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

Abstract Objectives Grip strength has been linked to risk of adverse health outcomes. This study aimed to quantitatively assess the associations between grip strength and risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations. Design A meta-analysis of prospective cohort studies was conducted. Setting Embase, Medline, and PubMed were searched from inception to September 14, 2016. Study-specific most adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were combined with a random effects model. Dose-response relation was assessed by restricted cubic splines. Results Data were obtained from 42 studies including 3,002,203 participants. For lowest versus highest category of grip strength, the HRs (95% CIs) were 1.41 (1.30-1.52) for all-cause mortality, 1.63 (1.36-1.96) for cardiovascular diseases and 0.89 (0.66-1.20) for cancer. The HRs (95% CIs) with per-5-kg decrease in grip strength was 1.16 (1.12-1.20) for all-cause mortality, 1.21 (1.14-1.29) for cardiovascular diseases, 1.09 (1.05-1.14) for stroke, 1.07 (1.03-1.11) for coronary heart disease, and 1.01 (0.98-1.05) for cancer. The observed associations did not differ by sex, and remained after excluding participants with cardiovascular diseases or cancer at baseline. Adjustment for other covariates cannot fully explain the observed associations. Linear relationships were found between grip strength and risk of all-cause mortality and cardiovascular diseases within grip strength of 56 kg. Conclusion Grip strength was an independent predictor of all-cause mortality and cardiovascular diseases in community-dwelling populations.