Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies

• Published in: Journal of sport and health science Vol. 10; no. 3; pp. 290 - 295
• Main Authors: Soysal, Pinar, Hurst, Christopher, Demurtas, Jacopo, Firth, Joseph, Howden, Reuben, Yang, Lin, Tully, Mark A., Koyanagi, Ai, Ilie, Petre Cristian, López-Sánchez, Guillermo F., Schwingshackl, Lukas, Veronese, Nicola, Smith, Lee
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01-05-2021; ICREA,Pg.Lluis Companys 23,Barcelona 08010,Spain%The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust,King's Lynn PE304ET,UK%Faculty of Sport Sciences,University of Murcia,Murcia 30100,Spain%Institute for Evidence in Medicine,Medical Center-University of Freiburg,Faculty of Medicine,University of Freiburg,Freiburg 79085,Germany%Neuroscience Institute,Aging Branch,National Research Council,Padua 35122,Italy%The Cambridge Centre for Sport and Exercise Sciences,Anglia Ruskin University,Cambridge CB11PT,UK; Department of Geriatric Medicine,Bezmialem Vakif University,Istanbul 34093,Turkey%Institute of Neuroscience,Newcastle University,Newcastle upon Tyne NE17RU,UK%Primary Care Department,Azienda Usl Toscana Sud Est,Grosseto 52100,Italy%Division of Psychology and Mental Health,University of Manchester,Manchester M139PL,UK%College of Health&Human Services,University of North Carolina at Charlotte,Long Beach,CA 90815,USA%Department of Cancer Epidemiology and Prevention Research,Alberta Health Services,Holy Cross Centre,AlbertaT5J 3E4,Canada%School of Health Sciences,Institute of Mental Health Sciences,Ulster University,Newtownabbey BT151ED,UK%Research and Development Unit,Sant Joan de Déu Health Park,CIBER of Mental Health(CIBERSAM),Barcelona 08003,Spain; Shanghai University of Sport; Elsevier
• Subjects: Handgrip strength; Health outcomes; Meta-analysis; Review; Umbrella review; Health outcomes; Handgrip strength; Umbrella review; Meta-analysis
• ISSN: 2095-2546; 2213-2961
• DOI: 10.1016/j.jshs.2020.06.009

•We carried out an umbrella review of systematic reviews with meta-analyses of observational studies on handgrip strength and all health outcomes.•Three outcomes (lower all-cause mortality, lower cardiovascular mortality, and lower risk of disability) were found to have highly suggestive evidence.•One outcome (chair rise performance over time) was found to have suggestive evidence.•Five outcomes (walking speed, inability to balance, hospital admissions, cardiac death, and mortality in those with chronic kidney disease) were found to have weak evidence.
The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.
An umbrella review of systematic reviews with meta-analyses of observational studies was conducted. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV).
From 504 articles returned in a search of the literature, 8 systematic reviews were included in our review, with a total of 11 outcomes. Overall, nine of the 11 of the outcomes reported nominally significant summary results (p < 0.05), with 4 associations surviving the application of the more stringent p value (p < 10−6). No outcome presented convincing evidence. Three associations showed Class II evidence (i.e., highly suggestive): (1) higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population (n = 34 studies; sample size = 1,855,817; relative risk = 0.72, 95% confidence interval (95%CI): 0.67–0.78), (2) cardiovascular death risk in mixed populations (n = 15 studies; relative risk = 0.84, 95%CI: 0.78–0.91), and (3) incidence of disability (n = 7 studies; relative risk = 0.76, 95%CI: 0.66–0.87).
The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality, as well as disability. To further inform intervention strategies, future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.
[Display omitted]