Hand Signals
When she was a practicing occupational therapist, Elizabeth Fain started noticing something odd in her clinic: Her patients were weak.
More specifically, their grip strengths, recorded via a hand-held dynamometer, were “not anywhere close to the norms” that had been established back in the 1980s.
-Tom Vanderbilt
Raising the American Weakling
Fain knew that physical activity levels and hand-use patterns had changed a lot since then.
Jobs had become increasingly automated, the professional and service sectors had grown, all sorts of measures of physical activity (like the likelihood that a child walks to school had declined, and the personal computer age had dawned.
But to see the numbers decline so steeply and quickly was still a surprise, and not just to her.
Unlike most findings in the sleepy field of occupational therapy, her findings, which were published last year in the Journal of Hand Therapy, touched off a media firestorm, as the revelation seemed to encapsulate any number of smoldering fears in one handy conflagration: The loss of human potential in the face of automation, of our increasing time spent on smartphones and other devices, the erosion of our masculine norms, of the fragility and general shiftlessness of millennials.
Even taking into account the cautionary statistical notes—that the sample sizes of the 1980s studies were not huge, that Fain’s study was mostly college students—the idea of a loss in human strength, expressed through a statistical measure hardly anyone had previously heard of, seemed to hint at some latter-day version of degeneration.That message was reinforced by the sheer predictive power of grip strength.
In a study published in 2015 in The Lancet, the health outcomes of nearly 140,000 people across 17 countries were tracked over four years, via a variety of measures—including grip strength. Grip strength was not only “inversely associated with all-cause mortality”—every 5 kilogram (kg) decrement in grip strength was associated with a 17 percent risk increase-but as the team, led by McMaster University professor of medicine Darryl Leong, noted: “Grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure.”
Gripping is part of a long story in which we have been getting weaker for millions of years.
Grip strength has even been found to be correlated more robustly with “ageing markers” than chronological aging itself. It has become a key method of diagnosing sarcopenia, the loss of muscle mass associated with aging.
Low grip strength has been linked to longer hospital stays, and in a study of hospitalized cancer patients, it was linked to a “an approximate 3-fold decrease in probability of discharge alive.” In older subjects, lower grip strength has even been linked with declines in cognitive performance.
“I’ve seen people refer to it as a ‘will-to-live’ meter,” says Richard Bohannon, a professor of health studies at North Carolina’s Campbell University.
Grip strength, he suggests, is not necessarily an overall indicator of health, nor is it causative—if you start building your grip strength now it does not ensure you will live longer—“but it is related to important things.”
What’s more, it’s non-invasive, and inexpensive to measure. Bohannon notes that in his home-care practice, a grip strength test is now de rigueur. “I use it in basically all of my patients,” he says. “It gives you an overall sense of their status, and high grip strength is better than low grip strength.”
The argument seemed to line up neatly. We are raising a generation of weaklings, more prone to everything from premature aging to mental disorders.
Or is the opposite true? Is this just the latest step in the age-old weakening of our species as we emerged from the trees and built up civilization?