Predicting Cause-Specific Mortality of Older Men Living in the Veterans Home by Handgrip Strength and Walking Speed: A 3-Year, Prospective Cohort Study in Taiwan

Objective: To determine prognostic value of handgrip strength (HGS) and walking speed (WS) in predicting the cause-specific mortality for older men. Design: Prospective cohort study. Setting: Banciao Veterans Care Home. Participants: 558 residents aged 75 years and older. Measurements: Anthropometric data, lifestyle factors, comorbid conditions, biomarkers, HGS, and WS at recruitment; all-cause and cause-specific mortality at 3 years after recruitment. Results: During the study period, 99 participants died and the baseline HGS and WS were significantly lower than survivors (P both <.001). Cox survival analysis showed that subjects with slowest quartile of WS were at significantly higher risk of all-cause mortality and cardiovascular mortality (hazard ratio [HR] 3.55, 95% confidence interval [CI] 1.69-7.43; HR 11.55, 95% CI 2.30-58.04, respectively), whereas the lowest quartile of HGS significantly predicted a higher risk of infection-related death (HR 5.53, 95% CI 1.09-28.09). Participants in the high-risk status with slowest quartile for WS but not those in the high-risk status with weakest quartile for HGS had similar high risk of all-cause mortality with the group with combined high-risk status (HR 2.96, 95% CI 1.68-5.23; HR 2.58, 95% CI 1.45-4.60, respectively) compared with the participants without high-risk status (reference group). Conclusions: Slow WS predicted all-cause and cardiovascular mortality, whereas weak HGS predicted a higher risk of infection-related death among elderly, institutionalized men in Taiwan. Combining HGS with WS simultaneously had no better prognostic value than using WS only in predicting all-cause mortality.