How should we express grip strength when predicting health outcomes?

Drs Stuart Gray @DrStuGray, Carlos Celis @carloscelism, Fred Ho and Mrs Fanny Petermann @Fanny_Petermann are researchers in the Institute of Cardiovascular and Medical Sciences and the Institute of Health and Wellbeing at the University of Glasgow. Here they discuss their Age and Ageing paper The association between handgrip strength and future health outcomes does not differ if grip strength is used in absolute or relative terms.

Did you know that your hand grip strength can be used to predict future health outcomes? Well, it can! Our recent study provides good evidence that lower grip strength is closely associated with an increase in risk of dying early, some cancers, heart and lung diseases. However, as grip strength is also affected by a wide range of factors including age, gender, and body size, we still don’t know which is the best way to use grip strength to predict health outcomes.

In our study, we investigated different ways to express grip strength and whether this altered its associations with mortality and disease risk. This research was carried out using data from the UK Biobank study and was able to include ~355,000 participants, aged 40-69 years, who were healthy at baseline. These participants were followed up for around five years and mortality and diseases outcomes recorded via linkage to health records.

Our study provides evidence that those with lower grip strength have up to 3-times higher risk of dying early and up to 2-times higher risk of developing heart disease, compared to individuals with normal grip strength (23 kg and 39kg of grip strength for women and men, respectively). We found that the relationship between grip strength and these health outcomes was not different comparing its expression in absolute terms (kg) or relative to height (cm), weight (kg), fat-free mass (kg), BMI (kg/m2), fat-free mass index (kg/m2) or using age- and gender-specific scoring systems. Not only were the patterns of the association similar when grip strength was expressed differently, but the predictive ability, was also very similar.

Our study provides strong evidence that the measurement of grip strength may have a useful role in predicting elevated higher risk of poorer subsequent health outcomes, even when just using grip strength. Such findings may make measuring and interpreting grip strength values easier to use in the clinical setting.  

Read the Age and Ageing paper here:


Great to see use of linked data and UK Biobank.  Interesting summary.  Surprised no reference to frailty given grip strength’s association with phenotypic model of frailty. Can the equivalent analysis be done for gait speed?

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