OBJECTIVES Quantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities. DESIGN Longitudinal panel. SETTING Detailed interviews that included physical measures were conducted in person, whereas core interviews were often performed over the telephone. PARTICIPANTS Data from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the Health and Retirement Study were analyzed. MEASURES A handgrip dynamometer was used to assess handgrip strength (HGS) in each participant. Men with HGS <26 kg were considered weak, ≥26 kg were considered not weak, and ≥32 kg were considered strong. Women with HGS <16 kg were classified as weak, ≥16 kg were classified as not-weak, and ≥20 kg were classified as strong. The National Death Index and postmortem interviews determined the date of death. The greedy matching algorithm was used to match cohorts. RESULTS Of the 1077 weak and not-weak matched pairs, 401 weak (37.2%) and 296 not-weak (27.4%) older Americans died over an average 4.4 ± 2.5-year follow-up. There were 392 weak (37.0%) and 243 strong (22.9%) persons who died over a mean 4.5 ± 2.5-year follow-up from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95% confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality relative to persons in the not-weak and strong control cohorts, respectively. CONCLUSIONS AND IMPLICATIONS Our findings may indicate a causal association between muscle weakness and mortality in older Americans. Health care providers should include measures of HGS as part of routine health assessments and discuss the health risks of muscle weakness with their patients.

中文翻译：

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虚弱可能与美国老年人的早期死亡率有因果关系：匹配队列分析

目标 通过仔细匹配的队列量化肌无力与死亡率之间的关联，将有助于更好地确定肌无力对过早死亡的影响。我们在美国老年人的全国样本中使用了匹配队列分析，以确定与力量能力逐渐提高的对照组相比，那些虚弱的人是否具有更高的死亡风险。设计纵向面板。设置 包括身体测量在内的详细访谈是亲自进行的，而核心访谈通常是通过电话进行的。参与者 分析了 2006 年至 2014 年健康与退休研究浪潮中 19,729 名年龄至少为 50 岁的美国人的数据。测量 使用手柄测力计来评估每个参与者的手柄强度 (HGS)。HGS <26 kg 的男性被认为是虚弱的，≥26 kg被认为不弱，≥32 kg被认为是强壮。HGS <16 kg 的女性被归类为虚弱，≥16 kg 被归类为不虚弱，≥20 kg 被归类为强壮。国家死亡指数和尸检访谈确定了死亡日期。贪心匹配算法用于匹配队列。结果 在 1077 对弱和非弱匹配对中，401 对弱 (37.2%) 和 296 对不弱 (27.4%) 年长的美国人在平均 4.4 ± 2.5 年的随访中死亡。在平均 4.5 ± 2.5 年的随访期间，有 392 名弱者 (37.0%) 和 243 名强者 (22.9%) 从 1057 对弱者和强者配对中死亡。相对于非弱对照和强对照队列中的人，弱队列中的人的死亡率风险分别高 1.40 [95% 置信区间 (CI) 1.19, 1.64] 和 1.54 (CI 1.30, 1.83)。结论和意义 我们的研究结果可能表明美国老年人肌肉无力与死亡率之间存在因果关系。卫生保健提供者应将 HGS 的测量纳入常规健康评估的一部分，并与患者讨论肌肉无力的健康风险。