Five-repetition chair-stand test vs. handgrip strength: Which better predicts mortality risk? a follow-up study in 43,605 middle-aged and older adults

Abstract

Background

Ageing reduces muscle strength and function, increasing mortality risk. Identifying simple performance markers can guide interventions for healthy ageing.

Objective

To assess the prospective dose-response association of the 5-repetition Chair Stand Test (5-CST) and handgrip strength (HGS) with mortality in middle-aged and older adults.

Methods

This prospective study included community-dwelling participants aged 50 years or older from the SHARE study. HGS and 5-CST were assessed at baseline, with all-cause mortality tracked through follow-up interviews. Cox regression with restricted cubic splines was used, controlling for several confounders.

Results

43,605 participants (mean age (SD): 65.3 (9.1), 54 % women) were included. During a mean follow-up of 7.3 ± 2.2 years, there were 4154 deaths (9.5 %). Both 5-CST and HGS were curvilinearly associated with all-cause mortality. Using the median level of 5-CST as a reference (11 s), 10th percentile of 5-CST (7 s) showed a hazard ratio (HR) of 0.74 (95 %CI: 0.69, 0.80). The 90th percentile (18 s) of 5-CST showed a HR of 1.18 (95 %CI: 1.14, 1.22). Stratified analysis indicated 5-CST was most strongly associated with mortality in women. Regarding HGS, using the median level as a reference (33 kg), the 10th percentile of muscle strength (21 kg) showed a HR of 1.62 (95 %CI: 1.50, 1.75). The 90th percentile (51 kg) of muscle strength showed a HR of 0.58 (95 %CI: 0.52, 0.64).

Conclusion

Both tools provide valuable information, but HGS may be considered more relevant for identifying those at increased mortality risk, while 5-CST may be especially useful in women.