Handgrip strength predicts death more strongly in older Mexican men than women

Handgrip strength appears to carry different survival information for older Mexican men and women. In an analysis of the Mexican Health and Aging Study published in GeroScience, researchers followed 1,917 adults aged 50 years and older whose grip strength was assessed at the study’s third wave and tracked through 2021. Over that period, 371 participants died, allowing the team to test how two ways of expressing grip strength relate to the risk of death from any cause.

The study examined both absolute handgrip strength measured in kilograms and an allometric version that adjusts grip force for body size by dividing it by height squared. Both measures were converted into sex-specific quartiles and standardized z-scores, so a person’s grip was compared only with others of the same sex. The investigators fitted sex-stratified Cox proportional hazards models, ran interaction analyses to test whether the strength-mortality link differed between men and women, and calculated survey-weighted mortality rates per 1,000 person-years.

The headline result is a sex contrast. Among men, those in the lowest quartile of absolute handgrip strength had a hazard of death 5.56 times higher than men in the highest quartile, with a 95 percent confidence interval of 2.70 to 11.44. Each one-standard-deviation increase in absolute grip strength was associated with a lower hazard of death in men, corresponding to a hazard ratio of 0.53 with a confidence interval of 0.44 to 0.65.

Women showed the same direction of association but with smaller magnitude. Those in the lowest absolute handgrip strength quartile had a hazard of death 1.95 times that of women in the highest quartile, with a confidence interval of 1.07 to 3.55. The interval sits close to the boundary of no effect, indicating greater statistical uncertainty than in the male estimates. The authors report that associations between lower grip strength and higher mortality were stronger in men.

The sex difference was not merely a matter of scaling. When grip strength was normalized for height, the interaction test between sex and allometric handgrip strength reached statistical significance at p = 0.011. This formal interaction evidence strengthens the finding that the strength-mortality gradient is steeper in men and suggests the contrast is not an artifact of body size.

Survival curves reinforced the statistical models. Kaplan-Meier analyses showed separation between the lowest and highest grip strength quartiles for both the absolute and allometric measures, with participants in the weakest quartile dying at faster rates over follow-up. Because the cohort was drawn from a nationally representative aging survey and the mortality rates were survey-weighted, the estimates are designed to reflect the broader population of older Mexican adults rather than a selected clinical sample.

The observational design imposes firm limits on interpretation. Handgrip strength was measured at a single wave, participants were followed forward through 2021, and the Cox models describe associations, not causal effects. Unmeasured factors that both weaken grip and raise mortality risk, such as subclinical disease, nutritional status or frailty trajectories, could account for part of the association. The confidence intervals, particularly the wider interval in women, also mean the precise magnitude of risk in that group remains less certain.

The authors close with an explicit caveat about the two strength metrics: their comparative predictive performance remains to be established. The study demonstrates that both absolute and allometric handgrip strength are associated with all-cause mortality in this population, with stronger associations in men, but it does not settle which formulation clinicians or researchers should prefer for risk prediction. For a rapidly aging Mexican population, the finding adds to the evidence that a dynamometer reading, taken in seconds and costing little, encodes meaningful prognostic information, while flagging that its predictive weight depends on the sex of the person being tested.

Subject of Research: Sex-specific associations between handgrip strength and all-cause mortality in Mexican adults aged 50 and older

Article Title: Sex-specific associations between handgrip strength and all-cause mortality in older Mexican adults

Article References: Pérez-Sousa, M. Á., Borda, M. G., Ramírez-Vélez, R., Fernández-Aparicio, Á., & González-Jiménez, E. (2026). Sex-specific associations between handgrip strength and all-cause mortality in older Mexican adults. GeroScience. https://doi.org/10.1007/s11357-026-02639-4

Image Credits: AI Generated

DOI: 10.1007/s11357-026-02639-4

Keywords: handgrip strength, all-cause mortality, older adults, Mexican Health and Aging Study, sex differences, Cox proportional hazards, allometric scaling, geroscience, survival analysis, muscle strength, cohort study, aging