@article {9238,
	title = {Muscle weakness and physical disability in older Americans: Longitudinal findings from the U.S. Health and Retirement Study},
	journal = {The Journal of Nutrition, Health \& Aging},
	volume = {22},
	year = {2018},
	month = {04/2018},
	abstract = {Importance: Muscle weakness is an important indicator of disability, chronic disease and mortality. While we recently proposed sex/race specific grip strength cutpoints for clinical muscle weakness in a diverse, nationally representative sample of older Americans, the extent to which these cutpoints predict physical disability remains unknown. Objective: To examine whether sex/race specific muscle weakness cutpoints predict physical disability status in a nationally representative sample of Americans age 65+. Design: We used data from the 2006-2010 Health and Retirement Study. Fully-adjusted, weighted multinomial logistic regression models were used to quantify the odds of experiencing the onset, progression or persistence of disability in activities of daily living (ADL) among weak versus non-weak individuals over a 2-year period. Setting: General community, nationally representative sample of older Americans. Participants: Population-based, community dwelling sample of older American adults aged 65-years+; 57 percent were women, 91\% were White and the mean age was 75 years. Main Outcome(s) and Measure(s): The primary outcome of interest was disability dynamics, defined by changes in ADL status across at 2- year period. The primary exposure was clinical muscle weakness as defined by previously identified cutpoints. Hypotheses were formulated before analyses were conducted. Results: In this nationally representative sample (n= 8,725), 44\% of individuals were classified as weak at baseline. At follow-up, 55\% remained independent with no change in their ADL status, 11\% had an onset of disability and 4\% progressed in their disability status. The odds of experiencing an onset of ADL disability was 54\% higher among weak individuals compared those who were not weak at baseline (OR= 1.54, 95\% CI= 1.54, 1.5, p<.0001); the odds of experiencing a progression in physical disability status was 2.16 times higher among those who were weak at baseline compared to non-weak individuals (OR= 2.16, 95\% CI= 2.15, 2.16, p<.0001). Conclusions: This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life. Results underscore the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatest risk for adverse health outcomes.},
	keywords = {Activities of Daily Living, Disabilities, Muscle Weakness},
	issn = {1279-7707},
	doi = {10.1007/s12603-017-0951-y},
	url = {http://link.springer.com/10.1007/s12603-017-0951-yhttp://link.springer.com/content/pdf/10.1007/s12603-017-0951-y.pdfhttp://link.springer.com/content/pdf/10.1007/s12603-017-0951-y.pdfhttp://link.springer.com/article/10.1007/s12603-017-0951-y/fulltext.html},
	author = {Kate A Duchowny and Philippa J Clarke and Mark D Peterson}
}
