handgrip strength and mortality

Last edited 08/2023 and last reviewed 11/2023

Handgrip strength and mortality

Muscular strength, as assessed by handgrip strength, is a common way to test simple muscle function and is an excellent indication of decline in physical function and biological aging (1)

  • handgrip strength, frequently used to evaluate muscle strength, reflects the strength of the whole body
  • handgrip strenght has the advantage of being simple and safe to assess in older individuals

Kim et al undertook a study which investigated the prospective association between level of handgrip strength and the risk of all-cause and premature mortality in a general population of Korean middle-aged and older adults using data from a national cohort study over 10 years:

  • muscular strength was measured using handgrip strength
  • muscle weakness was defined using the sex-specific handgrip strength index based on the Asian Working Group on Sarcopenia in Older People (AWGSOP)
  • primary outcome was all-cause and premature mortality assessed based on the death certificate
  • findings:
    • hazard ratio (HR) for all-cause mortality was negatively associated with level of handgrip strength independent of potential confounding factors (HR: 2.06, 95% confidence interval [CI]: 1.62-2.63 for lowest quartile vs. highest quartile)
    • when examined using muscle weakness defined using the AWGSOP diagnosis, the mortality was 1.56 times higher in the weak group (HR: 1.56, 95% CI: 1.36-1.78)
      • also found that risk of premature mortality was observed in the lowest quartile (HR: 2.34, 95% CI: 1.80-3.05) and the muscle weakness group (HR: 1.80, 95% CI: 1.52-2.13) in the fully adjusted model
  • study authors concluded:
    • showed that handgrip strength and muscle weakness are strongly associated with an increased risk of all-cause and premature mortality in healthy middle-aged and older adults

A narrative review stated (2)

  • is adequate evidence to support the use of grip strength as an explanatory or predictive biomarker of specific outcomes such as generalized strength and function, bone mineral density, fractures, and falls, nutritional status, disease status and comorbidity load, cognition, depression, and sleep, hospital-related variables, and mortality

Handgrip and knee extension tests in adolescents and mortality

Study investigating measures of baseline examinations of knee extension, handgrip, and elbow flexion strength tests, as well as measures of diastolic and systolic blood pressure and body mass index - and then follow up these patients for a period of 24 years

  • 1,142,599 Swedish male adolescents aged 16-19 years were followed over a period of 24 years
  • findings:
    • 1)muscular strength in adolescence, as assessed by handgrip and knee extension tests, is strongly associated with premature death from any cause, independently of body mass index or diastolic blood pressure
      • effect sizes of these associations are similar to those of classic risk factors such as body mass index and blood pressure
    • 2) muscular strength is also associated with premature death from cardiovascular disease, independently of body mass index and blood pressure
    • 3) stronger adolescents have a lower risk of mortality due to suicide, whereas no association is apparent with mortality due to cancer.

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