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Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women

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García-Hermoso A.
Cavero-Redondo I.
Ramírez-Vélez R.
Ruiz J.R.
Ortega F.B.
Lee D.-C.
Martínez-Vizcaíno V.



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W.B. Saunders

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Objectives: The aims of the present systematic review and meta-analysis were to determine the relationship between muscular strength and all-cause mortality risk and to examine the sex-specific impact of muscular strength on all-cause mortality in an apparently healthy population. Data Sources: Two authors systematically searched MEDLINE, EMBASE and SPORTDiscus databases and conducted manual searching of reference lists of selected articles. Study Selection: Eligible cohort studies were those that examined the association of muscular strength with all-cause mortality in an apparently healthy population. The hazard ratio (HR) estimates with 95% confidence interval (CI) were pooled by using random effects meta-analysis models after assessing heterogeneity across studies. Data Extraction: Two authors independently extracted data. Data Synthesis: Thirty-eight studies with 1,907,580 participants were included in the meta-analysis. The included studies had a total of 63,087 deaths. Higher levels of handgrip strength were associated with a reduced risk of all-cause mortality (HR=0.69; 95% CI, 0.64-0.74) compared with lower muscular strength, with a slightly stronger association in women (HR=0.60; 95% CI, 0.51-0.69) than men (HR=0.69; 95% CI, 0.62-0.77) (all P less than .001). Also, adults with higher levels of muscular strength, as assessed by knee extension strength test, had a 14% lower risk of death (HR=0.86: 95% CI, 0.80-0.93; P less than .001) compared with adults with lower muscular strength. Conclusions: Higher levels of upper- and lower-body muscular strength are associated with a lower risk of mortality in adult population, regardless of age and follow-up period. Muscular strength tests can be easily performed to identify people with lower muscular strength and, consequently, with an increased risk of mortality. © 2018 American Congress of Rehabilitation Medicine
Palabras clave
Adult , All cause mortality , Article , Cohort analysis , Controlled study , Data extraction , Data synthesis , Death , Embase , Female , Follow up , Grip strength , Hazard ratio , Human , Knee , Male , Medline , Meta analysis , Mortality risk , Muscle strength , Risk assessment , Systematic review , Aged , Cause of death , Health survey , Middle aged , Mortality , Muscle disease , Muscle strength , Pathophysiology , Physiology , Proportional hazards model , Sex ratio , Adult , Aged , Cause of death , Cohort studies , Female , Humans , Male , Middle aged , Muscle strength , Muscular diseases , Population surveillance , Proportional hazards models , Sex distribution , Death , Hand strength , Leg strength , Muscles
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