---
title: "Association of Muscle Strength With All-Cause Mortality in the…"
description: "Higher muscle strength is gradually associated with a lower risk of death in people aged 90 and older."
url: "https://magellanlongevity.com/study/d39439054.md"
canonical: "https://magellanlongevity.com/study/d39439054.html"
html: "https://magellanlongevity.com/study/d39439054.html"
type: "study"
study_key: "d39439054"
journal: "J Cachexia Sarcopenia Muscle"
year: 2024
pmid: "39439054"
doi: "10.1002/jcsm.13619"
citations: 1
updated: 2026-09-02
author: "Gabriel Radu, DO"
author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765."
publisher: "Magellan Longevity"
content_format: "markdown"
---

# Association of Muscle Strength With All-Cause Mortality in the Oldest Old: a 28-country cohort

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## Citation

| Field | Value |
| --- | --- |
| Journal | J Cachexia Sarcopenia Muscle |
| Year | 2024 |
| PMID | [39439054](https://pubmed.ncbi.nlm.nih.gov/39439054/) |
| DOI | [10.1002/jcsm.13619](https://doi.org/10.1002/jcsm.13619) |
| Study key | d39439054 |

## Takeaway

Higher muscle strength is gradually associated with a lower risk of death in people aged 90 and older.

## The question

Does muscle strength associate with all-cause mortality risk in the oldest old in a gradual or threshold-specific manner?

## Hypothesis

The study investigates the prospective association of muscle strength with all-cause mortality in the oldest old.

## Methods

This study included 1890 adults aged 90 years or older from 27 European countries and Israel. Muscle strength was measured using handgrip dynamometry. Time-varying Cox regression with restricted cubic splines was used to determine the association of muscle strength with mortality, adjusting for several confounding factors.

## Results

Over a mean follow-up of 4.2 years, 51.4% of participants died. Mean handgrip strength was 20.4 kg overall, with men having 26.7 kg and women 16.4 kg. Lower and higher levels of muscle strength were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively, using the median strength (18 kg) as reference. The 10th percentile of muscle strength (10 kg) had a hazard ratio (HR) of 1.27, while the 90th percentile (31 kg) had an HR of 0.69. Sex-stratified results showed similar trends, with the 10th percentile for men (15 kg) having an HR of 1.33 and for women (10 kg) an HR of 1.19. The 90th percentile for men (35 kg) had an HR of 0.75 and for women (23 kg) an HR of 0.75.

## Conclusion

Muscle strength is gradually and inversely associated with mortality risk in the oldest old, rather than having a specific threshold.

## Limitations

The abstract does not explicitly state limitations, but the findings were confirmed by sensitivity analyses.

## Verbatim from the abstract

> Muscle strength is gradually and inversely associated with mortality risk in the oldest old

## Hazard Ratios for All-Cause Mortality by Muscle Strength Percentile

| Measure | Hazard Ratio |
| --- | --- |
| 10th Percentile (10 kg) | 1.27 |
| Median (18 kg) | 1 |
| 90th Percentile (31 kg) | 0.69 |

*Hazard ratios for all-cause mortality at different percentiles of muscle strength, relative to the median muscle strength (18 kg).*

## Where this study is used on Magellan

This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions.

| Compound or device | Evidence grade | Graded pages |
| --- | --- | --- |
| Grip-Strength Dynamometer | Measurement tool | [Grip-Strength Dynamometer](https://magellanlongevity.com/p/153.md) |

## Reference

1. **Association of Muscle Strength With All-Cause Mortality in the Oldest Old: a 28-country cohort**
   J Cachexia Sarcopenia Muscle 2024 · [PMID 39439054](https://pubmed.ncbi.nlm.nih.gov/39439054/) · [DOI 10.1002/jcsm.13619](https://doi.org/10.1002/jcsm.13619)

   > Muscle strength is gradually and inversely associated with mortality risk in the oldest old

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## Related on Magellan Longevity

- [Grip-Strength Dynamometer](https://magellanlongevity.com/p/153.md) — product graded on this and related evidence
- [Evidence: Handgrip strength (muscle strength)](https://magellanlongevity.com/study/s153.md)
- [Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: a…](https://magellanlongevity.com/study/d36332759.md)
- [Evidence: quantifies handgrip-force biomarker](https://magellanlongevity.com/study/s162.md)
- [Longevity research map](https://magellanlongevity.com/longevity-research-map.html)
- [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md)

## Scope and disclosures

Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication.

Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases.

Reviewed for accuracy by a board-certified physician (DO).