Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies.
Level 3 - non-randomized controlled study
Umbrella review synthesizing systematic reviews and meta-analyses of observational studies.
PubMed 32565244 · doi:10.1016/j.jshs.2020.06.009
What was done
An umbrella review was conducted to evaluate the credibility and strength of evidence from systematic reviews with meta-analyses of observational studies linking handgrip strength to health outcomes. Evidence was graded from convincing (Class I) to weak (Class IV) based on random-effects summary effect sizes, p-values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance.
What was found
Eight systematic reviews covering 11 health outcomes were included from 504 initial articles. Nine of 11 outcomes showed nominally significant summary associations (p < 0.05), and 4 met a stricter threshold (p < 10^-6). No outcome met criteria for Class I (convincing) evidence. Three outcomes demonstrated Class II (highly suggestive) evidence: - All-cause mortality risk in the general population: relative risk 0.72 (95% CI: 0.67–0.78; 34 studies, n = 1,855,817) - Cardiovascular mortality risk in mixed populations: relative risk 0.84 (95% CI: 0.78–0.91; 15 studies) - Incidence of disability: relative risk 0.76 (95% CI: 0.66–0.87; 7 studies)
Why it matters
This review establishes handgrip strength as a consistent prognostic biomarker for mortality and disability across broad populations. It clarifies that while the statistical associations are robust, current evidence is observational rather than proven causal intervention targets.
Limits
All primary evidence is observational, leaving open the possibility of reverse causation and unmeasured confounding by underlying health status. No outcome achieved convincing (Class I) evidence. The abstract does not specify diagnostic cut-offs, measurement protocols, or details for the other 8 evaluated outcomes.
Cited by
- supports Grip strength has been associated with longevity.