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

Abstract

Objectives: therapeutic advances in management of osteoporosis and sarcopenia have occurred at different rates over the last two decades; here we examined associations between grip strength and bone mineral density (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; deaths were recorded from baseline (1998–2004) until 31st 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: mean (SD) baseline age of participants was 64.3 (2.5) and 65.9 (2.6) years in men and women respectively. Lower grip strength was associated with increased risk of all-cause mortality (hazard ratio (95% CI): 1.30 (1.06,1.58), p = 0.010) and cardiovascular-related mortality (1.75 (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 in comparison with BMD. We hypothesize that this may reflect better recognition and treatment of low BMD in this cohort.

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Identifiers

ORCID for Leo D. Westbury: orcid.org/0009-0008-5853-8096

ORCID for Harnish P. Patel: orcid.org/0000-0002-0081-1802

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

ORCID for Elaine M. Dennison: orcid.org/0000-0002-3048-4961

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