Doctors check blood pressure at nearly every visit. Very few check how hard you can squeeze. A large international study suggests that may be backward.
The study behind the claim
The Prospective Urban Rural Epidemiology study, known as PURE, enrolled adults ages 35 to 70 in 17 countries ranging from Canada and Sweden to India and Zimbabwe. Between 2003 and 2009, researchers measured grip strength in both hands with a handheld device called a dynamometer, along with the usual risk factors.
In 2015, Darryl Leong and colleagues at McMaster University reported on 139,691 participants1 followed for a median of four years. During that time, 3,379 of them died.
Lower grip strength tracked closely with worse outcomes. For every 5-kilogram decline in grip2, risk of death from any cause rose 16 percent. Cardiovascular death and non-cardiovascular death each rose 17 percent. Heart attack risk rose 7 percent and stroke risk 9 percent.
The associations held after the researchers accounted for age, education, employment, physical activity, smoking and alcohol use. They were similar in men and women and across age groups. And in a direct comparison, grip strength was a stronger predictor of death from any cause than systolic blood pressure.
The pattern was also remarkably consistent across very different settings. The link between grip and each major outcome looked much the same in high-income, middle-income and low-income countries. One exception stood out. In high-income countries, people with weaker grips were slightly less likely to be diagnosed with cancer, a finding the authors said needed further study.
Why a hand squeeze says so much
Grip strength on its own is not especially important. What it reflects is. It correlates well with strength in the legs and trunk, and with how much muscle a person has overall. That matters because muscle is not just for movement. It stores glucose, buffers the body during illness and supplies protein when the body is under stress.
The PURE data hint at this. People with stronger grips were less likely to die after they developed a serious illness such as a heart attack, stroke, cancer or pneumonia. Strength seemed to work as a reserve that helped people survive what came next.
What counts as weak
In 2019, the European Working Group on Sarcopenia in Older People revised its definition of sarcopenia, the progressive loss of muscle mass and function with age. Under that consensus3, grip strength below 27 kilograms in men or 16 kilograms in women signals probable sarcopenia and should prompt further testing.
Those cutoffs are set low on purpose, to identify clear weakness. Other researchers have argued that higher thresholds better predict risk of death. Either way, the more useful number for most people is their own trend. A grip that is dropping year over year is worth attention even if it is still above a cutoff.
How to get measured
Many physical therapists, sports medicine clinics and geriatric practices own a dynamometer, and the test takes about a minute. You sit with your elbow bent at a right angle and squeeze as hard as you can, usually three times with each hand, and the best result is recorded. Home dynamometers are inexpensive, but readings vary between devices, so compare yourself on the same one over time.
If you have a primary care visit coming up, it is reasonable to ask whether the office can measure it.
What to do with the result
The goal is not to build a stronger handshake. Squeezing a grip trainer may raise the number without changing the muscle mass the number is meant to reflect.
The better approach is whole-body resistance training two or more days a week. Carries are especially useful because they train grip along with the legs, back and core. Walking a set distance while holding a weight in each hand, which trainers call a farmer's carry, is simple and scalable. Rows, deadlifts done with good form, hanging from a bar and daily tasks such as carrying groceries all count.
Adequate protein matters too, particularly after 65, because training builds muscle only when the body has the raw material for it.
No study has shown that raising grip strength by itself extends life. But the evidence that strength protects older adults from falls, disability and loss of independence is broad and consistent. A minute with a dynamometer is a cheap way to find out where you stand.
