Objectively measured physical capability levels and mortality: systematic review and meta-analysis

Objective: To do a quantitative systematic review, including published and unpublished data, examining the associations between individual objective measures of physical capability (grip strength, walking speed, chair rising, and standing balance times) and mortality in community dwelling populations. Design: Systematic review and meta-analysis. Data sources: Relevant studies published by May 2009 identified through literature searches using Embase (from 1980) and Medline (from 1950) and manual searching of reference lists; unpublished results were obtained from study investigators. Study selection: Eligible observational studies were those done in community dwelling people of any age that examined the association of at least one of the specified measures of physical capability (grip strength, walking speed, chair rises, or standing balance) with mortality. Data synthesis: Effect estimates obtained were pooled by using random effects meta-analysis models with heterogeneity between studies investigated. Results: Although heterogeneity was detected, consistent evidence was found of associations between all four measures of physical capability and mortality; those people who performed less well in these tests were found to be at higher risk of all cause mortality. For example, the summary hazard ratio for mortality comparing the weakest with the strongest quarter of grip strength (14 studies, 53 476 participants) was 1.67 (95% confidence interval 1.45 to 1.93) after adjustment for age, sex, and body size (I2=84.0%, 95% confidence interval 74% to 90%; P from Q statistic <0.001). The summary hazard ratio for mortality comparing the slowest with the fastest quarter of walking speed (five studies, 14 692 participants) was 2.87 (2.22 to 3.72) (I2=25.2%, 0% to 70%; P=0.25) after similar adjustments. Whereas studies of the associations of walking speed, chair rising, and standing balance with mortality have only been done in older populations (average age over 70 years), the association of grip strength with mortality was also found in younger populations (five studies had an average age under 60 years). Conclusions: Objective measures of physical capability are predictors of all cause mortality in older community dwelling populations. Such measures may therefore provide useful tools for identifying older people at higher risk of death. With Contributions from Dr P.A. Bath, University of Sheffiel

Processed meat consumption and Lung function: modification by antioxidants and smoking

This article has supplementary material available from www.erj.ersjournals.com: This study was supported by the Medical Research Council, UK. H. Okubo was supported in part by fellowship of the Astellas Foundation for Research on Metabolic Disorders, Japan and the Naito Memorial Grant for Research Abroad from the Naito Foundation, Japan

Type of milk feeding in infancy and health behaviours in adult life: findings from the Hertfordshire Cohort Study

A number of studies suggest that breast-feeding has beneficial effects on an individual's cardiovascular risk factors in adulthood, although the mechanisms involved are unknown. One possible explanation is that adults who were breastfed differ in their health behaviours. In a historical cohort, adult health behaviours were examined in relation to type of milk feeding in infancy. From 1931 to 1939, records were kept on all infants born in Hertfordshire, UK. Their type of milk feeding was summarised as breastfed only, breast and bottle-fed, or bottle-fed only. Information about adult health behaviours was collected from 3217 of these men and women when they were aged 59–73 years. Diet was assessed using an administered FFQ; the key dietary pattern was a ‘prudent’ pattern that described compliance with ‘healthy’ eating recommendations. Of the study population, 60 % of the men and women were breastfed, 31 % were breast and bottle-fed, and 9 % were bottle-fed. Type of milk feeding did not differ according to social class at birth, and was not related to social class attained in adult life. There were no differences in smoking status, alcohol intake or reported physical activity according to type of milk feeding, but there were differences in the participants' dietary patterns. In a multivariate model that included sex and infant weight gain, there were independent associations between type of feeding and prudent diet scores in adult life (P= 0·009), such that higher scores were associated with having been breastfed. These data support experimental findings which suggest that early dietary exposures can have lifelong influences on food choice

Work participation and risk factors for health-related job loss among older workers in the Health and Employment after Fifty (HEAF) study: Evidence from a 2-year follow-up period

Funding KWB The HEAF study is funded by grant awards from Versus Arthritis (formerly Arthritis Research UK) (19817 and 20665) and the Medical Research Council programme grant (MC_UU_12011/5); and the Economic and Social Research Council and Medical Research Council jointly (ES/L002663/1); the study is coordinated by the MRC Lifecourse Epidemiology Unit, Southampton. https://www.versusarthritis.org https://mrc.ukri.org/ https://esrc.ukri.org/ The funders did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Acknowledgments We wish to thank the Clinical Practice Research Datalink and the 24 general practices that supported data collection; also, the staff of the MRC Lifecourse Epidemiology Unit who provided data entry and computing support (notably Vanessa Cox). Finally, we thank the HEAF participants for giving their time so generously to participate in the study.Peer reviewedPublisher PD

Morbidities Among Older Workers And Work Exit : The Heaf Cohort

Funding: The HEAF study is funded by grant awards from Versus Arthritis (formerly Arthritis Research UK) (19817 and 20665) and the Medical Research Council programme grant (MC_UU_12011/5); and the Economic and Social Research Council and Medical Research Council jointly (ES/L002663/1); the study is coordinated by the MRC Lifecourse Epidemiology Unit, Southampton. GN and CHL receive financial support from the MRC Versus Arthritis Centre for Musculoskeletal Health and Work. Acknowledgements: We wish to thank Professor Keith Palmer for his work incepting the HEAF cohort and Dr Stephen Duffield for his contribution to the coding of the CPRD data. Also, we are grateful to the Clinical Practice Research Datalink and the 24 general practices that supported data collection, the staff of the MRC Lifecourse Epidemiology Unit who provided data entry and computing support (notably Vanessa Cox). Finally, we thank the HEAF participants for giving their time so generously to participate in the study.Peer reviewedPostprin

Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality

Bevilacqua, Gregorio D'Angelo, Stefania Ntani, Georgia Syddall, Holly Emma Harris, Elizabeth Clare Linaker, Cathy Stevens, Martin Cooper, Cyrus Walker-Bone, Karen eng England BMC Public Health. 2021 Mar 23;21(1):574. doi: 10.1186/s12889-021-10610-5.Peer reviewedPublisher PD

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Biodex, and this effect was most marked in the strongest participants. Nevertheless, there was a good correlation between the measures (r = 0.91, p ! 0.0001). Classifi cation of individuals into tertiles of muscle strength showed good agreement between the two methods (Kappa = 0.69, p ! 0.0001). Conclusions: Our fi ndings suggest that the HHD using a supine positioning offers a feasible, inexpensive, and portable test of quadriceps muscle strength for use in healthy older people. It underestimates the absolute quadriceps strength compared to the Biodex particularly in stronger people, but is a useful tool for ranking muscle strength of older people in epidemiological studies. It may also be of value for quick and objective assessment of physical function in the clinical setting

Hand-grip strength is a simple and effective outcome predictor in esophageal cancer following esophagectomy with reconstruction: a prospective study

<p>Abstract</p> <p>Background</p> <p>Surgery for esophageal cancer usually carries considerable complication and mortality rate. Adequate preoperative evaluation is mandatory to decrease complication rate. Hand-grip strength is a useful measure to assess the extent of aging, nutrition and patient's overall condition. Because preoperative nutrition state and physiologic aging process play important roles in postoperative recovery, we would like to know if hand-grip strength is an adequate tool for such evaluation.</p> <p>Material and methods</p> <p>From January 1st, 2007 to December 31, 2008, there was 68 cases underwent esophagectomy with reconstruction due to esophageal cancer in our hospital. After excluding 7 patients of incomplete data and loss of follow-up, there were 61 patients included in the study.</p> <p>Results</p> <p>There were 54 men and 7 women. The mean age is 60.7. Most of patients had squamous cell carcinoma. Patient with weak hand-grip strength prior to operation had exceedingly high rates of complication and mortality within 6 months after operation. Compared to other risk factors, low grip strength has highest relative risks for both mortality and morbidity.</p> <p>Conclusion</p> <p>Because test for hand-grip strength is cheap, not time-consuming and has high predictive value, it may be included in routine preoperative evaluation.</p

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods and Findings:&lt;/b&gt; Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.&lt;/p&gt

Social patterning in grip strength and in its association with age; A cross sectional analysis using the UK Household Longitudinal Study (UKHLS)

Background: Grip strength in early adulthood and midlife is an important predictor of disability, morbidity and mortality in later life. Understanding social patterning in grip strength at different life stages could improve insight into inequalities in age-related decline and when in the life course interventions could prevent the emergence of inequalities. Methods: Using United Kingdom Household Longitudinal Study (UKHLS) data on 19,292 people aged 16 to 99, fractional polynomial models were fitted to identify which function of age best described its association with grip strength. Linear regressions were used to establish whether socio-economic position (SEP), as measured by maternal education, highest educational qualification and income, was associated with grip strength. To test whether the association between age and grip strength was modified by SEP, interactions between SEP and the age terms were added. Differentiation was used to identify the age at which grip strength was highest for men and women and predicted levels of grip strength at peak were compared. Results: SEP is significantly associated with grip strength on all SEP measures, except education for men. Grip strength is highest at a younger age, and less strong for all measures of disadvantage for women and most measures for men. Interaction terms were not statistically significant indicating that the association between age and grip strength was not modified by SEP. Grip strength peak was 29.3 kg at age 33 for women with disadvantaged childhood SEP compared with 30.2 kg at age 35 for women with advantaged childhood SEP. Conclusion: The SEP differences in age and level of peak grip strength could be indicative of decline in muscle strength beginning earlier and from a lower base for disadvantaged groups. This could impact on the capacity for healthy ageing for those with disadvantaged SEP