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PURPOSE: This study investigated the combined impact of low hand grip strength (HGS) and number of comorbidities on the risk of all-cause mortality in Korean middle-aged and older adults. METHODS: Data from the 2006 baseline and 2016 follow-up assessments of the Korean longitudinal study of aging (KLoSA) involving 9,270 Korean adults aged ≥45 years (55.6% women) were used in the study. Study participants were classified as zero, one, and two or more categories based on number of co-morbidities and as high, middle, and low categories based on HGS distributions. The Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of all-cause mortality according to HGS categories and number of comorbidities. RESULTS: During the 9.7±2.7 year follow-up period, 1,285 deaths from all causes occurred. In both middle and low HGS categories, one and two or more comorbidities resulted in an increased risk of all-cause mortality (HR=1.493; 95% CI=1.220-1.828; p<.001 and HR=1.427; 95% CI=1.190-1.711; p<.001, respectively) compared to no comorbidity (HR=1). Furthermore, the increased risks of all-cause mortality remained significant even after adjustments for a number of confounders such as age, sex, socio-economic status, and parameters of health behaviors and conditions. In high HGS category, there were no significant differences in the risk of all-cause mortality according to number of co-morbidities. CONCLUSIONS: The current finding suggested that promotion of upper body muscular strength may play an important role in preventing premature death from all causes, especially among those who suffer from co-morbidities.

The Combined Impact of Low Hand Grip Strength and Co-morbidity on the Risk of All-cause Mortality in Korean Middle-aged and Older Adults