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Performance

5 Physical Measures You Didn’t know were Linked to Longevity

Dr. David Lipman
Time to read:
12 min

When most people think about longevity they rarely consider what life will be like as they age. These measures give us some insight into what will allow us to keep living, but also ensure we have quality of life.

  1. Grip Strength
  2. Leg Strength
  3. Pushups
  4. Balance
  5. Walking Speed

These probably seem somewhat strange to some readers and it bears noting that when really digesting the research around these a reasonable take away may be as simple as needing to be physically active to ensure we age well (use it or lose it). Alternately, for those somewhat familiar with aging and causes of death as we age there may also be head nodding. Given the mortality and morbidity associated with things like falls many of these suddenly make a lot more sense.

Let’s take a closer look at the list and dissect the parts of it.

Grip strength

This may be the most surprising for readers, most likely due to it being so rarely measured and talked about. The need for strong grip is also probably not immediately apparent to most readers. Whilst grip strength contributes to many activities of daily living (ADLs), like opening jars, it also starts to play a major role in falls prevention and the ability to get back up from the floor when one falls, both enormous factors in safety in the elderly. Beyond this though, the reason grip strength is on this list and so well supported by research may be as simple as the fact that it is generally a fairly good measure of general strength. That is, in general, people who are strong have good grip strength and those who aren’t, do not because to manifest strength we need to hold things and transfer the force through our hands.

How is it measured?

Grip strength in the research and clinical settings is usually measured with a hand grip dynamometer.

Does this need specific training?

Probably not provided there is a generally appropriate and well rounded strength training protocol in place. This should include heavy pulling movements to ensure grip strength is challenged. But there is also no reason not to train it if this is something you would like to do. This may include using thicker implements/bars, specific grip work like plate pinches or just hanging from a bar itself.

Leg strength

Sometimes paired with grip strength in the scientific literature, this is a crucial metric for healthy aging and maintaining an independent life. It impacts things like falls risk, ability to get up from the ground post falling and is a huge part in many tests used for both longevity and falls risk (for example the “timed up and go test”).

How is it measured?

Leg strength can be measured a few ways, one is a deadlift type set up, pulling against the force transducer, the other is using a leg extension type machine setup for force output.

Does this need specific training?

Yes, leg strength is a key part of health for a myriad of reasons. These are the biggest muscles in the body so in terms of response to training and metabolic health leg training is key. Additionally maintaining bone mineral density in the lower body is a huge factor in health and wellness.

Leg strength work can be used in a way that it can improve grip strength and/or balance too, so this is a highly efficient and crucial part of training for health and longevity.

*Don’t forget to train the muscles of the lower leg or “calves”. These play a vital role in balance.

Pushups

Discerning readers may have joined the dots and already understand that these are a vital part of standing from a fallen position, which  is true. Additionally to this though, the research actually supports the use of a pushup test as a cardiovascular health risk stratifier.

The pushup is far from just a measure of relative strength, or indeed a ‘chest’ exercise as it is often thought of. It has components of core strength and stability, as well as shoulder girdle strength and control.

How is it measured?

Number of pushups in 1 minute is usually used. This may give insight into its use as a cardiovascular risk stratifier, it requires a certain level of “fitness” in addition to strength to sustain a high output for 1 minute as is required in this test.

Does this need specific training?

Pushups themselves are a great exercise whilst they represent a challenge. Beyond the ability to do 30 or so, they become less of a significant stimulus in training. Generalised strength in this movement pattern for example bench press, or even similar ones such as overhead press represent important training movements.

So yes, but perhaps not with pushups specifically once they are relatively easy for you.

Balance

An enormous factor in falls prevention but also in quality of life. With better balance, there is improved confidence and no concern on a variety of surfaces, in whatever footwear you choose to use.

How is it measured?

Usually time until balance is lost whilst standing on one leg. You would be surprised how short this may be  for some people.

Does this need specific training?

There are differing views on this, and some of this depends on your current ability. A well rounded strength training program with components of single leg strength training via single leg support is probably sufficient for those without a significant balance deficit already. Others may find something as simple as brushing your teeth on one leg enough (also harder than it sounds).

Walking Speed

This is probably more of an indication of loss of function. That is, faster speeds in your 30s isn’t that helpful, but reduced walking speed in our later years is a big red flag. It probably really represents the output of things like balance, fitness and strength combined in one metric.

The impact of this cannot be understated though, despite it being difficult to comprehend as someone who is years away from this. When walking speed is slow enough, things as seemingly innocuous as crossing the road before the light changes become a challenge.

How is it measured?

There are a variety of tests that can be used, but often the 6 minute walk test (yes, it is as it sounds) is what is used.

Does this need specific training?

Probably not specifically but a well designed program to aid in strength, balance and cardiovascular fitness in your youth will help avoid this being an issue.

Take Home Messages:

A properly structured exercise program that looks to at least maintain, but for many increase, levels of physical activity and strength is crucial for a long lifespan and healthspan. This program should include appropriate strength related activities which include balance components, for example single leg exercises. Additionally, whilst not mentioned in the research of this article, activities should be weight bearing and look to maintain bone mineral density too.

So get training, because as the popular Chinese proverb says: “The best time to plant a tree was 20 years ago. The second best time is now.”

References:

  1. Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging. 2019;14:1681-1691. Published 2019 Oct 1. doi:10.2147/CIA.S194543. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778477/
  2. Rantanen T, Harris T, Leveille SG, Visser M, Foley D, Masaki K, Guralnik JM. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci. 2000 Mar;55(3):M168-73. doi: 10.1093/gerona/55.3.m168. PMID: 10795731. https://pubmed.ncbi.nlm.nih.gov/10795731/
  3. Stenholm S, Tiainen K, Rantanen T, Sainio P, Heliövaara M, Impivaara O, Koskinen S. Long-term determinants of muscle strength decline: prospective evidence from the 22-year mini-Finland follow-up survey. J Am Geriatr Soc. 2012 Jan;60(1):77-85. doi: 10.1111/j.1532-5415.2011.03779.x. Epub 2011 Dec 28. PMID: 22211568. https://pubmed.ncbi.nlm.nih.gov/22211568/
  4. Ortega FB, Silventoinen K, Tynelius P, Rasmussen F. Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ. 2012 Nov 20;345:e7279. doi: 10.1136/bmj.e7279. PMID: 23169869; PMCID: PMC3502746. https://pubmed.ncbi.nlm.nih.gov/23169869/
  5. Anne B. Newman, Varant Kupelian, Marjolein Visser, Eleanor M. Simonsick, Bret H. Goodpaster, Stephen B. Kritchevsky, Frances A. Tylavsky, Susan M. Rubin, Tamara B. Harris, on Behalf of the Health, Aging and Body Composition Study Investigators, Strength, But Not Muscle Mass, Is Associated With Mortality in the Health, Aging and Body Composition Study Cohort, The Journals of Gerontology: Series A, Volume 61, Issue 1, January 2006, Pages 72–77, https://doi.org/10.1093/gerona/61.1.72
  6. Cooper R, Strand B H, Hardy R, Patel K V, Kuh D. Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study BMJ 2014; 348 :g2219 doi:10.1136/bmj.g2219. https://www.bmj.com/content/348/bmj.g2219/article-info
  7. Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, Brach J, Chandler J, Cawthon P, Connor EB, Nevitt M, Visser M, Kritchevsky S, Badinelli S, Harris T, Newman AB, Cauley J, Ferrucci L, Guralnik J. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. doi: 10.1001/jama.2010.1923. PMID: 21205966; PMCID: PMC3080184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080184/
  8. Yang J, Christophi CA, Farioli A, et al. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Netw Open. 2019;2(2):e188341. doi:10.1001/jamanetworkopen.2018.8341. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778
Dr. Frank Lipman, Chief Medical Officer at Hearty

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Written by
Dr. David Lipman

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