title: Grip strength across the life course: normative data from twelve British studies.
abstract: BACKGROUND
  Epidemiological studies have shown that weaker grip strength in later life is associated with disability, morbidity, and mortality. Grip strength is a key component of the sarcopenia and frailty phenotypes and yet it is unclear how individual measurements should be interpreted. Our objective was to produce cross-sectional centile values for grip strength across the life course. A secondary objective was to examine the impact of different aspects of measurement protocol.
  
  
  METHODS
  We combined 60,803 observations from 49,964 participants (26,687 female) of 12 general population studies in Great Britain. We produced centile curves for ages 4 to 90 and investigated the prevalence of weak grip, defined as strength at least 2.5 SDs below the gender-specific peak mean. We carried out a series of sensitivity analyses to assess the impact of dynamometer type and measurement position (seated or standing).
  
  
  RESULTS
  Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. Males were on average stronger than females from adolescence onwards: males' peak median grip was 51 kg between ages 29 and 39, compared to 31 kg in females between ages 26 and 42. Weak grip strength, defined as strength at least 2.5 SDs below the gender-specific peak mean, increased sharply with age, reaching a prevalence of 23% in males and 27% in females by age 80. Sensitivity analyses suggested our findings were robust to differences in dynamometer type and measurement position.
  
  
  CONCLUSIONS
  This is the first study to provide normative data for grip strength across the life course. These centile values have the potential to inform the clinical assessment of grip strength which is recognised as an important part of the identification of people with sarcopenia and frailty.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Dodds
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Syddall
authors.affiliation: MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Cooper
authors.affiliation: Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom.
authors.forename: Michaela
authors.initials: M
authors.lastname: Benzeval
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Deary
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Dennison
authors.affiliation: Social & Public Health Sciences Unit, Medical Research Council, Glasgow, United Kingdom.
authors.forename: Geoff
authors.initials: G
authors.lastname: Der
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Catharine R
authors.initials: CR
authors.lastname: Gale
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Hazel M
authors.initials: HM
authors.lastname: Inskip
authors.affiliation: Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.affiliation: Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Kirkwood
authors.affiliation: MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Sian M
authors.initials: SM
authors.lastname: Robinson
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: John M
authors.initials: JM
authors.lastname: Starr
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.affiliation: MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.affiliation: MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D015995:Prevalence; D055948:Sarcopenia / Q000453:epidemiology; D006113:United Kingdom; D044465:White People; D055815:Young Adult