Based on The time course of motor and cognitive decline in older adults and their associations with brain pathologies: a multicohort study published in Lancet Healthy Longev 2024; 2025
In the world of aging research, grip strength is gaining surprising scientific traction—not just as a measure of physical capability, but as a window into brain health and longevity. A new multicohort study published in The Lancet Healthy Longevity adds compelling evidence: declining hand strength may precede cognitive decline by several years and serve as an early marker of age-related brain changes.
The Study: A Closer Look at Decline
Researchers analyzed data from 1,303 older adults, all of whom underwent annual motor and cognitive testing and later donated their brains for detailed post-mortem examination. The participants were part of three long-running community-based studies: the Religious Orders Study, the Rush Memory and Aging Project, and the Minority Aging Research Study. None had dementia at enrollment.
Over nearly three decades of data, scientists tracked changes in three domains: cognitive function, gait speed, and hand strength. Using sophisticated non-linear models (functional mixed-effects models), they found that while cognitive ability remained stable until about 15 years before death, both gait and hand strength began declining much earlier—often decades prior.
Motor Decline Before Cognitive Decline
The most striking finding: grip strength and walking ability declined steadily throughout older adulthood, long before measurable cognitive changes set in. On average, reductions in hand strength began nearly 10 years before cognitive decline. These changes weren’t just due to age—they were partially linked to underlying brain pathologies.
Certain types of brain damage had stronger associations with motor function. For example, tau tangles—hallmarks of Alzheimer’s disease—were linked with all three forms of decline (cognitive, gait, and grip), but their effect on grip strength only emerged about 3.5 years before death. In contrast, macroinfarcts (large strokes in the brain) were associated with declining hand strength even earlier—about 2.7 years before death—and showed a much earlier impact on gait.
Why It Matters
This study challenges the traditional assumption that cognitive symptoms are the earliest indicators of neurodegenerative disease. Instead, subtle physical changes—especially in grip strength—may appear first, offering a crucial window for early detection and intervention.
It also suggests that grip strength could serve as a practical, low-cost biomarker for identifying older adults at risk for vascular cognitive impairment or Alzheimer’s-related changes, even before memory problems appear.
Importantly, the study found that motor decline was not fully explained by aging or brain pathology alone. This points to other contributing factors—such as muscle health, spinal cord changes, inflammation, and lifestyle—that deserve further investigation.
What Can You Do?
Grip strength is not destiny. Resistance training, physical activity, and a nutrient-rich diet—particularly one supporting neuromuscular function—can help preserve strength into older age. Routine screening using simple tools like hand dynamometers could help identify those at risk, long before cognitive symptoms emerge.
DR HUNT’s opinion
Grip strength isn’t just about a firm handshake—it’s a window into aging itself. As this new research shows, monitoring motor function may be one of the most powerful tools we have for detecting age-related disease before it takes hold.