Grip Strength and Frailty: The New Essential Biomarker

Imagine if a simple handshake could offer powerful insights into someone’s frailty.

This isn’t just a metaphor. Grip strength has emerged as an indispensable data point for assessing and monitoring patients with complex health conditions.

The measurement of grip strength in aging patients provides a fast, non-invasive gauge of functional health as it is closely linked to sarcopenia and frailty.

Frailty increases and physical function decreases as a result of reduced muscle strength.

This heightens the risk of events such as falls or infections, which drive up healthcare utilization and costs.

This document explains how grip strength can be used in clinical practice to assess sarcopenia and frailty in aging patients. Read on to find out, what does weak grip strength indicate?

“Grip strength is a key indicator of health; it’s a proxy for your overall strength and physical function.”

Peter Attia MD; Longevity Expert

Must-Know Metrics: Grip Strength and Frailty

Grip Strength and Frailty

Grip strength below 44.1 lbs* for men and 28.8 lbs* for women is one of the five key criteria for identifying frailty according to the Fried Frailty Phenotype (FFP). [Fried et al., 2011]

Grip Strength and Mobility Limitations

Grip strength below 48.7* lbs for men and 32.0 lbs* for women is a key threshold for identifying mobility limitations, particularly a walking speed of less than 0.8 m/s. [Delinocente et al., 2021]

Grip Strength and Sarcopenia

Grip strength below 41.0 lbs* for men 24.3 lbs* and for women is a key criterion for diagnosing sarcopenia, as defined by the European Working Group on Sarcopenia in Older People (EWGSOP2). [Cruz Jentoft et al., 2014]

*Note that all cut off points have been converted to GripAble-equivalent measurements for consistency

Grip Strength and Frailty in Practice

Clinical Application

Measure grip strength during routine check-ups to assess risk factors and track trends over time.

For high-risk patients, consider providing a hand dynamometer for regular, at-home monitoring and frailty assessment. Grip strength dropping below cut-off points or decreasing by more than a quartile requires attention.

Patient Empowerment

Give patients access to their grip strength scores. A clear, tangible measure they can easily understand and actively improve with guidance.

Unlike blood pressure, grip strength measurement is relatable and empowering, enabling patients to track their progress as a key indicator of their independence.

Practical Considerations

Let grip strength support other standard measurements in geriatric assessments:

Replace gait speed tests with grip strength in scenarios where falls risk is significant
Add objective insights to patient-reported outcomes with this minimally invasive tool.

Impact: Grip Strength and Frailty

Reduce Utilization: identify disease early and understand patient prognosis

Improve Patient Satisfaction: where appropriate, give patients a quick, non-invasive tool to monitor disease status and response to treatment at home

Support Risk Adjustment: quantify disease and treatment impact by using grip strength results as an objective measure of muscle loss

What next?

For further reading, dive into our extensive collection of studies on using a hand dynamometer, grip strength and more here including:

Contribute: Partner with us in research or patient case studies to advance the knowledge of grip strength as a biomarker.

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

Get in touch: Website: able-care.co Email: hello@able-care.co

Citations

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Blanquet, M, et al. Handgrip strength as a valid practical tool to screen early-onset sarcopenia in acute care wards: a first evaluation. European Journal of Clinical Nutrition 76.1 (2022): 56-64. [LINK]

Bohannon, RW. Grip strength: an indispensable biomarker for older adults. Clinical interventions in aging (2019): 1681-169. [LINK]

Cruz-Jentoft AJ, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. Erratum in: Age Ageing. 2019 Jul 1;48(4):601. [LINK]

Chen, LK et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. Journal of the American Medical Directors Association 21.3 (2020): 300-307. [LINK]

Damluji AA, et al. Sarcopenia and Cardiovascular Diseases. Circulation. (2023) May 16;147(20):1534-1553. [LINK]

Delinocente, MLB et al Accuracy of different handgrip values to identify mobility limitation in older adults, Archives of Gerontology and Geriatrics, Volume 94, (2021) [LINK]

Fried, LP, et al Frailty in Older Adults: Evidence for a Phenotype, The Journals of Gerontology: Series A, Volume 56, Issue 3, 1 March 2001, Pages M146-M157, [LINK]

Hall, MJ, et al. Trends in inpatient hospital deaths: national hospital discharge survey, 2000-2010. No. 118. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2013. [LINK]

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Hamasaki, H, et al. Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Scientific Reports 7.1 (2017): 7041.[LINK]

Lieber, SB, et al. Association of phenotypic frailty and hand grip strength with telomere length in SLE. Lupus Science & Medicine 11.1 (2024): e001008. [LINK]

Pal, R, et al. Diagnostic cut-offs, prevalence, and biochemical predictors of sarcopenia in healthy Indian adults: the Sarcopenia-Chandigarh Urban Bone Epidemiological Study (Sarco-CUBES). European Geriatric Medicine 11 (2020): 725-736. [LINK]

Roberts, HC., et al. Grip strength and its determinants among older people in different healthcare settings. Age and ageing 43.2 (2014): 241-246. [LINK]

Stringa, N, et al. The phenotypic and genotypic association of grip strength with frailty, physical performance and functional limitations over time in older adults. Age Ageing 52.10 (2023) [LINK]

Studenski, SA, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 69.5 (2014): 547-558. [LINK]

Orkaby, AR Moving beyond chronological age: Frailty as an important risk factor for cardiovascular disease. In European Heart Journal (Vol. 42, Issue 37, pp. 3866-3868). (2021) Oxford University Press. [LINK]

Wu, S, et al. Comparing survey-based frailty assessment to medicare claims in predicting health outcomes and utilization in medicare beneficiaries. Journal of aging and health 32.7-8 (2020): 764-777. [LINK]