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Long-Term Determinants of Muscle Strength Decline: Prospective Evidence from the 22-Year Mini-Finland Follow-Up Survey


Address correspondence to Sari Stenholm, National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Peltolantie 3, FI-20720 Turku, Finland. E-mail:



To examine long-term changes in handgrip strength and the factors predicting handgrip strength decline.


Longitudinal cohort study with 22 years of follow-up.


Population-based Mini-Finland Health Examination Survey in Finland.


Nine hundred sixty-three men and women aged 30 to 73 at baseline.


Handgrip strength was measured using a handheld dynamometer at baseline and follow-up. Information on potential risk factors, namely lifestyle and chronic conditions, and their changes throughout the follow-up were based on health interviews.


Based on linear mixed-effect models, midlife physically strenuous work, excess body weight, smoking, cardiovascular disease, hypertension, diabetes mellitus, and asthma predicted muscle strength decline over 22 years of follow-up (P < .05 for all). In addition, pronounced weight loss, becoming physically sedentary, persistent smoking, incident coronary heart disease, other cardiovascular disease, diabetes mellitus, chronic bronchitis, chronic back syndrome, long-lasting cardiovascular disease, hypertension, and asthma were associated with accelerated handgrip strength decline (P < .05 for all).


Lifestyle and physical health earlier in life determine rate of muscle strength decline in old age. Efforts should be made to recognize persons at risk in a timely manner and target early interventions to middle-aged persons to slow down muscle strength decline and prevent future functional limitations and disability.

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