What are Biomarkers? The Role of Biomarkers such as Grip Strength in Modern Healthcare

In this guide, we answer several important questions such as: what are biomarkers exactly and why does modern healthcare need new ones, such as grip strength?

The biomarkers market is projected to keep growing, from $57bn in 2025 to $97bn by 2030 with a CAGR of 11.21%, according to Mordor Intelligence. Factors including the increased prevalence of life-threatening diseases, more demand for early diagnosis, and rising biomarker research funding are driving this growth.

The world is facing both demographic and epidemiological shifts. The proportion of the global population aged 60 years and older will nearly double to 22%, with the number of individuals over 80 expected to triple to 426 million, according to the WHO.

This aging trend is especially pronounced in high-income countries but is now accelerating rapidly in low- and middle-income nations too. The rising prevalence of chronic diseases is magnifying the burden of aging on healthcare:

Cardiovascular diseases (CVDs) remain the leading cause of death globally, accounting for 35.6 million deaths projected by 2050.
Chronic respiratory diseases affect over 454 million people worldwide, with mortality driven by conditions like COPD and asthma.
Renal disease is on the rise, linked to risk factors like hypertension and diabetes.
Cancer cases are forecast to increase 47% by 2040, placing immense strain on healthcare systems.

Aging populations are particularly vulnerable to polychronic or multiple chronic conditions (MCCs), defined as having two or more chronic diseases simultaneously. In the US, 88% of older adults have at least one MCC, and 60% have two or more, according to the Centers for Disease Control and Prevention (CDC).

Managing MCCs is resource-intensive: those with four or more chronic conditions account for a whopping 94% of Medicare expenditures.

What are biomarkers?

The stats above highlight the pressing need for biomarkers that can address the interconnected nature of aging, frailty, and chronic disease.

Biomarkers are measurable indicators of a biological state or condition. They monitor health, diagnose diseases, predict outcomes, and assess treatment effectiveness.

Biomarkers are objective, quantifiable measures of what’s happening in the body at a molecular, cellular, or physiological level.

The last couple of decades have seen an extraordinary amount of biomedical research into the field of biomarkers. They play a pivotal role in improving clinical decision-making by enabling:

Diagnosis: Accurately identifying the presence of diseases or conditions.
Risk stratification: Assessing the likelihood of developing a condition or experiencing complications.
Monitoring disease progression: Tracking the trajectory of chronic diseases over time.
Evaluating treatment response: Measuring the efficacy of interventions and ensuring therapies are optimized.
Prognostic insights: Predicting clinical outcomes, such as survival rates or recurrence of disease.

In particular, biomarkers have transformed the management of chronic conditions including cardiovascular disease (CVD), respiratory disease, renal disease, cancer, and neurodegenerative disorders. For example, different types of biomarkers can help manage:

Cancer: PSA blood tests help diagnose and monitor prostate cancer, while the HER2 protein guides treatment decisions for breast cancer.
Cardiovascular disease: The protein troponin is a gold-standard biomarker for detecting heart attacks, while B-type natriuretic peptides (BNP) hormone tests monitor heart failure severity.
Neurodegenerative conditions: Amyloid-β and tau proteins detect early changes in Alzheimer’s disease.

These examples demonstrate the importance of biomarkers in guiding clinical care to improve healthcare outcomes, particularly for chronic conditions that require long-term management.

However, as populations age and the prevalence of MCCs rises, it is becoming clear that many existing biomarkers have critical limitations in addressing the complexity of modern healthcare challenges.

Why we need new biomarkers

Although traditional biomarkers have revolutionized healthcare, many have significant limitations when applied to aging populations with complex, multi-system health challenges.

These limitations include their reactive nature, narrow scope, and inability to address the interconnected health issues common in older adults.

While scientific literature has described more than 100,000 different biomarkers, the number applied in clinical practice may only be around 100 (Holland; What makes a good biomarker?; 2016).

Several limitations prevent many traditional biomarkers from addressing the complexity of modern healthcare challenges:

#1 Limited scope of current biomarkers

Most traditional biomarkers are single-disease focused, designed to detect or manage specific conditions:

HbA1c monitors diabetes, while cholesterol levels assess cardiovascular risk.
Biomarkers like creatinine for kidney disease or PSA for prostate cancer address specific organs but fail to provide a holistic picture of overall health.

This narrow focus does not reflect the interconnectedness of multiple chronic conditions, common in aging populations, where diseases like diabetes, heart disease and arthritis often coexist and compound one another.

Primarily, traditional biomarkers predict disease progression for specific conditions.

But they do not capture broader indicators of health, such as physical resilience, functional decline, or frailty. These are factors that strongly influence independence and quality of life in older adults.

#2 Reactive nature of traditional biomarkers

Many biomarkers act as trailing indicators, signaling disease only after significant physiological damage has occurred:

Elevated troponin levels indicate cardiac damage after a heart attack.
Abnormal serum creatinine reflects kidney dysfunction only after substantial loss of kidney function.

This reactive nature limits opportunities for early intervention and prevention, particularly for aging populations where early declines in physical and functional health may signal disease risk. For example:

Frailty may develop over years before clinical symptoms appear.
Muscle loss (sarcopenia) precedes functional impairment but is not identified through traditional biomarkers.

By the time reactive biomarkers are detected, interventions often become more complex, costly, and less effective.

#3 Lack of functional health assessment

Traditional biomarkers focus on disease detection but fail to assess functional health: the ability to maintain physical resilience, mobility, and independence.

These dimensions are especially critical for older adults and yet are poorly addressed by existing tools:

Frailty and sarcopenia: Declines in muscle strength and mobility significantly impact aging populations but remain invisible to traditional markers like cholesterol or blood pressure.
Cognitive and emotional health: Biomarkers rarely account for cognitive decline or mental well-being, factors deeply intertwined with aging and chronic disease outcomes.

This gap highlights the need for biomarkers that reflect whole-person health, including physical, cognitive, and emotional resilience.

#4 Insufficient integration of aging dynamics

Traditional biomarkers often do not distinguish between chronological aging (years lived) and biological aging (true physiological decline).

As a result, they fail to predict individual variability in healthspan or longevity.

Aging populations follow diverse and non-linear health trajectories due to lifestyle, genetics, and multi-morbidity.

Existing biomarkers cannot capture this complexity, leading to fragmented and suboptimal care strategies.

#5 Burden on healthcare systems

Traditional biomarkers contribute to the fragmentation of healthcare systems, where specialists focus on individual conditions rather than holistic patient needs.

This approach increases costs and inefficiencies, particularly for older adults with multi-morbidity:

Escalating costs: Reactive care drives expensive late-stage interventions, frequent hospital readmissions, and prolonged treatment of advanced conditions.
Care coordination gaps: Traditional biomarkers often fail to inform integrated care strategies that optimize outcomes across specialties and care settings.

A valuable new biomarker: Grip strength

To address these limitations, new biomarkers must:

Act as proactive (leading) indicators: Identify early signs of health decline before irreversible damage occurs.
Offer a holistic view: Provide comprehensive insights into physical resilience, functional health, and overall biological aging.
Enable preventive care: Facilitate earlier interventions that delay disease onset, reduce frailty, and maintain independence.
Support personalized care: Tailor interventions to individual health profiles, considering multiple risk factors.
Promote cost-effective management: Reduce healthcare expenditures by preventing late-stage, resource-intensive interventions.

Scientific foundation for grip strength as a biomarker

Muscular strength, a fundamental component of physical fitness, reflects the body’s ability to generate maximal force during contraction.

Although muscular strength cannot be defined by a single measure, it is widely assessed by hand grip strength using handgrip dynamometry.

As a widely validated measure of muscular strength, grip strength has emerged as a simple yet powerful biomarker that correlates with overall health, resilience, and longevity.

Its ability to reflect systemic physiological changes makes it a valuable tool across clinical, research, and community settings.

Clinical validity and feasibility of grip strength

Grip strength has been widely adopted as a reliable, non-invasive, and cost-effective biomarker across the healthcare continuum:

Simple, quick, and accessible: Non-invasive, safe, and quick to perform using a handgrip dynamometer. It requires minimal training for administration, produces immediate results, and can be conducted in diverse settings, including hospitals, clinics, and homes, making it suitable for clinical, research, and community applications.
Reliable and scalable: Highly reproducible with standardized dynamometers, ensuring consistent and accurate results across individuals of all ages. Compared to complex whole-body strength tests, hand grip strength demonstrates low exclusion and dropout rates in large studies, increasing its feasibility and scalability for widespread use.
Affordable and cost-effective: Advances in technology have made handgrip dynamometers more affordable, with lower-cost devices providing comparable accuracy to higher-cost alternatives. This cost-effectiveness allows for broad adoption in preventive care, longitudinal health monitoring, and population-level health assessments.

Traditional biomarkers such as BMI, blood pressure, and cholesterol remain valuable. But they often provide a narrow, reactive view of health. Grip strength, by contrast, offers a more holistic and predictive measure of functional health and resilience.

Table: Comparison of grip strength vs. traditional biomarkers

Clinical applications of grip strength

Grip strength has emerged as a versatile clinical tool with proven utility across multiple stages of care, from early risk detection to monitoring disease progression and evaluating treatment response.

Its simplicity, non-invasive nature, and strong predictive power make it particularly valuable in clinical settings where actionable, functional health insights are required.

Risk Stratification:
Grip strength is a reliable tool for identifying individuals at increased risk of poor health outcomes, supporting preventative, personalized clinical decision-making by enabling early identification of at-risk patients.

Surgical Risk: Lower preoperative grip strength predicts longer hospital stays, complications, and delayed recovery especially in orthopaedic and cardiac surgeries.
Chronic Disease Management: In CKD and COPD, lower grip strength is associated with disease progression and mortality for example CKD patients with reduced grip strength show higher progression to end-stage disease.
Falls Risk Screening: Grip strength is a key marker in falls protocols, identifying those at higher risk of mobility loss and injury especially when combined with other key falls risk assessment metrics.

Prognosis
Grip strength is one of the strongest predictors of short- and long-term health outcomes across a variety of conditions.

Longevity: Low grip strength increases all-cause mortality risk by 67% and each 5kg reduction in grip strength was associated with a 16% increased risk of mortality.
Functional Decline: Central to the Fried Frailty Phenotype, grip strength predicts disability and mobility loss.
Cancer: Weak grip correlates with poor treatment tolerance and survival.
Mortality in Cardiovascular Disease: Predicts heart failure progression and is a better predictor of cardiovascular mortality than blood pressure.
Sports Medicine and Sports Performance: Grip strength tracks upper body power, resilience, and injury risk in athletes.

Monitoring Disease Progression
Grip strength provides an effective method for tracking disease progression and functional decline in chronic conditions. It serves as a dynamic marker reflecting real-time changes in physical health and resilience.

Chronic Diseases: low grip strength predicts risk of hospitalisation in those with a pre-existing diagnosis of irritable bowel syndrome.
Sarcopenia: regular grip strength monitoring is integral to tracking the progression of sarcopenia, a condition affecting 10-20% of older adults globally

Evaluating Treatment Response
Grip strength provides an objective, functional measure of intervention success.

Rehabilitation and Therapy: Improvements reflect functional recovery, especially post-surgery, stroke rehab, and falls prevention.
Nutrition and Pharmacology: Responds to dietary interventions targeting sarcopenia and tracks chemotherapy impact on muscle function.
Sports Performance and Medicine: In sports rehab, grip strength monitors muscle recovery and return-to-play readiness.

Table: Clinical applications of grip strength

Measuring Grip Strength Beyond Hospital Settings

Grip strength is a vital tool not only in clinical environments but also in community and home-based care. Extending its use beyond hospitals allows for proactive health monitoring that empowers individuals, improves outcomes, and reduces healthcare costs.

Beyond clinical use, grip strength serves as a population-level surveillance tool to monitor temporal trends in population health and assess the impact and progress of public health interventions aimed at improving physical strength and resilience.

Proactive Health Monitoring
Regular grip strength assessments whether in the community or at home can detect early signs of physical decline, enabling timely interventions. This approach helps delay frailty, reduce falls risk, and prevent the progression of chronic conditions, especially for individuals with limited access to healthcare.

Identifies at-risk individuals early, before serious symptoms develop.
Supports targeted, home-based interventions to maintain independence.
Fosters patient engagement and self-management of health metrics.

Cost Reduction Potential
Remote monitoring of grip strength helps lower healthcare costs by:

Reducing unnecessary hospital visits through early detection.
Preventing hospital readmissions and long-term care admissions with early home-based support.
Supporting preventive care strategies that delay frailty and chronic disease progression.

Able Assess: The data-driven grip strength platform for modern healthcare

While traditional biomarkers have revolutionized healthcare, many cannot support aging populations with complex, multi-system health challenges.

Grip strength has emerged as a powerful biomarker for biological resilience and physical performance. It surpasses traditional metrics such as blood pressure in predicting risk of chronic disease, health outcomes and longevity.

Grip strength is a proactive, cost-effective, and holistic measure of functional health with the potential to address the limitations of traditional biomarkers. It can transform the management of aging populations in healthcare.

The Able Assess Grip Strength Platform delivers accurate, reliable and sensitive grip strength data for better decision-making. It combines the best-in-class GripAble sensor with a user-friendly app, clinician-facing web portal and robust data model.

Furthermore, Able Assess Falls Risk Screening Platform is the world’s first platform to measure four key metrics for falls risk screening, including grip strength: providing a standardized, scalable and low-cost solution for falls prevention.

Able Care has designed the first falls risk screening tool that empowers every clinical and non-clinical staff member to deliver a standardized, objective, low-cost, data driven assessment in under 5 minutes.

Get the essentials on hand dynamometry and how to integrate grip strength into your practice with our comprehensive hand dynamometer guide.

For further reading about Able Assess, explore our extensive collection of studies including:

Partner with us in research or patient case studies to advance the knowledge of grip strength as a biomarker. And for more information about Able Care, please don’t hesitate to contact us.