Exercise
Grip Strength and Longevity: Does a Stronger Grip Mean a Longer Life?
Weaker grip predicts a higher risk of dying in large studies. It's a useful health signal, not proof that stronger hands alone help you live longer.
A grip test is about as low-tech as medicine gets: a handle, a gauge and a few seconds of squeezing as hard as you can. Humanic Blue’s question is what researchers have learned that one number can—and cannot—predict.
Grip strength and longevity are consistently linked in large observational studies. People with a weaker grip are more likely to die during the years they’re followed, and the link holds across dozens of countries. But grip can’t tell one person how long they’ll live, and no trial has tested whether squeezing a hand exerciser extends lifespan. Researchers use grip because it’s a quick, cheap window into broader muscle and nervous-system health.
For anyone interested in living longer and better, the useful part is the signal. A low or falling result is a reason to look more closely at overall strength, mobility, nutrition, illness and activity. It isn’t a grade, and clinical cutoffs aren’t universal “longevity scores.”
In This Article
- Why a hand test says something about the whole body
- Weaker grip predicts a higher risk of dying, in study after study
- Predicting an outcome isn’t the same as causing it
- The sarcopenia cutoffs, and why different groups disagree
- How to test so the number means something
- What to train, beyond the hands
- The studies and numbers behind all of this
Key Takeaways
- Lower grip strength is consistently linked with a higher risk of dying from any cause and from heart disease in observational studies, which track people without assigning an intervention.
- Grip can signal broader physical capacity. Nobody has shown that a stronger grip itself causes a longer life.
- Clinical grip cutoffs flag possible sarcopenia, a muscle disorder involving low strength and low muscle quantity or quality. They differ between expert groups and cannot diagnose it on their own.
- Whether training the hands alone helps people live longer has not been tested.
- Whole-body muscle strengthening is part of US activity guidance for older adults.
What does a grip-strength test measure?
The NIH Toolbox, a set of standardized tests developed for the National Institutes of Health, describes its grip test simply: participants “squeeze a hand dynamometer as hard as they can, one hand at a time.” A dynamometer is the device that measures that squeezing force, in pounds on the Toolbox’s digital model and in kilograms in the mortality studies below.
Why would a hand say anything about the rest of the body? The European Working Group on Sarcopenia in Older People explains that grip correlates moderately with strength elsewhere in the body, which makes it a reliable stand-in for more complicated measures of arm and leg strength. The team that built the Toolbox’s motor tests, led by UCLA geriatrician David Reuben, adds a caveat: that link with leg strength weakens with age and possibly with neurologic problems.
Grip isn’t only muscle, either. The National Institute on Aging notes that grip “also can weaken due to age-related changes in parts of the brain that coordinate movement.” That breadth is why grip works as a signal. It’s also why a low result cannot identify one particular cause.
Weaker grip, higher risk of dying
The Prospective Urban Rural Epidemiology (PURE) study, led by Darryl Leong at McMaster University’s Population Health Research Institute, followed nearly 140,000 adults aged 35 to 70 in 17 countries for a median of four years. Comparing people whose grip strength differed by 5 kilograms, the lower-grip group had about a 16% higher rate of dying from any cause, and about a 17% higher rate of dying from heart disease, after accounting for age, education, diet, smoking and existing illness. This compares people with different grip strengths; it does not measure the effect of one person losing 5 kilograms of grip (PURE, The Lancet). (Note 1)
Weaker grip also went with slightly more heart attacks and strokes. In the researchers’ analysis, grip predicted death better than systolic blood pressure—the top number in a blood-pressure reading—did. It didn’t predict diabetes, falls or fractures, and in high-income countries stronger grip went with a slightly higher cancer risk. See the PURE numbers
A later analysis pooled 48 studies of more than 3.1 million adults aged 35 to 85. The team, led by Rubén López-Bueno of the University of Zaragoza and the University of Valencia, rated the evidence as strong for a link between lower grip with higher death rates from any cause, from cancer and from heart disease. The shape of that link varied by cause of death (Ageing Research Reviews). (Note 2)
Does a weak grip cause shorter life?
These studies make grip strength a credible risk marker. They don’t show that a weak grip causes death. Chronic disease can sap strength; low activity can affect both strength and health; education, work, nutrition and body size can shape the result. In PURE, stronger grip went with more physical activity, higher education, more calories and protein, and greater height and weight. Researchers adjust for many of those factors, but observational analysis can’t remove all of them.
The PURE investigators wrote that more research is needed to test whether getting stronger actually lowers mortality and cardiovascular disease. That’s a different question from whether strength predicts mortality.
Four claims often get blended together:
- Lower grip predicts a higher risk of dying. The link remains across groups even after researchers account for other measured risk factors.
- Low grip can help flag possible sarcopenia. The European working group uses it as an initial assessment step, not the full diagnosis.
- Whole-body strength training is part of US activity guidance for older adults. That guidance concerns broader function, rather than a grip target for longer life.
- Training grip alone helps people live longer. This claim has not been tested in a trial.
Improving a predictor isn’t automatically the same as changing the outcome it predicts. A dynamometer reading is more like a dashboard light than a replacement part: it can show that something deserves attention without naming the cause.
What would distinguish grip strength as a health signal from grip strength as a cause of longer life?
Clinical cutoffs are screens, not grades
The European Working Group on Sarcopenia in Older People puts low muscle strength at the start of its diagnostic pathway. Its 2019 consensus, EWGSOP2, led by geriatrician Alfonso Cruz-Jentoft of Ramón y Cajal University Hospital in Madrid, uses grip below 27 kilograms for men and below 16 kilograms for women as the signal for probable sarcopenia (EWGSOP2 consensus). Confirming sarcopenia takes evidence of low muscle quantity or quality; adding poor physical performance makes it severe. The group’s meetings were funded by a grant from Abbott, and several authors, including Cruz-Jentoft, reported fees or advisory roles with nutrition companies. (Note 3)
Those numbers come from British reference data, set well below the average for young adults. Other expert groups use different lines: the Asian Working Group for Sarcopenia’s 2019 update uses 28 and 18 kilograms. A 2024 opinion article in Frontiers in Medicine by Arben Boshnjaku and Ermira Krasniqi, researchers in Kosovo, compared these approaches (2024 guideline comparison). It points to a University of Glasgow review in which estimated sarcopenia rates ran from about 10% to 27% depending on the definition used. See the cutoffs side by side
A person slightly above 27 or 16 kilograms hasn’t crossed into guaranteed health. A person below a threshold hasn’t received a prognosis. The EWGSOP2 authors write that an accurate reading depends on a calibrated handheld dynamometer, clearly defined test conditions and reference data from a suitable comparison population.
Population averages and clinical cutoffs answer different questions. Averages show how a result compares with similar people; cutoffs ask whether it’s low enough to prompt a closer look. Neither is a target shown to help people live longer.
What context does a low-grip screen need before it becomes a clinical interpretation?
Test position can move the number
The NIH Toolbox protocol, as published in the NIH research data dictionary, seats the person with feet on the floor, elbow bent to 90 degrees, arm against the trunk and wrist in a neutral position. They squeeze for a count of three: one practice try at less than full force, then one test trial with each hand. PURE did it differently, taking three measurements per hand and keeping the highest. Protocols vary, and each choice can nudge the number.
For tracking at home, consistency matters more than finding the most flattering posture. Use the same device, handle setting, arm position, warm-up and scoring method. Recent hard exercise, hand pain, injury, fatigue and motivation can all affect a single session.
EWGSOP2 describes the Jamar dynamometer as validated and widely used, and says other brands are still being explored. A reading from a home model may not match a clinic’s device. Trend data can still be useful if the setup stays the same, but a surprising or persistently low result is worth confirming with a professional.
Can a grip test explain why strength changed?
A falling result can accompany less activity or poorer nutrition, the factors PURE linked with weaker grip. It can also come from the hand itself. EWGSOP2 notes that hand problems such as advanced arthritis or stroke can make the test impossible, and the NHS lists a weak thumb or difficulty gripping among the symptoms of carpal tunnel syndrome. The grip test can’t sort those possibilities.
Grip also tracks with thinking skills. An NIA-funded study of nearly 14,000 adults aged 50 and older, led by Ryan McGrath at North Dakota State University, found that weaker grip went with higher odds of cognitive impairment. The NIA described grip as a potential low-cost aid for detecting impairment, alongside other measures, and the researchers said it would first need validating as a diagnostic tool. (Note 4)
Some changes are urgent. The CDC lists sudden numbness or weakness in the face, arm or leg, “especially on one side of the body,” among the signs of stroke and says to call 9-1-1 right away. Gradual decline alongside unintended weight loss, falls, slower walking or trouble rising from a chair is worth raising with a clinician, rather than answering with a harder grip routine.
Training the body behind the number
The CDC’s guidance for adults 65 and older calls for aerobic activity, balance work and muscle-strengthening activity on at least 2 days a week that works all major muscle groups: “legs, hips, back, abdomen, chest, shoulders, and arms.” The CDC says activity “helps your muscles grow stronger so you can keep doing your day-to-day activities without becoming dependent on others.”
Carrying, rowing, pulling and lifting challenge grip while also working the legs, hips, back and shoulders. The mortality studies did not test hand grippers as a longevity treatment. A rehabilitation question about a particular hand limitation is different from a claim about longer life.
For someone with pain, recent surgery, neurologic symptoms or a large side-to-side difference, a physical or occupational therapist can work out whether the limit is strength, joint motion, sensation or nerve function. That distinction shapes what kind of training fits.
What’s Interesting
Grip strength became a research favorite partly because it’s so ordinary. The NIH Toolbox’s designers wrote that its “requirements for portability and low cost” justified picking a single strength measure, and grip was it.
A test you could run at a kitchen table ended up in studies of millions of people. The hand is only the measuring site, though. The signal comes from a much larger system, which is exactly what makes it both useful and hard to interpret.
What This Means in Practice
The European working group’s diagnostic pathway puts low grip alongside other information: muscle quantity or quality and physical performance. Walking speed, getting up from a chair and changes in daily tasks describe abilities that a hand squeeze alone cannot capture. Recent falls, activity changes and weight loss also give a clinician context for investigating a decline.
The research describes averages across many thousands of people. Your own number sits inside your own health history, hand size, joints and body, so the same reading can mean different things for different people.
If you’re tracking at home, standardize the setup and watch the trend rather than reacting to a few pounds of variation. A primary-care clinician can look into medical and nutritional causes; a physical or occupational therapist can assess movement and build a progressive plan.
Grip is one piece of the larger strength-and-function picture in Why Muscle Matters for Longevity.
Bottom Line
In large populations, weaker grip goes with a higher risk of dying, but it can’t forecast one person’s lifespan. What remains unknown is whether raising grip strength by itself changes that risk; no trial has tested it. A lower or declining result is a reason to look at whole-body strength and health, with a clinician or therapist where needed. For living longer and better, the test’s value is that it can make a loss of physical capacity visible early enough to investigate.
A NOTE FROM LONGEVITY365
We read research, consult expert perspectives and work to make complicated health information easier to understand. What you’re reading here reflects how we’ve interpreted and organized that information. It is educational content—not personal medical advice, diagnosis or treatment guidance.
We’re not perfect, and neither is the available research. Evidence changes, new studies emerge and what’s appropriate for one person may not be appropriate for another.
Use this article as a starting point for your own research and conversations with qualified professionals. Always talk with your doctor or another trusted healthcare professional before making decisions that could affect your health, particularly if you take medications, are receiving treatment, have existing health conditions, are pregnant or have other circumstances that could affect what’s appropriate for you.
Reader Questions
A few questions to carry into the comments or your next conversation. Please leave out identifying or personal medical details.
- 01Which measurement or milestone would feel useful to track without letting it take over the whole point of moving?
- 02Which real-world barrier did the article address most usefully: time, confidence, access, recovery, or knowing where to start?
- 03What question would you bring to a clinician, physical therapist, trainer, or exercise professional after reading about Grip Strength and Longevity: Does a Stronger Grip Mean a Longer Life?
Extra Insights & Sources
For readers who want the details behind each claim above.
What We Know
- Lower grip strength predicts higher all-cause and cardiovascular mortality across large, diverse cohorts. Supported (observational).
- Grip strength is an accepted case-finding measure for probable sarcopenia. Guideline-supported.
- Results depend on protocol, device and population, so a standardized method is needed for useful comparison. Established measurement principle.
- Muscle-strengthening activity for all major muscle groups on at least 2 days a week is part of CDC guidance for adults 65 and older. Guideline-supported.
What We Don’t Know
- Whether deliberately increasing grip strength reduces mortality, independent of improving whole-body health. Unknown.
- One universal grip target that maximizes lifespan for every age, sex and body size. None has been identified. Unsupported.
- How big a change on a home device must be before it reflects a real change in the body rather than device or testing variation. Unknown; device- and protocol-dependent.
The PURE study in detail
A hazard ratio (HR) compares event rates over follow-up: 1.16 means a 16% higher relative rate, not 16 extra deaths per 100 people. A 95% confidence interval (CI) describes the range of estimates compatible with the data under the analysis. These are group associations, not individual predictions.
Between January 2003 and December 2009, PURE enrolled 142,861 participants from households in 17 countries of varying incomes; 139,691 with known vital status were analyzed. Grip was measured with a Jamar dynamometer. During a median follow-up of 4.0 years, 3,379 participants (2%) died.
For a 5-kg lower grip strength when comparing different people, adjusted hazard ratios were 1.16 (95% CI 1.13–1.20) for all-cause mortality, 1.17 (1.11–1.24) for cardiovascular mortality, 1.17 (1.12–1.21) for non-cardiovascular mortality, 1.07 (1.02–1.11) for heart attack (myocardial infarction) and 1.09 (1.05–1.15) for stroke. There was no significant association with new diabetes, hospital admission for pneumonia or chronic obstructive pulmonary disease (COPD), injury from a fall, or fracture. In high-income countries, the reported cancer ratio was 0.916 (95% CI 0.880–0.953) per 5-kg lower grip. Because this ratio compares lower grip with higher grip, the value below 1 means lower grip went with a lower cancer rate—the same direction as saying stronger grip went with higher cancer risk. That association was not found in middle- and low-income countries; it does not show that grip strength caused cancer.
The model adjusted for age, sex, country income level, education, employment, tobacco and alcohol use, dietary energy and protein intake, diabetes, heart failure, coronary artery disease, COPD, prior stroke, prior cancer, body-mass index and waist-to-hip ratio. A standard deviation expresses a change relative to the spread of results in the study. Per standard-deviation reduction, grip predicted death more strongly (HR 1.37, 1.28–1.47) than systolic blood pressure did (1.15, 1.10–1.21).
The authors concluded that measuring grip strength is a simple, inexpensive way to sort people into risk groups of all-cause death, cardiovascular death and cardiovascular disease. They called for further research to identify what determines muscular strength and to test whether improving strength reduces mortality and cardiovascular disease.
The dose-response meta-analysis in detail
López-Bueno and colleagues searched PubMed/MEDLINE, Web of Science and Scopus to February 8, 2022, for prospective cohort studies of healthy adults with objectively measured grip. They included 48 studies with 3,135,473 participants (49.6% women, aged 35 to 85). I² describes how much results varied between studies beyond chance; higher values indicate greater inconsistency. Higher grip was associated with lower all-cause mortality between 26 and 50 kg in a close-to-linear pattern (I² 45.7%), meaning death rates tended to fall steadily as grip increased across that range. Cancer mortality trended toward a U-shaped association, with lower risk in the middle range of 16 to 33 kg (I² 77.4%); cardiovascular mortality showed a close-to-linear inverse pattern between 24 and 40 kg (I² 79.7%). The authors concluded that the evidence is strong for an association between lower handgrip strength and higher risk of death from any cause, from cancer and from cardiovascular disease. The included studies were observational, so the pooled results describe association, not the effect of changing grip.
EWGSOP2 and the other cutoffs
EWGSOP2 (Age and Ageing, 2019) identifies probable sarcopenia by low muscle strength, confirms it with low muscle quantity or quality, and calls it severe when low physical performance is also present. Its grip cutoffs (below 27 kg for men and 16 kg for women) are drawn from British normative data (Dodds and colleagues, 2014), set at a T-score of −2.5 or lower: at least 2.5 standard deviations below the young-adult reference average. Its other low-strength cutoff is a chair-stand time over 15 seconds for five rises; a gait speed of 0.8 m/s or slower indicates severe sarcopenia. The paper advises grip strength for routine use in hospital, specialty and community settings. Where grip can’t be measured because of hand disability, it suggests leg-strength methods instead.
Grip cutoffs used by several expert groups, as compiled in Table 1 of Boshnjaku and Krasniqi’s 2024 article (Note 5):
| Group | Men | Women |
|---|---|---|
| EWGSOP (2010) | below 30 kg | below 20 kg |
| EWGSOP2 (2019) | below 27 kg | below 16 kg |
| Foundation for the NIH (FNIH) | below 26 kg | below 16 kg |
| Asian Working Group for Sarcopenia (AWGS) | below 26 kg | below 18 kg |
| AWGS 2019 update | below 28 kg | below 18 kg |
The global review they cite, led by Fanny Petermann-Rocha at the University of Glasgow (Journal of Cachexia, Sarcopenia and Muscle, 2022), included 263 studies in its narrative synthesis and 151 in its meta-analysis (692,056 people, mean age 68.5). Sarcopenia prevalence ranged from 10% to 27% across classifications and cut-off points, and severe sarcopenia from 2% to 9%. Men had higher prevalence under EWGSOP2 (11% vs. 2%). Across all diagnostic approaches, Boshnjaku and Krasniqi note reported ranges from 0.2% to 86.5%. (Note 6)
Grip and cognition in detail
McGrath and colleagues (Journal of Alzheimer’s Disease, 2019) analyzed 13,828 participants aged 50 and older from the 2006 wave of the Health and Retirement Study, followed every two years for eight years. Every 5-kg lower handgrip strength was associated with odds ratios of 1.10 (95% CI 1.04–1.15) for any cognitive impairment and 1.18 (1.04–1.32) for severe impairment. That is 10% and 18% higher odds, respectively; odds compare the chance of an outcome with the chance of its absence and are not the same as absolute risk. The NIA’s summary reported that 1,309 participants had some degree of cognitive impairment. It said the findings “suggest that handgrip strength may be a potential low-cost, easy way to help detect cognitive impairment and, in combination with other measures, to identify people who may benefit from early interventions.” The NIA also noted that grip “could be an easy test used by doctors to help distinguish cognitive dysfunction from normal age-related decline” if validated. (Note 4)
How the NIH Toolbox test works
The NIH Toolbox grip test is adapted from the grip-testing protocol of the American Society of Hand Therapy (as the NIH data dictionary names it), uses the Jamar Plus+ Digital Hand Dynamometer, takes about three minutes and is listed for ages 3 and up. In the Toolbox’s validation work, Reuben and colleagues (Neurology, 2013) found that grip and knee-extension strength “reflect a common underlying construct” in healthy individuals, but that “the correlation between grip and knee-extension strength decreases with age and possibly in the presence of neurologic impairments.” For that reason, the team added a portable knee-extension strength measure. (Note 7)
Sources
- NIH Toolbox: Grip Strength Test
- NIH research data dictionary (FITBIR): NIH Toolbox Motor Domain Grip Strength Test
- Reuben DB, et al. Motor assessment using the NIH Toolbox, Neurology, 2013: PMC3662336
- Leong DP, et al. PURE grip strength study, The Lancet, 2015: PubMed 25982160
- López-Bueno R, et al. Handgrip dose-response meta-analysis, Ageing Research Reviews, 2022: PubMed 36332759
- Cruz-Jentoft AJ, et al. EWGSOP2 consensus, Age and Ageing, 2019: PMC6322506
- Boshnjaku A, Krasniqi E. International guidelines vs. population-specific cutoffs, Frontiers in Medicine, 2024: PMC11310033
- Petermann-Rocha F, et al. Global prevalence of sarcopenia, Journal of Cachexia, Sarcopenia and Muscle, 2022: PubMed 34816624
- McGrath R, et al. Handgrip strength and cognitive functioning, Journal of Alzheimer’s Disease, 2019: PubMed 31322562
- National Institute on Aging: Lower handgrip strength associated with cognitive impairment (November 21, 2019)
- Centers for Disease Control and Prevention: Older Adult Activity: An Overview (updated December 4, 2025)
- Centers for Disease Control and Prevention: Signs and Symptoms of Stroke
- NHS: Carpal tunnel syndrome (page last reviewed April 17, 2024)
Notes
Note 1: Funded by the Population Health Research Institute, the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Ontario, with unrestricted grants from AstraZeneca, Sanofi-Aventis, Boehringer Ingelheim, Servier, GlaxoSmithKline, Novartis and King Pharma, and national and local organizations in participating countries. The paper states the funders had no role in the study, and the authors declared no competing interests.
Note 2: Authors were supported by the European Union (NextGeneration EU), Chile’s National Research and Development Agency and the Government of Andalusia. The paper states these funders had no role in the study.
Note 3: The European Geriatric Medicine Society received a grant from Abbott to fund the working group’s operations and two meetings. The paper states Abbott had no role in choosing members or preparing the manuscript but could send observers to the meetings, and that members were not paid. Authors’ declared ties include speaker fees and advisory-board roles with Abbott Nutrition, Nestlé and Nutricia (Alfonso Cruz-Jentoft) and research grants or lectures with Nestlé, Nutricia, Fresenius Kabi and Abbott (Tommy Cederholm), among others listed in the paper.
Note 4: Funded in part by National Institute on Aging grant R01AG044424 and by North Dakota State University. Co-author Brian Clark disclosed consulting fees from Regeneron Pharmaceuticals, Abbott Laboratories and the Gerson Lehrman Group, and equity in AEIOU Scientific; the other authors reported nothing to disclose.
Note 5: Cutoffs other than EWGSOP2’s come from a published summary, not the groups’ official reports: Table 1 of Boshnjaku and Krasniqi’s 2024 article in Frontiers in Medicine. The authors reported no financial support for that article.
Note 6: Funded through Chilean government doctoral support for the first author (ANID-Becas Chile); the authors declared no conflicts of interest.
Note 7: Funded with federal funds from the NIH Blueprint for Neuroscience Research and the Office of Behavioral and Social Sciences Research, NIH contract HHS-N-260-2006-00007-C.
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