Associations of handgrip strength with all-cause and cancer mortality in older adults: a prospective cohort study in 28 countries

Rubén López-Bueno, Lars Louis Andersen, Joaquín Calatayud, José Casaña, Igor Grabovac, Moritz Oberndorfer, Borja Del Pozo Cruz

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BACKGROUND: mixed evidence exists on the association between muscle strength and mortality in older adults, in particular for cancer mortality. AIM: to examine the dose-response association of objectively handgrip strength with all-cause and cancer mortality. STUDY DESIGN AND SETTING: data from consecutive waves from the Survey of Health, Ageing and Retirement in Europe comprising 27 European countries and Israel were retrieved. Overall, 54,807 men (45.2%; 128,753 observations) and 66,576 women (54.8%; 159,591 observations) aged 64.0 (SD 9.6) and 63.9 (SD 10.2) years, respectively, were included. Cox regression and Fine-Grey sub-distribution method were conducted. RESULTS: during the follow-up period (896,836 person-year), the fully adjusted model showed the lowest significant risk estimates for the highest third of handgrip strength when compared with the first third (reference) in men (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.34-0.50) and women (HR, 0.38; 95% CI, 0.30-0.49) for all-cause mortality. We identified a maximal threshold for reducing the risk of all-cause mortality for men (42 kg) and women (25 kg), as well as a linear dose-response association in participants aged 65 or over. No robust association for cancer mortality was observed. CONCLUSION: these results indicate an inverse dose-response association between incremental levels of handgrip and all-cause mortality in older adults up to 42 kg for men and 25 kg for women, and a full linear association for participants aged 65 years or over. These findings warrant preventive strategies for older adults with low levels of handgrip strength.

Original languageEnglish
Article numberafac117
JournalAge and Ageing
Issue number5
Publication statusPublished - May 2022

Bibliographical note

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email:


  • ageing
  • longevity
  • longitudinal
  • older people
  • physical activity
  • physical exercise


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