Grip strength in men and women aged 50–79 years is associated with non-vertebral osteoporotic fracture during 15 years follow-up: The Tromsø Study 1994–1995

  • A. J. SøgaardEmail author
  • J. H. Magnus
  • Å. Bjørnerem
  • K. Holvik
  • A. H. Ranhoff
  • N. Emaus
  • H. E. Meyer
  • B. H. Strand
Original Article



In 50–79-year-olds who participated in the Tromsø Study (1994–1995), the risk of non-vertebral osteoporotic fractures during 15 years follow-up increased by 22% in men and 9% in women per 1 SD lower grip strength. The strongest association was observed in men aged 50–64 years.


We aimed to explore whether low grip strength was associated with increased risk of non-vertebral osteoporotic fracture in the population-based Tromsø Study 1994–1995.


Grip strength (bar) was measured by a Martin Vigorimeter and fractures were retrieved from the X-ray archives at the University Hospital of North Norway between 1994 and 2010. At baseline, weight and height were measured, whereas information on the other covariates were obtained through self-reported questionnaires. Cox regression was used to estimate the hazard ratio (HR) of fracture in age- and gender-specific quintiles of grip-strength, and per 1 SD lower grip strength. Similar analyses were done solely for hip fractures. Adjustments were made for age, height, body mass index (BMI), marital status, education, smoking, physical activity, use of alcohol, self-perceived health, and self-reported diseases.


In 2891 men and 4002 women aged 50–79 years, 1099 non-vertebral osteoporotic fractures—including 393 hip fractures—were sustained during the median 15 years follow-up. Risk of non-vertebral osteoporotic fracture increased with declining grip strength: hazard ratios per SD decline was 1.22 (95% CI 1.05–1.43) in men and 1.09 (95% CI 1.01–1.18) in women. HR for fracture in lower vs. upper quintile was 1.58 (95% CI 1.02–2.45) in men and 1.28 (95% CI 1.03–1.59) in women. The association was most pronounced in men aged 50–64 years with HR = 3.39 (95% CI 1.76–6.53) in the lower compared to the upper quintile.


The risk of non-vertebral osteoporotic fracture increased with declining grip-strength in both genders, particularly in men aged 50–64 years.


Age Cohort study Gender Grip strength Hip fracture Non-vertebral osteoporotic fracture 



We would like to thank Professor Vinjar Fønnebø, UiT The Arctic University of Norway; Dr Anne Tollan, MD PhD, Hoddles Creek, Victoria, Australia; Professor Ragnar Martin Joakimsen, University Hospital of North Norway, Tromsø, Norway; Professor Gro Rosvold Berntsen, Norwegian Centre for E-health Research, University Hospital of North Norway; Professor Lone Jørgensen, UiT The Arctic University of Norway; Associate Professor, Dr Luai A. Ahmed, Institute of Public Health, United Arab Emirates University, Al Ain, UAE; and the Tromsø Study for their priceless contributions in collection and quality assurance of the data used in this paper. We are also grateful to all the study participants. Without their support through the whole history of the Tromsø Study, there would have been nothing to report.

Funding information

No external funding has been received to finance this project.

Compliance with ethical standards

All participants in the Tromsø Study gave informed written signed consent. The study and the data linkages have been approved by the Norwegian Data Inspectorate, the Regional Committee for Medical and Health Research Ethics (North) (2011/1659/REK nord), UiT The Arctic University of Norway, and Norwegian Institute of Public Health. The study has been conducted in full accordance with the Helsinki Declaration of the World Medical Association.

Conflicts of interest

Anne Johanne Søgaard, Jeanette H Magnus, Åshild Bjørnerem, Kristin Holvik, Anette Hylen Ranhoff, Nina Emaus, Haakon E Meyer, and Bjørn Heine Strand declare that they have no conflict of interest.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  1. 1.Division of Mental and Physical Health, Department of Chronic Diseases and AgeingNorwegian Institute of Public HealthOsloNorway
  2. 2.Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
  4. 4.Department of Obstetrics and GynaecologyUniversity Hospital of North NorwayTromsøNorway
  5. 5.Department of Clinical ScienceUniversity of BergenBergenNorway
  6. 6.Department of Health and Care SciencesUiT The Arctic University of NorwayTromsøNorway
  7. 7.Institute of Health and SocietyUniversity of OsloOsloNorway
  8. 8.Norwegian National Advisory Unit on Aging and HealthVestfold Hospital TrustTønsbergNorway

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