Grip Strength Reads the Hand First: Carpal Tunnel Syndrome, Thumb Carpometacarpal Arthritis and Neuropathy as Hidden Causes of Low Grip in Older Adults

Hand surgeons measure grip with a dynamometer to judge the hand. Aging research uses the same reading to judge the whole body: grip below 27 kg in men or 16 kg in women flags probable sarcopenia. The dynamometer reads the hand first. Carpal tunnel syndrome, cubital tunnel syndrome, thumb carpometacarpal osteoarthritis and a healed distal radius fracture lower grip without lowering strength elsewhere. Peripheral neuropathy and rheumatoid arthritis can lower grip while carrying their own risk of disability and death. A trained hand may hide weak legs. The grip protocols of four large population studies screen the hand only for recent surgery, acute symptoms or visible limitations, or not at all, and taking the stronger hand misses bilateral carpal tunnel syndrome, present in most patients in one electrodiagnostic series. A worked illustration shows how a modest hand deficit in a minority of older women could account for a meaningful share of readings below the cut point. We propose a five-item hand-status checklist, asked of each hand before grip is measured, with interpretation principles for clinicians and reporting items for studies. How often hand disease leads to a person being labeled weak remains to be measured.