Handgrip Strength Associated With Age-Related Macular Degeneration

The strength of an individual’s handgrip was associated with age-related macular degeneration (AMD) in a recent study, with incidence of AMD increasing in those with worse strength.¹ This result highlights the need for muscle strength interventions to be considered when looking to maintain visual health.

AMD is an eye disease that affects the central vision of those who are affected by the condition. Handgrip strength has previously been associated with overall health, including links found between handgrip strength and dementia in the UK Biobank.² Geriatric neurodegeneration is thought to be the origin of both handgrip strength deterioration and the occurrence of AMD, making it crucial to identify the specific link between them. This study used the UK Biobank cohort to identify the association between low handgrip strength and incident AMD.

The UK Biobank included participants aged 40 to 69 years at baseline from 22 assessment centers, with recruitment occurring between 2006 and 2010. Those without information on handgrip strength, who were aged less than 50 years, and did not have prevalent AMD at baseline were excluded from the study.

The primary outcome was incidence of AMD. All participants were followed up from baseline to their occurrence of AMD, death, end of the study period, or loss to follow-up. The end of the study period was November 2021. Questionnaires were given to participants at baseline to collect data on age, sex, race, employment status, education level, body mass index, household income, smoking, physical activity, and alcohol consumption. Self-reported information was used to collect data on comorbidities.

There were 382,174 participants included in the study who had a median (IQR) follow-up of 12.65 (11.82-13.38) years. A total of 7987 patients developed AMD.

Individuals were more likely to be older, male, less White ethnicity, of a lower education level, less employed, have a lower household income, have less physical activity, and be more likely to have a comorbidity if they were in the lowest quintile (Q1) for handgrip strength when compared with the highest quintile (Q5).

There was a higher overall risk of AMD in older adults in the Q4-Q1 of age-and-sex-specific handgrip strength compared with Q5 (Q4: HR, 1.05; Q3: HR, 1.09; Q2: HR, 1.19; Q1: HR, 1.36). A higher risk of developing AMD was found in older adults in lower quintiles of handgrip strength compared with those in Q5. A 6% increased risk of incident AMD per 5 kg lower handgrip strength was calculated in the fully adjusted model. Handgrip strength and AMD had a stronger association with women (HR, 1.09; 95% CI, 1.06-1.12) compared with men (HR, 1.04; 95% CI, 1.02-1.07).

There were some limitations to this study. Handgrip strength classification was only based on baseline characteristics and did not account for changing strength over time. Most of the participants in the UK Biobank are White and had a healthier lifestyle, which could introduce selection bias. Unmeasured confounding factors could not all be eliminated. Self-reported covariates could have biased the results. Causality may not be inferred due to the observational design of the study.

“We found that handgrip strength is strongly and inversely associated with the incidence of [AMD], with insignificant deviation between sub-populations except for sex,” the authors concluded. “These findings indicate that [handgrip strength] impairment contributes a potential cause to a higher risk of AMD in the elderly, while further studies are in need to expore this relationship in more detail. Once strongly verified [handgrip strength] measurement may be applied to assist the risk evaluation of senile neurogenerative visual deficit…”

References

1. Wang S, Hong Y, Qu Y, et al. Association between low handgrip strength and the increased risk of age-related macular degeneration: results from UK biobank cohort study. Aging Clin Exp Res. Published online December 5, 2025. doi:10.1007/s40520-025-03208-z
2. Duchowny KA, Ackley SF, Brenowitz WD, et al. Associations between handgrip strength and dementia risk, cognition, and neuroimaging outcomes in the UK Biobank Cohort Study. JAMA Netw Open. 2022;5(6):e2218314. doi:10.1001/jamanetworkopen.2022.18314