If we want to measure health, it’s tricky. Which aspect of health are you going to measure?
Fortunately there is one measure which can be agreed upon and that is longevity.
Generally living a long life is a fairly good indication of health (unless those final years are prolonged artificially while in poor health.) The trouble with longevity as a measure is that by the time you learn anything, it’s a bit late.
Nevertheless, there is a growing body of evidence which firmly establishes the link between muscle weakness and early death. Some studies measure handgrip strength, others use the large axial and limb muscles but all reach basically the same conclusion – the stronger you are, the longer you live and the less disability you suffer. This effect is independent of age, fitness, exercise and BMI (body weight).
For your convenience I have compiled a list of relevant studies (in chronological order with links to the originals) here:
Blair, S. N. (1996). Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women. JAMA: The Journal of the American Medical Association, 276(3), 205. http://doi.org/10.1001/jama.1996.03540030039029
Laukkanen, P., Heikkinen, E., & Kauppinen, M. (1995). Muscle strength and mobility as predictors of survival in 75-84-year- old people. Age and Ageing, 24(6), 468–473. http://doi.org/10.1093/ageing/24.6.468
Lee, C. D., Blair, S. N., & Jackson, a S. (1999). Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. The American Journal of Clinical Nutrition, 69(3), 373–80. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10075319
Rantanen, T., Harris, T., Leveille, S. G., Visser, M., Foley, D., Masaki, K., & Guralnik, J. M. (2000). Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 55(3), M168–M173. http://doi.org/10.1093/gerona/55.3.M168
Katzmarzyk, P. T., & Craig, C. L. (2002). Musculoskeletal fitness and risk of mortality. Medicine and Science in Sports and Exercise, 34(5), 740–744. http://doi.org/10.1097/00005768-200205000-00002
Rantanen, T., Volpato, S., Luigi Ferrucci, M., Eino Heikkinen, M., Fried, L. P., & Guralnik, J. M. (2003). Handgrip Strength and Cause-Specific and Total Mortality in Older Disabled Women: Exploring the Mechanism. Journal of the American Geriatrics Society, 51(5), 636–641. http://doi.org/10.1034/j.1600-0579.2003.00207.x
FitzGerald, S. J., Barlow, C. E., Kampert, J. B., Morrow, J. R., Jackson, A. W., & Blair, S. N. (2004). Muscular Fitness and All-Cause Mortality: Prospective Observations. Journal of Physical Activity and Health, 1(1), 7–18. http://doi.org/10.1123/jpah.1.1.7
Willardson, J. M., & Tudor-Locke, C. (2005). Survival of the Strongest: A Brief Review Examining the Association Between Muscular Fitness and Mortality. Strength and Conditioning Journal, 27(3), 80–85. http://doi.org/10.1519/1533-4295(2005)027[0080:SOTSAB]2.0.CO;2
Newman, A. B., Kupelian, V., Visser, M., Simonsick, E. M., Goodpaster, B. H., Kritchevsky, S. B., … Harris, T. B. (2006). Strength, but not muscle mass, is associated with mortality in the Health, Aging and Body Composition Study cohort. J Gerontol A Biol Sci Med Sci, 61(1), 72–77. http://doi.org/61/1/72 [pii]
Sasaki, H., Kasagi, F., Yamada, M., & Fujita, S. (2007). Grip Strength Predicts Cause-Specific Mortality in Middle-Aged and Elderly Persons. The American Journal of Medicine, 120(4), 337–342. http://doi.org/10.1016/j.amjmed.2006.04.018
Gale, C. R., Martyn, C. N., Cooper, C., & Sayer, A. A. (2007). Grip strength, body composition, and mortality. International Journal of Epidemiology, 36(1), 228–235. http://doi.org/10.1093/ije/dyl224
Swallow, E. B., Reyes, D., Hopkinson, N. S., Man, W. D.-C., Porcher, R., Cetti, E. J., … Polkey, M. I. (2007). Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax, 62(2), 115–120. http://doi.org/10.1136/thx.2006.062026
Ali, N. A., O’Brien, J. M., Hoffmann, S. P., Phillips, G., Garland, A., Finley, J. C. W., … Marsh, C. B. (2008). Acquired weakness, handgrip strength, and mortality in critically III patients. American Journal of Respiratory and Critical Care Medicine, 178(3), 261–268. http://doi.org/10.1164/rccm.200712-1829OC
Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N. (2008). Association between muscular strength and mortality in men: prospective cohort study. Bmj, 337(jul01 2), a439–a439. http://doi.org/10.1136/bmj.a439
Ruiz, J. R., Castro-Pinero, J., Artero, E. G., Ortega, F. B., Sjostrom, M., Suni, J., & Castillo, M. J. (2009). Predictive validity of health-related fitness in youth: a systematic review. British Journal of Sports Medicine, 43(12), 909–923. http://doi.org/10.1136/bjsm.2008.056499
Ruiz, J. R., Sui, X., Lobelo, F., Lee, D. C., Morrow, J. R., Jackson, A. W., … Blair, S. N. (2009). Muscular strength and adiposity as predictors of adulthood cancer mortality in men. Cancer Epidemiology Biomarkers and Prevention, 18(5), 1468–1476. http://doi.org/10.1158/1055-9965.EPI-08-1075
Xue, Q. L., Beamer, B. A., Chaves, P. H. M., Guralnik, J. M., & Fried, L. P. (2010). Heterogeneity in rate of decline in grip, hip, and knee strength and the risk of all-cause mortality: The women’s health and aging study II. Journal of the American Geriatrics Society, 58(11), 2076–2084. http://doi.org/10.1111/j.1532-5415.2010.03154.x
Phillips, A. C., Der, G., & Carroll, D. (2010). Self-reported health, self-reported fitness, and all-cause mortality: Prospective cohort study. British Journal of Health Psychology, 15(2), 337–346. http://doi.org/10.1348/135910709X466180
Cooper R Kuh D Hardy R Mortality Review Group FALCon and HALCyon Study Teams.Objectively measured physical capability levels and mortality: systematic review and meta-analysis.(2010) BMJ. 2010 Sep 9;341:c4467. doi: 10.1136/bmj.c4467.
Han, S. S., Kim, K. W., Kim, K.-I., Na, K. Y., Chae, D.-W., Kim, S., & Chin, H. J. (2010). Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians. Journal of the American Geriatrics Society, 58(2), 312–317. http://doi.org/10.1111/j.1532-5415.2009.02672.x
Artero, E. G., Lee, D., Ruiz, J. R., Sui, X., Ortega, F. B., Church, T. S., … Blair, S. N. (2011). A Prospective Study of Muscular Strength and All-Cause Mortality in Men With Hypertension. Journal of the American College of Cardiology, 57(18), 1831–1837. http://doi.org/10.1016/j.jacc.2010.12.025
Sundermann, S., Dademasch, A., Rastan, A., Praetorius, J., Rodriguez, H., Walther, T., … Falk, V. (2011). One-year follow-up of patients undergoing elective cardiac surgery assessed with the Comprehensive Assessment of Frailty test and its simplified form. Interactive CardioVascular and Thoracic Surgery, 13(2), 119–123. http://doi.org/10.1510/icvts.2010.251884
Norman, K., Stobäus, N., Gonzalez, M. C., Schulzke, J. D., & Pirlich, M. (2011). Hand grip strength: Outcome predictor and marker of nutritional status. Clinical Nutrition. http://doi.org/10.1016/j.clnu.2010.09.010
Artero, E. G., Lee, D., Lavie, C. J., España-Romero, V., Sui, X., Church, T. S., & Blair, S. N. (2012). Effects of Muscular Strength on Cardiovascular Risk Factors and Prognosis. Journal of Cardiopulmonary Rehabilitation and Prevention, 32(6), 351–358. http://doi.org/10.1097/HCR.0b013e3182642688
Masunari, N., Fujiwara, S., Kasagi, F., Takahashi, I., Yamada, M., & Nakamura, T. (2012). Height loss starting in middle age predicts increased mortality in the elderly. Journal of Bone and Mineral Research, 27(1), 138–145. http://doi.org/10.1002/jbmr.513
Garc??a-Pe??a, C., Garc??a-Fabela, L. C., Guti??rrez-Robledo, L. M., Garc??a-Gonz??lez, J. J., Arango-Lopera, V. E., & P??rez-Zepeda, M. U. (2013). Handgrip Strength Predicts Functional Decline at Discharge in Hospitalized Male Elderly: A Hospital Cohort Study. PLoS ONE, 8(7). http://doi.org/10.1371/journal.pone.0069849
Schaap, L. A., Koster, A., & Visser, M. (2013). Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons. Epidemiologic Reviews, 35(1), 51–65. http://doi.org/10.1093/epirev/mxs006
Cheung, C. L., Nguyen, U. S. D. T., Au, E., Tan, K. C. B., & Kung, A. W. C. (2013). Association of handgrip strength with chronic diseases and multimorbidity: A cross-sectional study. Age, 35(3), 929–941. http://doi.org/10.1007/s11357-012-9385-y
Puhan, M. A., Siebeling, L., Zoller, M., Muggensturm, P., & Riet, G. Ter. (2013). Simple functional performance tests and mortality in COPD. European Respiratory Journal, 42(4), 956–963. http://doi.org/10.1183/09031936.00131612
Isaia, G., Greppi, F., Pastorino, A., Bersano, E. M., Rrodhe, S., Ricauda, N. A., … Zanocchi, M. (2013). Predictive effects of muscle strength after hospitalization in old patients. Aging Clinical and Experimental Research, 25(6), 633–636. http://doi.org/10.1007/s40520-013-0162-2
Savino, E., Martini, E., Lauretani, F., Pioli, G., Zagatti, A. M., Frondini, C., … Volpato, S. (2013). Handgrip strength predicts persistent walking recovery after hip fracture surgery. American Journal of Medicine, 126(12). http://doi.org/10.1016/j.amjmed.2013.04.017
Chuang, S. Y., Chang, H. Y., Lee, M. S., Chia-Yu Chen, R., & Pan, W. H. (2014). Skeletal muscle mass and risk of death in an elderly population. Nutrition, Metabolism and Cardiovascular Diseases, 24(7), 784–791. http://doi.org/10.1016/j.numecd.2013.11.010
de Brito, L. B. B., Ricardo, D. R., de Araújo, D. S. M. S., Ramos, P. S., Myers, J., & de Araújo, C. G. S. (2014). Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology, 21(7), 892–898. http://doi.org/10.1177/2047487312471759
Hermans, G., Van Mechelen, H., Clerckx, B., Vanhullebusch, T., Mesotten, D., Wilmer, A., … Van Den Berghe, G. (2014). Acute outcomes and 1-year mortality of intensive care unit-acquired weakness: A cohort study and propensity-matched analysis. American Journal of Respiratory and Critical Care Medicine, 190(4), 410–420. http://doi.org/10.1164/rccm.201312-2257OC
Matos, C. M., Silva, L. F., Santana, L. D., Santos, L. S., Protásio, B. M., Rocha, M. T., … Lopes, A. A. (2014). Handgrip strength at baseline and mortality risk in a cohort of women and men on hemodialysis: A 4-year study. Journal of Renal Nutrition, 24(3), 157–162. http://doi.org/10.1053/j.jrn.2013.12.005
Timpka, S., Petersson, I. F., Zhou, C., & Englund, M. (2014). Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study. BMC Medicine, 12(1), 62. http://doi.org/10.1186/1741-7015-12-62
Rowe, R., Iqbal, J., Murali-Krishnan, R., Sultan, A., Orme, R., Briffa, N., … Gunn, J. (2014). Role of frailty assessment in patients undergoing cardiac interventions. Open Heart, 1(1), e000033. http://doi.org/10.1136/openhrt-2013-000033
Srikanthan, P., & Karlamangla, A. S. (2014). Muscle mass index as a predictor of longevity in older adults. American Journal of Medicine, 127(6), 547–553. http://doi.org/10.1016/j.amjmed.2014.02.007
Legrand, D., Vaes, B., Matheï, C., Adriaensen, W., Van Pottelbergh, G., & Degryse, J. M. (2014). Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. Journal of the American Geriatrics Society, 62(6), 1030–1038. http://doi.org/10.1111/jgs.12840
Donoghue, O. A., Savva, G. M., Cronin, H., Kenny, R. A., & Horgan, N. F. (2014). Using timed up and go and usual gait speed to predict incident disability in daily activities among community-dwelling adults aged 65 and older. Archives of Physical Medicine and Rehabilitation, 95(10), 1954–1961. http://doi.org/10.1016/j.apmr.2014.06.008
Bohannon, R. W., & Magasi, S. (2015). Identification of dynapenia in older adults through the use of grip strength t-scores. Muscle and Nerve, 51(1), 102–105. http://doi.org/10.1002/mus.24264
Dodds, R., & Sayer, A. A. (2015). Sarcopenia and frailty: new challenges for clinical practice. Clinical Medicine, 15(Suppl_6), s88–s91. http://doi.org/10.7861/clinmedicine.15-6-s88
Sayer, A. A., & Kirkwood, T. B. L. (2015). Grip strength and mortality: A biomarker of ageing? The Lancet, 386(9990), 226–227. http://doi.org/10.1016/S0140-6736(14)62349-7
Guadalupe-Grau, A., Carnicero, J. A., Gómez-Cabello, A., Avila, G. G., Humanes, S., Alegre, L. M., … García-García, F. J. (2015). Association of regional muscle strength with mortality and hospitalisation in older people. Age and Ageing, 44(5), 790–795. http://doi.org/10.1093/ageing/afv080
Rijk, J. M., Roos, P. R., Deckx, L., van den Akker, M., & Buntinx, F. (2015). Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis. Geriatrics & Gerontology International, n/a-n/a. http://doi.org/10.1111/ggi.12508
Costa, T. M. da R. L., Costa, F. M., Moreira, C. A., Rabelo, L. M., Boguszewski, C. L., & Borba, V. Z. C. (2015). Sarcopenia in COPD: relationship with COPD severity and prognosis. Jornal Brasileiro de Pneumologia, 41(5), 415–421. http://doi.org/10.1590/S1806-37132015000000040
Leong, D. P., Teo, K. K., Rangarajan, S., Lopez-Jaramillo, P., Avezum, A., Orlandini, A., … Yusuf, S. (2015). Prognostic value of grip strength: Findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet, 386(9990), 266–273. http://doi.org/10.1016/S0140-6736(14)62000-6
Martien, S., Delecluse, C., Boen, F., Seghers, J., Pelssers, J., Van Hoecke, A. S., & Van Roie, E. (2015). Is knee extension strength a better predictor of functional performance than handgrip strength among older adults in three different settings? Archives of Gerontology and Geriatrics, 60(2), 252–258. http://doi.org/10.1016/j.archger.2014.11.010
Volaklis, K. A., Halle, M., & Meisinger, C. (2015). Muscular strength as a strong predictor of mortality: A narrative review. European Journal of Internal Medicine. http://doi.org/10.1016/j.ejim.2015.04.013
Martín-Ponce, E., Hernández-Betancor, I., González-Reimers, E., Hernández-Luis, R., Martínez-Riera, A., & Santolaria, F. (2015). Prognostic value of physical function tests: hand grip strength and six-minute walking test in elderly hospitalized patients. Scientific Reports, 4(1), 7530. http://doi.org/10.1038/srep07530
Lino, V. T. S., Rodrigues, N. C. P., O’Dwyer, G., Andrade, M. K. D. N., Mattos, I. E., & Portela, M. C. (2016). Handgrip strength and factors associated in poor elderly assisted at a primary care unit in Rio de Janeiro, Brazil. PLoS ONE, 11(11). http://doi.org/10.1371/journal.pone.0166373
Kraschnewski, J. L., Sciamanna, C. N., Poger, J. M., Rovniak, L. S., Lehman, E. B., Cooper, A. B., … Ciccolo, J. T. (2016). Is strength training associated with mortality benefits? A 15 year cohort study of US older adults. Preventive Medicine, 87, 121–127. http://doi.org/10.1016/j.ypmed.2016.02.038
Ding, L., & Yang, F. (2016). Muscle weakness is related to slip-initiated falls among community-dwelling older adults. Journal of Biomechanics, 49(2), 238–243. http://doi.org/10.1016/j.jbiomech.2015.12.009
McLeod, M., Breen, L., Hamilton, D. L., & Philp, A. (2016). Live strong and prosper: the importance of skeletal muscle strength for healthy ageing. Biogerontology, 17(3), 497–510. http://doi.org/10.1007/s10522-015-9631-7
Fragala, M. S., Alley, D. E., Shardell, M. D., Harris, T. B., McLean, R. R., Kiel, D. P., … Kenny, A. M. (2016). Comparison of Handgrip and Leg Extension Strength in Predicting Slow Gait Speed in Older Adults. Journal of the American Geriatrics Society, 64(1), 144–150. http://doi.org/10.1111/jgs.13871
Strand, B. H., Cooper, R., Bergland, A., Jørgensen, L., Schirmer, H., Skirbekk, V., & Emaus, N. (2016). The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study. Journal of Epidemiology and Community Health, 70(12), 1214–1221. http://doi.org/10.1136/jech-2015-206776
Rossi, A. P., Fantin, F., Caliari, C., Zoico, E., Mazzali, G., Zanardo, M., … Zamboni, M. (2016). Dynapenic abdominal obesity as predictor of mortality and disability worsening in older adults: A 10-year prospective study. Clinical Nutrition, 35(1), 199–204. http://doi.org/10.1016/j.clnu.2015.02.005
Leong, D. P., Teo, K. K., Rangarajan, S., Kutty, V. R., Lanas, F., Hui, C., … Yusuf, S. (2016). Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. Journal of Cachexia, Sarcopenia and Muscle, 7(5), 535–546. http://doi.org/10.1002/jcsm.12112
Gaikwad, N. R., Gupta, S. J., Samarth, A. R., & Sankalecha, T. H. (2016). Handgrip dynamometry: A surrogate marker of malnutrition to predict the prognosis in alcoholic liver disease. Annals of Gastroenterology, 29(4), 509–514. http://doi.org/10.20524/aog.2016.0049
Celis-Morales, C. A., Lyall, D. M., Anderson, J., Iliodromiti, S., Fan, Y., Ntuk, U. E., … Gill, J. M. R. (2017). The association between physical activity and risk of mortality is modulated by grip strength and cardiorespiratory fitness: Evidence from 498 135 UK-Biobank participants. European Heart Journal, 38(2), 116–122. http://doi.org/10.1093/eurheartj/ehw249
Menant, J. C., Weber, F., Lo, J., Sturnieks, D. L., Close, J. C., Sachdev, P. S., … Lord, S. R. (2017). Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Osteoporosis International, 28(1), 59–70. http://doi.org/10.1007/s00198-016-3691-7
Celis-Morales CA, Welsh P, Lyall DM et al(2018) Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants https://www.ncbi.nlm.nih.gov/pubmed/29739772
Sang-Min Park et al. (2018) Low handgrip strength is closely associated with chronic low back pain among women aged 50 years or older: A cross-sectional study using a national health survey https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207759