Sex- and Age-Stratified relative handgrip strength and risk of eight chronic diseases in Middle-Aged and older adults: evidence from a National aging cohort study in China.

OBJECTIVE: Identifying cost-effective biomarkers for chronic disease screening remains a global challenge. This study examined sex- and age-specific associations between relative handgrip strength (RHGS) and eight chronic diseases to inform targeted screening and resource allocation. METHODS: Longitudinal data from 11,415 participants in the China Health and Retirement Longitudinal Study (CHARLS) aged ≥ 45 years were analyzed. Participants were stratified into sex-specific, body mass index-adjusted RHGS quartiles. Multivariable Cox proportional hazards models were used to examine associations between RHGS and risks of diabetes, dyslipidemia, low cognitive performance, depression, heart disease, hypertension, stroke, and arthritis, stratified by sex and age group. RESULTS: Over a median follow-up of 84 months, higher RHGS quartiles were linked to lower risks of diabetes, dyslipidemia, low cognitive performance, and stroke. In older males, the highest quartile was associated with a 53% lower risk of low cognitive performance and a nonlinear relationship with diabetes risk. In middle-aged males, the highest quartile meant a 64% lower risk of dyslipidemia. Among females, higher RHGS was associated with cardiovascular disease and reduced low cognitive risk in older females. Low baseline RHGS predicted higher risks, even if RHGS improved later. CONCLUSIONS: This study supports incorporating RHGS assessment into routine midlife health screenings and adopting sex- and age-specific strategies to improve cost-effective disease prevention. Clinically, prioritize cognitive screening in older adults with low RHGS, focus on glucose and lipid disorders in middle-aged individuals with low RHGS, and emphasize cardiovascular risk assessment in middle-aged and older females with low RHGS.