Loss of Physical Ability in Elders Is Linked to Earlier Death

Earlier this year I blogged about the increased risks of surgery in frail oldersters; researchers at Johns Hopkins had to develop a scoring system for frailty to establish this increased risk of complications.  Now a publication in the British Medical Journal reports the result of a meta-analysis that reviews the links between individual measures of physical capability and mortality in community-dwelling persons.

UK Medical Research Council scientists evaluated 28 studies that examined associations between at least one of 4 measures of physical capability — grip strength, walking speed, chair rise time, or standing balance performance — and all-cause mortality.     

The results for grip strength, obtained from 14 studies with 53,000 participants, showed the hazard ratio for mortality comparing the lowest with the highest 25% of subjects to be 1.67, after allowing for differences in age, sex, and body size.  This means a 67% greater rate of mortality in the subjects with weakest grip strength.    

The average hazard ratios for walking speed and chair rising time, based on 5 studies each, were 2.87 and 1.96 for the lowest vs. the highest 25% of subjects - in other words, roughly 2½ times and twice the lowest 25% mortality rate, respectively.  Data on standing balance were limited, but there was a trend toward higher mortality with poorer balance. 

The authors of the publication conclude that these measures of physical capability “may therefore provide useful tools for identifying older people at higher risk of death."  A big question remains: what benefits on mortality risk could one expect from an appropriate exercise program in those scoring in the lowest 25%?  Of course, the best solution is to remain physically active into old age as long as possible, before frailty can set in.