Association between hand grip strength and mortality: The North West, South Africa Prospective Urban Rural Epidemiology (PURE) study.

Hand Grip Strength (HGS) is employed in epidemiological contexts to measure muscle strength because it’s inexpensive, easy to perform and interpret. Population-based investigations use protocols that incorporate HGS measurements in health-status evaluations. Our aim was to investigate the association of HGS with all-cause mortality in a South African population. Methods This study was based on the South African leg of the Prospective Urban and Rural Epidemiology (PURE) study; a community-based, prospective cohort study. This work was based on baseline HGS collected in 2005. Deterministic linkage to the mortality was performed using death status in 2018. The Cox regression was applied to investigate all-cause mortality risk in relation to HGS tertiles. A non-linear dose response analysis has been applied to investigate the shape of the relation between HGS and all-cause mortality risk. All the results have been validated by numerous sensitivity analyses. Results Our work included 1 251 participants with a median age of 47 years (5th95th quantile range 36, 67) and 59.6% (n 746) of participants were women. During a median follow-up of 13.2 years, 374 deaths from all causes occurred. We observed a 25% (HR 0.80; 95% CI 0.61, 1.05) and a 63.9% (HR 0.61; 95% CI 0.44, 0.85) decreased risk of all-cause mortality for the 2nd and 3rd tertiles of dominant hand grip strength compared to the 1st. A similar risk reduction was observed for the nondominant hand. A linear monotone decreasing relation between HGS and all-cause mortality risk was reported. Conclusions HGS is inversely associated with mortality risk and can be used to predict mortality risk in the South African population