Grip Strength and Brain Health: What the Research Shows

Grip strength may seem like a small measure of health, but research suggests that patients with cognitive decline and dementia have weaker grip strength. In fact, the humble “squeeze test” may be a proxy for how well the brain and body are aging together.

“Grip strength is a simple measurement for total body strength, and research has consistently linked grip strength with cognitive health, including dementia risk,” said Zaldy Tan, MD, MPH, director of the Memory and Healthy Aging Program at Cedars-Sinai and medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders. “Measuring grip strength, even in early- to middle-age, allows us to identify people who may be at risk for cognitive decline later in life.”

{{providers}}

What Is Grip Strength and Why Does It Matter

Grip strength—how firmly you can hold, squeeze or carry objects—is emerging as a simple indicator of how well your body and brain are aging. In addition to reflecting the strength of your hands, grip strength is a window into larger system: nerves, muscles, joints, circulation and the brain pathways that coordinate movement.

“Lower grip values are associated with people who have cognitive impairment and dementia, so it’s really a marker of overall health, not just hand function,” said David Hay, MD, a hand surgeon at Cedars-Sinai Orthopaedics.

Measured with a hand dynamometer, available at physical therapy offices and some primary care practices, grip strength provides a simple snapshot of overall muscle strength. Norms vary by body size and population, but as a general guide: Men typically peak around 99 to 121 pounds (45 to 55 kilograms) in early-to-mid adulthood, while women peak around 55 to 77 pounds (25 to 35 kilograms). By the 70s and 80s, values typically fall to roughly 55 to 77 pounds for men and 33 to 55 pounds for women.

Measuring grip strength, even in early- to middle-age, allows us to identify people who may be at risk for cognitive decline later in life.

The Brain-Body Connection

Grip strength tracks overall fitness and how well the brain communicates with the body. The brain controls the muscles, but skeletal muscle also sends chemical and metabolic signals that can influence inflammation, insulin sensitivity, vascular health and brain function.

The data to back this up: A 2021 meta-analysis in Frontiers in Aging Neuroscience found that poorer grip strength was associated with nearly double the risk of cognitive decline and a 54% higher risk of dementia. A 2022 study in JAMA Network Open found similar results, linking stronger midlife grip to better brain health later in life, including larger brain volumes and fewer adverse imaging markers.

To be clear, weak grip strength doesn’t cause or prevent dementia by itself, but declining strength can be an early, measurable clue of muscle and brain health.

{{cta-block}}

Why Grip Strength Is Linked to Longevity

Researchers don’t fully understand why grip strength weakens in patients with cognitive decline, but they have a few theories:

• Frailty. Weak grip strength is a marker of frailty, a medical term for when a patient can’t recover well from injury or stressors—and being frail is associated with a higher risk of cognitive deficits.
• Reverse causation. People in early stages of cognitive decline become less active, leading to reduced strength over time. ‍
• Shared brain demand. Coordinating precise grip requires attention, sensory feedback, motor planning and brain-muscle communication. When you train your grip safely, you are not only strengthening the hand, you are also challenging the broader neuromuscular system.

Whatever the exact mechanism, everyday changes in hand function can be meaningful warning signals. “Subtle changes like declining dexterity or worsening handwriting may reflect emerging neurological problems,” Hay said.

When to Start Building Strength

Muscle mass typically peaks between ages 30 and 35, and midlife is an especially important window for protecting brain health. Lifestyle habits and strength patterns built during this phase of life can affect how the brain ages.

After age 50, strength begins to drop by about 10% to 15% per decade. “Maintaining a strength training routine can help stall that decline and help preserve health and function,” said Hay.

Strength training—and building muscle—is only one piece of abroader dementia-prevention lifestyle. Optimizing brain function throughout the lifespan requires a multifaceted approach, including:

• Aerobic activity
• Balance training
• Sleep
• Strong social connections
• A heart-healthy, whole foods diet
• Effective management of hypertension, diabetes, cholesterol, and hearing and vision loss
• Hobbies that engage both body and mind, such as tennis, golf, pickleball and woodworking

When to Talk to Your Doctor

Talk to your doctor if you notice new or worsening hand weakness, frequent dropping of objects, numbness, tremor, pain, changes in handwriting or difficulty buttoning clothes, opening jars or using utensils. These changes are especially important to discuss if you have a family history of dementia or another neurological condition.

“Changes in hand function can be an early sign of neurological disease worth addressing,” said Hay.