Clinical Investigations
Long-Term Determinants of Muscle Strength Decline: Prospective Evidence from the 22-Year Mini-Finland Follow-Up Survey
Sari Stenholm PhD,
Kristina Tiainen PhD,
Taina Rantanen PhD,
Päivi Sainio MSc,
Markku Heliövaara MD, PhD,
Olli Impivaara MD, PhD,
Seppo Koskinen MD, PhD,
Corresponding Author
Sari Stenholm PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Address correspondence to Sari Stenholm, National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Peltolantie 3, FI-20720 Turku, Finland. E-mail: [email protected]Search for more papers by this authorKristina Tiainen PhD
Tampere School of Public Health, University of Tampere, Tampere, Finland
Search for more papers by this authorTaina Rantanen PhD
Gerontology Research Centre, University of Jyväskylä, Jyväskylä, Finland
Search for more papers by this authorPäivi Sainio MSc
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorMarkku Heliövaara MD, PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorOlli Impivaara MD, PhD
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
Search for more papers by this authorSeppo Koskinen MD, PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorSari Stenholm PhD,
Kristina Tiainen PhD,
Taina Rantanen PhD,
Päivi Sainio MSc,
Markku Heliövaara MD, PhD,
Olli Impivaara MD, PhD,
Seppo Koskinen MD, PhD,
Corresponding Author
Sari Stenholm PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Address correspondence to Sari Stenholm, National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Peltolantie 3, FI-20720 Turku, Finland. E-mail: [email protected]Search for more papers by this authorKristina Tiainen PhD
Tampere School of Public Health, University of Tampere, Tampere, Finland
Search for more papers by this authorTaina Rantanen PhD
Gerontology Research Centre, University of Jyväskylä, Jyväskylä, Finland
Search for more papers by this authorPäivi Sainio MSc
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorMarkku Heliövaara MD, PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorOlli Impivaara MD, PhD
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
Search for more papers by this authorSeppo Koskinen MD, PhD
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Turku and Helsinki, Finland
Search for more papers by this authorAbstract
Objectives
To examine long-term changes in handgrip strength and the factors predicting handgrip strength decline.
Design
Longitudinal cohort study with 22 years of follow-up.
Setting
Population-based Mini-Finland Health Examination Survey in Finland.
Participants
Nine hundred sixty-three men and women aged 30 to 73 at baseline.
Measurements
Handgrip strength was measured using a handheld dynamometer at baseline and follow-up. Information on potential risk factors, namely lifestyle and chronic conditions, and their changes throughout the follow-up were based on health interviews.
Results
Based on linear mixed-effect models, midlife physically strenuous work, excess body weight, smoking, cardiovascular disease, hypertension, diabetes mellitus, and asthma predicted muscle strength decline over 22 years of follow-up (P < .05 for all). In addition, pronounced weight loss, becoming physically sedentary, persistent smoking, incident coronary heart disease, other cardiovascular disease, diabetes mellitus, chronic bronchitis, chronic back syndrome, long-lasting cardiovascular disease, hypertension, and asthma were associated with accelerated handgrip strength decline (P < .05 for all).
Conclusion
Lifestyle and physical health earlier in life determine rate of muscle strength decline in old age. Efforts should be made to recognize persons at risk in a timely manner and target early interventions to middle-aged persons to slow down muscle strength decline and prevent future functional limitations and disability.
References
- 1Rantanen T, Harris T, Leveille SG et al. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci 2000; 55A: M168–M173.
- 25Ferrucci L, Penninx BWJH, Volpato S et al. Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels. J Am Geriatr Soc 2002; 50: 1947–1954.
- 3Lauretani F, Russo C, Bandinelli S et al. Age-associated changes in skeletal muscles and their effect on mobility: An operational diagnosis of sarcopenia. J Appl Physiol 2003; 95: 1851–1860.
- 4Rantanen T, Guralnik JM, Foley D et al. Midlife hand grip strength as a predictor of old age disability. JAMA 1999; 281: 558–560.
- 5Manini TM, Clark BC. Dynapenia and aging: An update. J Gerontol A Biol Sci Med Sci 2011 Mar 28. doi:10.1093/gerona/glr010.
- 6Morley JE, Baumgartner RN, Roubenoff R et al. Sarcopenia. J Lab Clin Med 2001; 137: 231–243.
- 7Doherty T. Aging and sarcopenia. J Appl Physiol 2003; 95: 1717–1727.
- 8Marcell TJ. Sarcopenia: Causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci 2003; 58A: M911–M916.
- 9Boirie Y. Physiopathological mechanism of sarcopenia. J Nutr Health Aging 2009; 13: 717–723.
- 10Hughes VA, Frontera WR, Wood M et al. Longitudinal muscle strength changes in older adults: Influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci 2001; 56A: B209–B217.
- 11Frontera WR, Hughes VA, Fielding RA et al. Aging of skeletal muscle: A 12-yr longitudinal study. J Appl Physiol 2000; 88: 1321–1326.
- 12Rantanen T, Masaki KT, Foley D et al. Grip strength changes over 27 yr in Japanese-American men. J Appl Physiol 1998; 85: 2047–2053.
- 13Forrest KY, Zmuda JM, Cauley JA. Patterns and correlates of muscle strength loss in older women. Gerontology 2007; 53: 140–147.
- 14Aromaa A, Heliövaara M, Impivaara O et al. Health, functional limitations and need for care in Finland. Basic results from the Mini-Finland Health Survey. Helsinki and Turku: Publications of the Social Insurance Institution (In Finnish with an English summary), 1989.
- 15Aromaa A, Koskinen S. Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey. Helsinki: Publications of the National Public Health Institute B12/2004 [on-line]. Available at http://www.terveys2000.fi/julkaisut/baseline.pdf Accessed on July 26, 2011.
- 16Heliövaara M, Mäkelä M, Knekt P et al. Determinants of sciatica and low-back pain. Spine 1991; 16: 608–614.
- 17Mälkiä E. Muscular performance as a determinant of physical ability in Finnish adult population. Turku: Publications of the Social Insurance Institution (In Finnish with an English summary), 1983.
- 18Sainio P, Koskinen S, Natunen S et al. Functional capacity. In: S Heistaro, Ed. Methodology Report Health 2000 Survey. Helsinki: Publications of the National Health Institute. Available at http://www.terveys2000.fi/doc/methodologyrep.pdf Accessed July 26, 2011.
- 19Sanchez-Craig M, Wilkinson DA, Davila R. Empirically based guidelines for moderate drinking:1-year results from three studies with problem drinkers. Am J Public Health 1995; 85: 823–828.
- 20Mäkelä M, Heliövaara M, Sievers K et al. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol 1991; 134: 1356–1367.
- 21Aromaa A, Reunanen A, Impivaara O et al. Cardiovascular and respiratory survey methods. Part 2. The execution of the Mini-Finland Health Survey. Helsinki and Turku: Publications of the Social Insurance Institution (in Finnish with an English summary), 1985.
- 22Wilhelmsen L, Tibblin G, Werko L. A primary preventive study of Gothenburg, Sweden. Prev Med 1972; 1: 153–160.
- 23Verbeke G, Molenberghs G. Linear mixed models for longitudinal data, 2nd Ed. New York: Springer-Verlag, 2001.
- 24Edwards LJ. Modern statistical techniques for the analysis of longitudinal data in biomedical research. Pediatr Pulmonol 2000; 30: 330–344.
- 25Leino-Arjas P, Solovieva S, Riihimäki H et al. Leisure time physical activity and strenuousness of work as predictors of physical functioning: A 28 year follow up of a cohort of industrial employees. Occup Environ Med 2004; 61: 1032–1038.
- 26Hoogendoorn WE, van Poppel MN, Bongers PM et al. Physical load during work and leisure time as risk factors for back pain. Scand J Work Environ Health 1999; 25: 387–403.
- 27Häkkänen M, Viikari-Juntura E, Martikainen R. Job experience, work load, and risk of musculoskeletal disorders. Occup Environ Med 2001; 58: 129–135.
- 28Rantanen T, Era P, Heikkinen E. Physical activity and the changes in maximal isometric strength in men and women from the age of 75 to 80 years. J Am Geriatr Soc 1997; 45: 1439–1445.
- 29Lord SR, Ward JA, Williams P et al. The effect of a 12-month exercise trial on balance, strength, and falls in older women: A randomized controlled trial. J Am Geriatr Soc 1995; 43: 1198–1206.
- 30Jette AM, Lachman M, Giorgetti MM et al. Exercise–it's never too late: The strong-for-life program. Am J Public Health 1999; 89: 66–72.
- 31Fiatarone MA, O′Neill EF, Ryan ND et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769–1775.
- 32Frontera WR, Meredith CN, O'Reilly KP et al. Strength conditioning in older men: Skeletal muscle hypertrophy and improved function. J Appl Physiol 1988; 64: 1038–1044.
- 33Goodpaster BH, Chomentowski P, Ward BK et al. Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: A randomized controlled trial. J Appl Physiol 2008; 105: 1498–1503.
- 34Marcus RL, Addison O, Kidde JP et al. Skeletal muscle fat infiltration: Impact of age, inactivity, and exercise. J Nutr Health Aging 2010; 14: 362–366.
- 35Stenholm S, Harris TB, Rantanen T et al. Sarcopenic obesity—definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008; 11: 693–700.
- 36Stenholm S, Sallinen J, Koster A et al. Association between obesity history and hand grip strength in older adults - exploring the roles of inflammation and insulin resistance as mediating factors. J Gerontol A Biol Sci Med Sci 2011; 66A: 341–348.
- 37Visser M, Pahor M, Taaffe DR et al. Relationship of interleukin-6 and tumor necrosis factor-α with muscle mass and muscle strength in elderly men and women: The Health ABC Study. J Gerontol A Biol Sci Med Sci 2002; 57A: M326–M332.
- 38Schaap LA, Pluijm SM, Deeg DJ et al. Higher inflammatory marker levels in older persons: Associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci 2009; 64A: 1183–1189.
- 39Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006; 444: 840–846.
- 40Miller SL, Wolfe RR. The danger of weight loss in the elderly. J Nutr Health Aging 2008; 12: 487–491.
- 41Avila JJ, Gutierres JA, Sheehy ME et al. Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults. Eur J Appl Physiol 2010; 109: 517–525.
- 42Bouchard DR, Soucy L, Senechal M et al. Impact of resistance training with or without caloric restriction on physical capacity in obese older women. Menopause 2009; 16: 66–72.
- 43Frimel TN, Sinacore DR, Villareal DT. Exercise attenuates the weight-loss-induced reduction in muscle mass in frail obese older adults. Med Sci Sports Exerc 2008; 40: 1213–1219.
- 44Wang X, Miller GD, Messier SP et al. Knee strength maintained despite loss of lean body mass during weight loss in older obese adults with knee osteoarthritis. J Gerontol A Biol Sci Med Sci 2007; 62A: 866–871.
- 45van den Borst B, Koster A, Yu B et al. Is age-related decline in lean mass and physical function accelerated by obstructive lung disease or smoking? Thorax 2011; 66: 961–969.
- 46Sulander T, Martelin T, Rahkonen O et al. Associations of functional ability with health-related behavior and body mass index among the elderly. Arch Gerontol Geriatr 2005; 40: 185–199.
- 47Nelson HD, Nevitt MC, Scott JC et al. Smoking, alcohol, and neuromuscular and physical function of older women. Study of Osteoporotic Fractures Research Group. JAMA 1994; 272: 1825–1831.
- 48Abbatecola AM, Ferrucci L, Ceda G et al. Insulin resistance and muscle strength in older persons. J Gerontol A Biol Sci Med Sci 2005; 60A: 1278–1282.
- 49Barzilay JI, Cotsonis GA, Walston J et al. Insulin resistance is associated with decreased quadriceps muscle strength in nondiabetic adults aged >or = 70 years. Diabetes Care 2009; 32: 736–738.
- 50Navab M, Gharavi N, Watson AD. Inflammation and metabolic disorders. Curr Opin Clin Nutr Metab Care 2008; 11: 459–464.
- 51Lucas SR, Platts-Mills TA. Physical activity and exercise in asthma: Relevance to etiology and treatment. J Allergy Clin Immunol 2005; 115: 928–934.
- 52Ford ES, Heath GW, Mannino DM et al. Leisure-time physical activity patterns among US adults with asthma. Chest 2003; 124: 432–437.
- 53Mälkiä E, Impivaara O. Intensity of physical activity and respiratory function in subjects with and without bronchial asthma. Scand J Med Sci Sports 1998; 8: 27–32.
- 54Decramer M, Lacquet LM, Fagard R et al. Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med 1994; 150: 11–16.
- 55Gruenewald TL, Seeman TE, Karlamangla AS et al. Allostatic load and frailty in older adults. J Am Geriatr Soc 2009; 57: 1525–1531.
- 56Fried LP, Xue QL, Cappola AR et al. Nonlinear multisystem physiological dysregulation associated with frailty in older women: Implications for etiology and treatment. J Gerontol A Biol Sci Med Sci 2009; 64A: 1049–1057.
- 57Stenholm S, Maggio M, Lauretani F et al. Anabolic and catabolic biomarkers as predictors of muscle strength decline: The InCHIANTI Study. Rejuvenation Res 2010; 13: 3–11.
- 58Fried LP, Bandeen-Roche K, Kasper JD et al. Association of comorbidity with disability in older women: The Women's Health and Aging Study. J Clin Epidemiol 1999; 52: 27–37.
- 59Guralnik JM, LaCroix AZ, Abbot RD et al. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol 1993; 137: 845–857.
- 60Vianna LC, Oliveira RB, Araujo CG. Age-related decline in handgrip strength differs according to gender. J Strength Cond Res 2007; 21: 1310–1314.
- 61Frontera WR, Hughes VA, Lutz KJ et al. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol 1991; 71: 644–650.
- 62Newman AB, Kupelian V, Visser M et al. Strength, but not muscle mass, is associated with mortality in the Health, Aging and Body Composition Study cohort. J Gerontol A Biol Sci Med Sci 2006; 61A: M72–M77.
- 63Hu G, Tuomilehto J, Silventoinen K et al. The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women. Int J Obes (Lond) 2005; 29: 894–902.
- 64Erlichman J, Kerbey AL, James WP. Physical activity and its impact on health outcomes. Paper 1: The impact of physical activity on cardiovascular disease and all-cause mortality: An historical perspective. Obes Rev 2002; 3: 257–271.
- 65Dey DK, Rothenberg E, Sundh V et al. Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds. Eur J Clin Nutr 2001; 55: 482–492.
- 66Losonczy KG, Harris TB, Cornoni-Huntley J et al. Does weight loss from middle age to old age explain the inverse weight mortality relation in old age? Am J Epidemiol 1995; 141: 312–321.
- 67Droyvold WB, Lund Nilsen TI, Lydersen S et al. Weight change and mortality: The Nord-Trondelag Health Study. J Intern Med 2005; 257: 338–345.
