abstract

Objectives: Therapeutic advances in the management of osteoporosis and sarcopenia have occurred at different rates over the last 2 decades. Here we examine associations between grip strength and BMD with subsequent all-cause and cause-specific mortality in a UK community-dwelling cohort.

Methods: Data from 495 men and 414 women from the Hertfordshire Cohort Study were analysed. Grip strength was assessed by grip dynamometry, femoral neck BMD was ascertained using DXA and deaths were recorded from baseline (1998-2004) until 31 December 2018. Grip strength and BMD in relation to mortality outcomes (all-cause, cardiovascular-related, cancer-related and mortality due to other causes) were examined using Cox regression with adjustment for age and sex.

Results: The mean baseline age of participants was 64.3 years (s.d. 2.5) and 65.9 years (s.d. 2.6) in men and women, respectively. Lower grip strength was associated with increased risk of all-cause mortality [hazard ratio (HR) 1.30 (95% CI 1.06, 1.58), P = 0.010] and cardiovascular-related mortality [HR 1.75 (95% CI 1.20, 2.55), P = 0.004]. In contrast, BMD was not associated with any of the mortality outcomes (P > 0.1 for all associations).

Conclusion: We report strong relationships between grip strength and mortality compared with BMD. We hypothesize that this may reflect better recognition and treatment of low BMD in this cohort.

Keywords: epidemiology; mortality; osteoporosis; sarcopenia.