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Developmental factors associated with decline in grip strength from midlife to old age: a British birth cohort study
  1. Diana Kuh,
  2. Rebecca Hardy,
  3. Joanna M Blodgett,
  4. Rachel Cooper
  1. MRC Unit for Lifelong Health and Ageing at UCL, London, UK
  1. Correspondence to Professor Diana Kuh; d.kuh{at}


Objectives To test whether developmental factors are associated with grip strength trajectories between 53 and 69 years, and operate independently or on the same pathway/s as adult factors.

Design British birth cohort study.

Setting England, Scotland and Wales.

Participants 3058 men and women.

Main outcome measures Grip strength (kg) at ages 53, 60–64 and 69 were analysed using multilevel models to estimate associations with developmental factors (birth weight, growth parameters, motor and cognitive development) and father’s social class, and investigate adult factors that could explain observed associations, testing for age and sex interactions.

Results In men, heavier birth weight, beginning to walk ‘on time’, later puberty and greater weight 0–26 years and in women, heavier birth weight and earlier age at first standing were independently associated with stronger grip but not with its decline. The slower decline in grip strength (by 0.07 kg/year, 95% CI 0.02 to 0.11 per 1 SD, p=0.003) in men of higher cognitive ability was attenuated by adjusting for adult verbal memory.

Conclusions Patterns of growth and motor development have persisting associations with grip strength between midlife and old age. The strengthening associations with cognition suggest that, at older ages, grip strength increasingly reflects neural ageing processes. Interventions across life that promote muscle development or maintain muscle strength should increase the chance of an independent old age.

  • muscle strength
  • ageing
  • life course
  • development
  • birth cohort

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  • Contributors DK, RC, JMB and RH contributed to the study design and data interpretation and DK, RC and RH collected the data. DK undertook the literature search, the data analysis and wrote the first draft of the manuscript; all authors revised the manuscript. DK is the guarantor and accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was supported by the UK Medical Research Council MC_UU_12019/1, which provides core funding for the MRC National Survey of Health and Development and supports DK, JB, RC and RH by MC_UU_12019/1, MC_UU_12019/2, MC_UU_12019/4. JB also receives support from UCL (Overseas and Graduate Research Scholarships).

  • Disclaimer The funders had no role in the study or the decision to submit the paper for publication.

  • Competing interests All authors have completed the ICMJE uniform disclosure form and declare: DK, JB, RC and RH received financial support from the UK Medical Research Council for the submitted work. JB also receives support from UCL (Overseas and Graduate Research Scholarships); no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethics approval Ethical approval for the most recent visit was given by Queen Square Research Ethics Committee (13/LO/1073) and Scotland A Research Ethics Committee (14/SS/1009).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data used in this publication are available to bona fide researchers on request to the NSHD Data Sharing Committee via a standard application procedure. Further details can be found at doi:10.5522/NSHD/Q101; doi:10.5522/NSHD/Q102; 10.5522/NSHD/Q103.

  • Patient consent for publication Not required.

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