Grip Strength and How Long You Will Live
How hard you can squeeze predicts your risk of death better than blood pressure in some studies. Here is what grip strength reveals and how to improve it.
Picture a hospital clinic for older patients. A nurse hands a man in his seventies a small device that looks like a heavy stapler with a dial on top. "Squeeze it as hard as you can," she says. He grips, his knuckles whiten, the needle swings round and stops at 24 kilograms. She writes it down, resets the dial, and asks him to do it twice more with each hand.
It takes less than two minutes. No needles, no scans, no blood tests. Yet that one number, how hard he can squeeze, says something real about how long he is likely to live. In large studies, grip strength has turned out to be one of the simplest and most reliable predictors of death that medicine has.
Around 62 million people die worldwide each year, as our live death counter shows in real time. Most of those deaths happen in later life, and a striking share of them are foreshadowed years earlier by a gradual loss of muscle. This article looks at why.
The headline study
The landmark paper was published in The Lancet in 2015 by Darryl Leong and colleagues, as part of the Prospective Urban Rural Epidemiology (PURE) study. It measured the grip strength of nearly 140,000 adults aged 35 to 70 in 17 countries, from Canada and Sweden to India, Bangladesh and Zimbabwe, and followed them for a median of four years.
| Outcome | Change in risk for every 5 kg lower grip strength |
|---|---|
| Death from any cause | About 16% higher |
| Death from cardiovascular disease | About 17% higher |
| Death from other causes (non-cardiovascular) | About 17% higher |
| Heart attack | About 7% higher |
| Stroke | About 9% higher |
The most quoted finding was that grip strength predicted death from any cause, and death from heart disease, more strongly than systolic blood pressure did. Blood pressure is one of the most measured numbers in medicine. Grip strength is rarely measured at all outside research and specialist clinics.
The pattern held in rich and poor countries alike, which matters. It suggests grip strength is picking up something fundamental about the body, not simply reflecting wealth or access to healthcare.
The UK Biobank confirms it
In 2018, Carlos Celis-Morales and colleagues at the University of Glasgow published a study in the BMJ using data from around 500,000 UK adults in the UK Biobank. They found that lower grip strength was linked to higher risk of death from all causes, heart disease, respiratory disease and several cancers, in both men and women, and across ages from 40 to 69.
| Study | Who | Main finding |
|---|---|---|
| Rantanen et al., JAMA 1999 | About 6,000 Japanese-American men in Hawaii | Midlife grip predicted disability 25 years later |
| Leong et al., Lancet 2015 (PURE) | About 140,000 adults, 17 countries | Each 5 kg lower grip linked to about 16% higher death risk |
| Celis-Morales et al., BMJ 2018 | About 500,000 UK adults | Weaker grip linked to higher death from heart, lung disease and cancer |
| Momma et al., BJSM 2022 | Meta-analysis of muscle-strengthening studies | 30 to 60 minutes a week linked to roughly 10 to 20% lower death risk |
The Honolulu study is particularly interesting because of the time span. Men whose grip was measured in middle age, when most were healthy, were more likely to become disabled a quarter of a century later if their grip had been weak. Grip strength seems to be an early warning signal, not just a sign of illness that has already arrived.
Why would a handshake predict death?
Nobody thinks weak hands kill people directly. Grip strength matters because it acts as a window onto the whole body.
| What grip strength reflects | Why it matters for survival |
|---|---|
| Total muscle mass and strength | Muscle is a reserve the body draws on during illness |
| Overall physical activity | Active people keep their strength for longer |
| Nutrition | Poor diet and weight loss reduce strength early |
| Hidden illness | Heart failure, lung disease and cancer all sap strength |
| Inflammation | Chronic inflammation breaks down muscle |
| Nerve and brain health | Grip relies on signals from the brain |
Muscle is not only for movement. It is the body's largest store of protein and one of its main sites for handling blood sugar. When someone becomes seriously ill, after a fall, an infection, surgery or a hospital stay, they lose muscle fast. People who start with more muscle have more to lose before they become frail. Most of the people behind the live death counter are older adults for whom that reserve ran out. That is one reason weak grip predicts death from conditions as different as pneumonia and heart disease.
What counts as a strong grip
Grip strength rises through early adulthood, peaks around the age of 30 to 40, and then declines slowly, faster after 60. A large British study by Richard Dodds and colleagues, published in PLOS ONE in 2014, combined data from 12 UK studies to create reference values across life.
| Age | Typical grip, men (kg) | Typical grip, women (kg) |
|---|---|---|
| 20 to 29 | About 45 to 50 | About 28 to 30 |
| 30 to 39 | About 48 to 51 | About 29 to 31 |
| 40 to 49 | About 46 to 49 | About 28 to 30 |
| 50 to 59 | About 42 to 45 | About 25 to 27 |
| 60 to 69 | About 37 to 41 | About 22 to 25 |
| 70 to 79 | About 32 to 35 | About 19 to 21 |
| 80+ | About 26 to 30 | About 16 to 18 |
These are approximate middle values, measured with a hand dynamometer using the stronger hand. There is a wide spread around them. What matters most is not hitting an exact number but where you sit relative to people your age, and whether your strength is falling faster than it should.
When weak grip becomes a medical problem
Doctors use grip strength to help diagnose sarcopenia, the loss of muscle mass and strength with age. The European Working Group on Sarcopenia in Older People updated its definition in 2019 and made low muscle strength the main starting point, with grip strength the recommended test.
| Measure | Threshold for low strength (EWGSOP2, 2019) |
|---|---|
| Grip strength, men | Under 27 kg |
| Grip strength, women | Under 16 kg |
| Chair stand test | More than 15 seconds for five rises |
Sarcopenia is common. Estimates vary widely depending on the definition used, but a meaningful share of people over 65 meet the criteria, and the proportion is much higher in care homes and hospital wards. It is linked to falls, fractures, loss of independence and death. Falls alone are one of the leading causes of injury death in older people, as our sibling article on how many people die from falls every day sets out.
The sitting-rising test
Grip strength is not the only quick test of this kind. Brazilian researcher Claudio Gil Araújo developed the sitting-rising test, in which you sit on the floor cross-legged and stand back up using as little support as possible. You start with 10 points and lose a point each time you use a hand, knee or forearm for support.
In a study of more than 2,000 adults aged 51 to 80, published in the European Journal of Preventive Cardiology in 2012, people with the lowest scores had a death risk several times higher than those with the highest scores over about six years of follow-up. Like grip, the test captures strength, flexibility and balance in one simple measure.
Can you change your number?
This is the encouraging part. Unlike your genes or your age, strength responds to training at almost any age. Studies of people in their eighties and nineties have shown meaningful gains in strength after just a few months of supervised resistance exercise.
What remains less certain is whether raising your grip strength lowers your risk of death to the same extent that a naturally strong grip predicts it. Grip is a marker, and improving the marker without improving the underlying health would not help. But the evidence on strength training itself is encouraging. A 2022 meta-analysis led by Haruki Momma in the British Journal of Sports Medicine found that 30 to 60 minutes a week of muscle-strengthening activity was linked to a roughly 10 to 20% lower risk of death from all causes, heart disease and cancer.
| Activity | What it builds |
|---|---|
| Carrying shopping bags or a heavy rucksack | Grip, shoulders, core |
| Gardening and digging | Grip, back, legs |
| Resistance bands or weights twice a week | All major muscle groups |
| Bodyweight squats and sit-to-stands | Leg strength, the key to staying independent |
| Dead hangs from a bar | Grip and shoulder strength |
| Squeezing a stress ball or hand gripper | Grip specifically (useful, but limited on its own) |
The WHO recommends muscle-strengthening activity on at least two days a week for all adults, alongside aerobic exercise. Most adults in most countries do not meet that target. Our guide to how much exercise it takes to lower your risk of dying shows that combining strength work with aerobic exercise is linked to bigger reductions in risk than either alone.
Strength and walking work together. The sibling article on how many steps a day you need to live longer covers the walking side, and resting heart rate and life expectancy covers fitness of the heart.
Protein matters too
Muscle cannot be built or kept without enough protein, and older adults often eat less of it. Many experts now suggest that people over 65 aim for somewhat more protein than younger adults, spread across meals, particularly when combined with strength exercise. People with kidney disease should check with their doctor first, as very high protein intakes are not suitable for everyone.
What this means for you
A strong grip will not guarantee a long life, and a weak one is not a death sentence. But the research sends a clear message: muscle is a vital organ for ageing well. It protects against falls, helps the body survive illness and keeps people independent for longer.
If you are in the 50 to 69 or 70 to 84 age groups, there is no better time to start. You can check where you stand on wider risks with our risk calculator, and see the long-term picture on the life expectancy page.
While you were reading
This article takes about 12 minutes to read. In that time, about 1,400 people have died around the world, roughly 118 every minute. Many of them were older adults whose decline began years ago with a slow, unnoticed loss of strength. You can watch the toll rise second by second on our live death counter.
Two minutes and a dynamometer can reveal a lot. Twice-weekly strength work could change what it says.
Data sources: Leong et al., "Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study", The Lancet, 2015. Celis-Morales et al., "Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality", BMJ, 2018. Rantanen et al., "Midlife hand grip strength as a predictor of old age disability", JAMA, 1999. Dodds et al., "Grip strength across the life course: normative data from twelve British studies", PLOS ONE, 2014. Cruz-Jentoft et al., "Sarcopenia: revised European consensus on definition and diagnosis", Age and Ageing, 2019. Brito et al., "Ability to sit and rise from the floor as a predictor of all-cause mortality", European Journal of Preventive Cardiology, 2012. Momma et al., "Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases", British Journal of Sports Medicine, 2022. Grip values are rounded approximations.
This article is for informational purposes only and does not constitute medical advice. Speak to your GP or a physiotherapist before starting strength training if you have a health condition.
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