International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions

• Published in: Journal of sport and health science 2024-12, p.101014, Article 101014
• Main Authors: Tomkinson, Grant R., Lang, Justin J., Rubín, Lukáš, McGrath, Ryan, Gower, Bethany, Boyle, Terry, Klug, Marilyn G., Mayhew, Alexandra J., Cadenas-Sanchez, Cristina, Magnussen, Costan G., Kidokoro, Tetsuhiro, Christensen, Kaare, Leong, Darryl P., Aadahl, Mette, Abdin, Edimansyah, Alcazar, Julian, Amaral, Cledir De A., Amaral, Thatiana L.M., Fernandes, Alex Andrade, Baldwin, Jennifer N., Bammann, Karin, Barbosa, Aline R., Bardo, Ameline, Bjerregaard, Peter, Bobak, Martin, Boreham, Colin A., Bös, Klaus, Marins, João Carlos Bouzas, Castillo-Martínez, Lilia, Chen, Liang-Kung, Cooper, Cyrus, Correa-Bautista, Jorge E., Cournil, Amandine, de Bruin, Eling D., Moreira, Bruno De Souza, Anjos, Luiz Antonio Dos, Forrester, Gillian, Frolova, Elena, Gebre, Abadi K., Ghaleb, Atef M., Gill, Tiffany K., Gondo, Yasuyuki, Alvarez, Citlali Gonzalez, Hannah, Mary K., Hogrel, Jean-Yves, Huemer, Marie-Theres, Iidaka, Toshiko, Jdanov, Dmitri A., Kemmler, Wolfgang, Kim, Dae-Yeon, Kivell, Tracy L., Kjær, Ingirid G.H., Kluttig, Alexander, Kozakai, Rumi, Langer, Danit, Larsen, Lisbeth A., Lee, Wei-Ju, Leon, David A., Lichtenstein, Eric, Little, Bertis B., Lourenço, Roberto Alves, Malhotra, Rahul, Malina, Robert M., Matsumoto, Kiyoaki, Mazor-Karsenty, Tal, McKay, Marnee J., Mensegere, Abhishek L., Mohammadian, Mostafa, Neri, Anita Liberalesso, Niessner, Claudia, Othón, Gabriel Núñez, Olveira, Gabriel, Orchard, Suzanne G., Pajak, Andrezj, Park, Chan Woong, Pasco, Julie A., Reyes, Maria E. Peña, Pereira, Leani Souza Máximo, Peters, Annette, Poon, Eric Tsz-Chun, Pratt, Jedd, Rodríguez-García, Wendy, Sánchez-Torralvo, Francisco José, Schmidt-Trucksäss, Arno, Shah, Shamsul Azhar, Sim, Marc, Strand, Bjørn Heine, Suetta, Charlotte, Sui, Sophia X., Tamosiunas, Abdonas, Thorand, Barbara, Tveter, Anne Therese, Wagner, Jonathan, Wang, Dao, Warden, Stuart J., Wearing, Julia, Westbury, Leo D., Woll, Alexander, Yoshimura, Noriko, Yu, Ruby
• Format: Article
• Language: English
• Subjects: Adult; Hand strength; Life Sciences; Mass screening; Population health; Reference values; Santé publique et épidémiologie
• ISSN: 2095-2546; 2213-2961; 2213-2961
• DOI: 10.1016/j.jshs.2024.101014

•Handgrip strength (HGS)—maximal isometric grip force—is an excellent marker of general strength and health.•Using a systematic review strategy, this study pooled HGS data from 100 unique observational studies representing 2.4 million adults aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward.•This study presents the world's largest and most geographically comprehensive international sex- and age-specific norms for HGS across the adult lifespan. Norms for absolute and body size-normalized HGS were tabulated as percentile values and visualized as smoothed percentile curves.•These norms have utility for global peer-comparisons, health screening, and surveillance. Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 47.8 kg [males] and 29.7 kg [females] for absolute HGS or 16.3 kg/m2 [males] and 11.3 kg/m2 [females] for HGS/Ht2), and declined afterwards. The age-related decline in HGS ac