Get a Grip and Don’t Waste Your Breath: Grip Strength and Peak Expiratory Flow Are Strong Predictors of Mortality in Older Populations

Noreen Goldman, Princeton University
Dana A. Glei, Georgetown University
Luis Rosero-Bixby, Universidad de Costa Rica
Shi-Ti Chiou, Bureau of Health Promotion, Taiwan
Maxine Weinstein, Georgetown University

Although previous studies have indicated that performance assessments strongly predict future survival, few have evaluated the incremental value beyond that of self reported activity and mobility limitations. We assess and compare the added value of four tests: walking speed, chair stands, grip strength, and peak expiratory flow (PEF). Using population-based samples of older adults in Costa Rica and Taiwan, we estimate proportional hazard models of mortality for an approximate five-year period. Self-reported measures of physical limitations contribute substantial gains in mortality prediction, while performance-based assessments yield small incremental gains. PEF provides the greatest added value, followed by grip strength. For predicting mortality, our results suggest there is little to gain from including more than one or two performance assessments. PEF and grip strength are simpler to administer, impose less burden on the respondent, and are better predictors of mortality than walking speed or chair stands.