Two simple strength tests predict longevity in older women

By Katia Hetter, CNN

(CNN) — A surprisingly simple measure may offer clues about longevity.

Muscular strength, as determined by two tests, was a key predictor of a person’s risk of death, according to a new study published in JAMA Network Open.

Researchers followed more than 5,000 women between the ages of 63 and 99 and found that those participants with greater strength had a significantly lower risk of death over the next eight years.

The findings raise questions about how strength influences healthy aging and what people can do to maintain strength. To better understand the study’s implications, I spoke with CNN wellness expert Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University. Wen previously served as Baltimore’s health commissioner.

CNN: What were this study’s main findings?

Dr. Leana Wen: Researchers analyzed data from women who were enrolled in a large, long-running study of aging. At the start, investigators assessed muscular strength in two ways: by measuring handgrip strength and by timing how quickly participants could stand up from a seated position without using their arms. The researchers then followed these women for about eight years and tracked who survived during that period.

The key finding was that women with stronger grip strength and better chair-stand performance had a lower risk of death from any cause during follow-up.

The association remained even after researchers accounted for factors such as age, chronic medical conditions, socioeconomic characteristics, physical activity levels and measures of sedentary behavior. In other words, muscular strength itself appeared to be an important predictor of longevity. This finding is consistent with previous research indicating that handgrip strength could be a good indicator of overall strength and performance in daily life.

CNN: Why is muscular strength linked to longevity?

Wen: Muscular strength reflects the health of multiple systems in the body. When people maintain strength as they age, it often indicates that their muscles, bones, nervous system and metabolism are functioning well together. These systems support mobility, balance and the ability to perform everyday activities.

Stronger muscles also help protect against injuries and disability. We can see that in people with better strength, who are generally less likely to fall or may recover more easily if they do. They tend to maintain independence longer because they can perform routine tasks such as climbing stairs, getting groceries and carrying bags.

There are also metabolic benefits. Skeletal muscle plays a major role in regulating blood sugar and energy use. Preserving muscle mass and strength has been linked with better control of conditions such as type 2 diabetes and cardiovascular disease. These factors together may help explain why muscular strength appears to correlate with survival.

CNN: The researchers used both grip strength and the ability to stand up from sitting in a chair. Why are these particular tests useful?

Wen: These tests are simple but informative measures of functional strength. Researchers often use grip strength because it is easy to measure and correlates with overall strength throughout the body. Grip strength also tends to decline with aging and illness, so it can serve as a signal of underlying health.

The chair-stand test measures lower-body strength, particularly in the thighs and hips. These muscles are critical for mobility and balance. The ability to stand from a seated position without using the arms reflects how well someone can perform a common movement required for daily life.

Both tests are quick, inexpensive and easy to administer, and they do not require specialized equipment. They also assess practical strength rather than just muscle size.
That distinction is important because functional ability often matters more than muscle mass alone when it comes to maintaining independence and preventing disability in older adults.

CNN: One striking finding is that strength predicted longevity even among women who did not meet recommended exercise levels. What does that mean?

Wen: Physical activity guidelines recommend that adults engage in both aerobic exercise and muscle-strengthening activities. Specifically, the US Centers for Disease Control and Prevention recommends 150 minutes of moderate to vigorous aerobic activity a week and at least two days per week of strength training.

In real life, many people fall short of those targets. What this study suggests is that muscular strength itself carries important information about health, even among individuals who otherwise are not meeting physical activity targets.

One interpretation is that maintaining strength may provide protective benefits independent of overall activity level. Another possibility is that people who remain stronger may naturally incorporate small but meaningful forms of movement into their daily lives, such as walking more and continuing household tasks.

The takeaway is not that exercise guidelines should be ignored. Rather, the results underscore that strength is a key component of physical fitness. Even modest improvements in muscular strength may be meaningful for long-term health, and people who engage in walking and other aerobic activities should be sure to also continue strength training.

CNN: How common is loss of muscle strength as people age, and what health problems are linked to it?

Wen: Declining muscle mass and strength with age is extremely common. Beginning in midlife, adults gradually lose muscle tissue and strength each decade. Without interventions such as resistance training, the decline tends to accelerate later in life; adults who do not regularly engage in strength training can lose 4 to 6 pounds of muscle (1.8 kilograms to 2.7 kilograms) per decade.

Loss of strength can have wide-ranging consequences. It is strongly associated with frailty, falls and fractures, which are all major causes of injury and disability among older adults. Reduced muscle strength is also linked to slower walking speed, difficulty performing everyday activities and a higher likelihood of needing assistance with daily living.

In addition, less muscle strength has been associated with chronic health conditions such as cardiovascular disease, metabolic disorders and cognitive decline. While strength loss is a natural part of aging, maintaining muscle function can significantly influence quality of life and health outcomes.

CNN: Does this study mean people should start checking their grip strength or chair-stand ability at home?

Wen: These tests can be useful indicators of functional fitness, but they are not meant to be diagnostic tools when done casually at home. In research and clinical settings, grip strength is measured using specialized devices that provide standardized readings.

That said, the movements involved can offer a general sense of functional ability. For example, someone might notice if it is becoming harder to open jars, carry objects or stand up from a chair without using their hands. Changes like these can signal declining strength and may prompt a conversation with their health care provider.

Clinicians sometimes incorporate simple functional assessments into routine care for older adults, especially when evaluating mobility and fall risk. The goal is not just measurement but also identifying opportunities to maintain or improve strength.

CNN: What are practical ways people can maintain or improve their strength as they get older, especially if they have not done strength training before?

Wen: The encouraging news is that muscular strength can improve at almost any age. Even people who begin resistance training later in life can gain strength and improve their functional ability.

One approach is structured strength training. This may involve short exercises using free weights, resistance bands, weight machines or body-weight movements such as squats, wall push-ups and step-ups. The aim is to challenge major muscle groups so they adapt and become stronger.

People also can incorporate strength-building movements into daily activities. Gardening, carrying groceries, climbing stairs and rising repeatedly from a chair can all engage muscles that support mobility and independence.

For beginners, it is often helpful to start gradually and focus on proper technique. Many people benefit from guidance from a physical therapist, certified trainer or structured community program designed for older adults. The goal is consistency rather than intensity at the outset.

Maintaining strength also depends on other factors. Balanced nutrition, adequate sleep and overall physical activity all support muscle health. When combined, these strategies can help preserve strength and function well into people’s lives.

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