Wu · Journal of the American Medical Directors Association 2017 · systematic review and meta-analysis of prospective cohort studies · n=42 studies (3,002,203 participants)

Association of Grip Strength With Risk of All-Cause Mortality, Cardiovascular Diseases, and Cancer in Community-Dwelling Populations: A Meta-analysis of Prospective Cohort Studies.

Cited 283 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of prospective cohort studies

PubMed 28549705 · doi:10.1016/j.jamda.2017.03.011 · record verified 2026-08-26

What was done

A systematic review and meta-analysis of prospective cohort studies from Embase, Medline, and PubMed (inception through September 14, 2016) was conducted to evaluate the relationship between grip strength and risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations. Risk estimates from 42 studies comprising 3,002,203 participants were combined using random-effects models and dose-response restricted cubic splines based on the most-adjusted hazard ratios (HRs).

What was found

Comparing the lowest versus highest categories of grip strength, pooled HRs were 1.41 (95% CI 1.30-1.52) for all-cause mortality, 1.63 (95% CI 1.36-1.96) for cardiovascular diseases, and 0.89 (95% CI 0.66-1.20) for cancer. Each 5-kg decrease in grip strength was associated with higher risk of all-cause mortality (HR 1.16, 95% CI 1.12-1.20), cardiovascular diseases (HR 1.21, 95% CI 1.14-1.29), stroke (HR 1.09, 95% CI 1.05-1.14), and coronary heart disease (HR 1.07, 95% CI 1.03-1.11), but not cancer (HR 1.01, 95% CI 0.98-1.05). A linear relationship was observed below 56 kg of grip strength, with associations persisting across sexes and after excluding participants with baseline cardiovascular disease or cancer.

Why it matters

This large meta-analysis demonstrates that simple, non-invasive grip strength assessment is an independent prognostic marker for cardiovascular events and overall mortality in community-dwelling populations. It also clarifies that grip strength is not associated with cancer risk.

Limits

All included data derive from observational cohorts, leaving potential for residual confounding despite multivariable adjustments. Inter-study variability in grip strength measurement protocols, follow-up durations, and covariate adjustments was not fully detailed in the abstract.

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