Grip Strength: Why Your Handshake Predicts Your Lifespan
Grip strength is a simple, inexpensive marker of risk: in large cohort studies, weaker grip predicted higher all-cause and cardiovascular mortality.1,4
- In the PURE study of 139,691 adults in 17 countries, followed for a median of 4 years, each 5 kg lower grip strength was associated with 16% higher all-cause mortality, 17% higher cardiovascular mortality and 9% higher stroke risk, and grip strength predicted death better than systolic blood pressure.1
- Grip strength reflects overall muscle strength, and low muscle strength is the key feature of sarcopenia, the age-related loss of muscle.2
- In UK Biobank, grip strength below 26 kg in men and 16 kg in women was associated with higher risk for nearly all the health outcomes studied.4
- Resistance training is a powerful way to counter the loss of strength and muscle with age.3 Whether raising grip strength itself lowers mortality has not been tested.1
- Grip is measured with a handheld dynamometer; PURE used the Jamar model.1 Published norms let you see where you stand for your age and sex.
The PURE study, published in The Lancet in 2015, measured grip strength with a Jamar dynamometer in 139,691 adults aged 35 to 70 across 17 countries of differing incomes. Over a median of 4 years, 3,379 died. Each 5 kg lower grip strength was associated with a 16% higher risk of death from any cause and 17% higher cardiovascular mortality, and grip strength was a stronger predictor of all-cause and cardiovascular death than systolic blood pressure.1 You can compare your own grip strength, chair-stand time and walking speed with published norms using our functional fitness norms calculator.
Other large studies agree. In UK Biobank, among 502,293 adults aged 40 to 69, each 5 kg lower grip strength was linked to higher mortality from all causes, cardiovascular disease, respiratory disease and cancer, in both women and men.4 Grip strength does not predict everything, though: PURE found no association with diabetes, falls or fractures, and in high-income countries weaker grip went with slightly lower cancer risk.1
Why Grip Strength Predicts Mortality
Grip strength does not matter for survival in itself; it is a marker of overall muscle strength. The European consensus on sarcopenia makes low muscle strength the key feature of the condition, confirmed by low muscle quantity or quality, with poor physical performance marking severe sarcopenia.2
Several explanations are plausible. Muscle is the body’s main protein reserve during illness or surgery, strength depends on healthy nerves as well as muscle, and chronic inflammation and inactivity erode both, contributing to sarcopenia. Grip strength may capture all of these at once, but the studies above show association, not cause.
Reference Values and Weak-Grip Cut-offs
The largest normative study pooled 60,803 measurements from 49,964 people in 12 British studies. Grip strength rises to a peak in early adulthood, holds through midlife and declines after that. Median peak grip was 51 kg in men (ages 29 to 39) and 31 kg in women (ages 26 to 42). Weak grip, defined as at least 2.5 standard deviations below the peak average, affected 23% of men and 27% of women by age 80.5
Studies use slightly different cut-offs for weak grip; UK Biobank used below 26 kg for men and 16 kg for women.4
How to Improve Grip Strength
Resistance training is a powerful way to counter the loss of strength and muscle with age.3 Exercises that load the hands and forearms, such as deadlifts, farmer’s carries, rows and pull-ups, train grip directly, and grip responds to gradually increasing load like any other muscle quality.
Any progressive strength program will help grip, and carries and hangs give it extra work. Whether a stronger grip itself extends life has not been tested: the PURE authors called for trials of whether improving strength reduces mortality.1
Put this research into practice: Biological Age Calculator
References
- 1Leong DP, et al. "Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study." Lancet. 2015;386(9990):266-73. PubMed · DOI
- 2Cruz-Jentoft AJ, et al. "Sarcopenia: revised European consensus on definition and diagnosis." Age Ageing. 2019;48(1):16-31. PubMed · DOI
- 3Fragala MS, et al. "Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association." J Strength Cond Res. 2019;33(8):2019-2052. PubMed · DOI
- 4Celis-Morales CA, et al. "Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants." BMJ. 2018;361:k1651. PubMed · DOI
- 5Dodds RM, et al. "Grip strength across the life course: normative data from twelve British studies." PLoS One. 2014;9(12):e113637. PubMed · DOI
