NCHS Data Brief ■ No. 179 ■ January 2015

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Muscle weakness is linked to impaired mobility and mortality in older persons 

(1,2). The Foundation for the National Institutes of Health (FNIH) Sarcopenia 

Project recently developed sex-specific criteria to diagnose different degrees 

of muscle strength (i.e., weak, intermediate, and normal) in older adults based 

on maximum hand grip strength (1,3). These thresholds are related to the 

level of muscle weakness that is associated with slow gait speed, an important 

mobility impairment (3). This report uses the FNIH criteria to provide national 

estimates of muscle strength in older adults in the United States in 2011–2012. 

Keywords: grip strength • National Health and Nutrition Examination Survey 

(NHANES)

What was the muscle strength status of older U.S. adults 

overall and by age in 2011–2012? 

In 2011–2012, 5% of persons aged 60 and over had weak muscle strength, 

13% had intermediate strength, and 82% had normal strength, according to the 

FNIH criteria (Figure 1). Reduced (weak and intermediate) strength increased 

with age, while normal strength decreased with age. Among persons aged 

60–79, 2% had weak strength, 8% had intermediate strength, and 90% had 

Key findings 

Data from the National 

Health and Nutrition 

Examination Survey, 

2011–2012

● Five percent of adults aged 

60 and over had weak muscle 

strength. Thirteen percent had 

intermediate muscle strength, 

while 82% had normal muscle 

strength. 

● The prevalence of reduced 

(weak and intermediate) muscle 

strength increased with age, 

while the prevalence of normal 

strength decreased with age.

● Muscle strength status did 

not differ by sex, except among 

persons aged 80 and over, 

where women had a higher 

prevalence of weak muscle 

strength than men. 

● Non-Hispanic Asian and 

Hispanic persons had a higher 

prevalence of reduced muscle 

strength than non-Hispanic 

white persons. 

● Difficulty with rising from 

a chair increased as strength 

status decreased.

Prevalence of Reduced Muscle Strength in Older U.S. Adults: 

United States, 2011–2012

Anne C. Looker, Ph.D.; and Chia-Yih Wang, Ph.D.

Normal strength Intermediate strength Weak strength

Figure 1. Muscle strength status in adults aged 60 and over, by age: United States, 2011–2012

60 and over 60–79 80 and over

1

Significantly different from those aged 60–79 in the same muscle strength category, p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

82%

13%

5%

2%

1

19%

8%

1 90% 34%

1

47%
NCHS Data Brief ■ No. 179 ■ January 2015

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normal strength. In contrast, among those aged 80 and over, 19% had weak strength, 34% had 

intermediate strength, and 47% had normal strength. 

Did the prevalence of reduced muscle strength differ by sex among older 

adults in 2011–2012? 

Reduced muscle strength status, based on sex-specific criteria, did not differ by sex overall or 

when compared within age groups, with one exception: The prevalence of weak strength was 

higher in women aged 80 and over when compared with men of the same age (Figure 2).

0

20

40

60

60 and over 80 and over 1

Intermediate

strength

Weak

strength

Men Women Men Women Men Women

Figure 2. Percentage with reduced muscle strength among adults aged 60 and over, by sex and age: United States, 

2011–2012

60–79

Percent

5

15

15

2

22

31

36

6

14

2

9

1

Age-adjusted.

2

Significantly different from men in the same muscle strength category, p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

2

7
NCHS Data Brief ■ No. 179 ■ January 2015

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Did the prevalence of reduced muscle strength differ by race and Hispanic 

origin among older adults in 2011–2012? 

The prevalence of reduced muscle strength differed by race and Hispanic origin after adjusting for 

age differences (Figure 3). The age-adjusted prevalence of weak strength (15%) and intermediate 

strength (25%) in non-Hispanic Asian persons was higher than the prevalence of these conditions 

in non-Hispanic white persons (5% with weak strength; 13% with intermediate strength) or 

non-Hispanic black persons (6% with weak strength; 13% with intermediate strength). The 

age-adjusted prevalence of weak strength (9%) and intermediate strength (23%) in Hispanic 

persons was also higher than the prevalence of these conditions in non-Hispanic white persons. In 

addition, the age-adjusted prevalence of Hispanic persons with intermediate strength was higher 

than the prevalence in non-Hispanic black persons. Neither condition differed between 

non-Hispanic Asian and Hispanic persons. 

0

10

20

30

40

50

Non-Hispanic Hispanic

Asian

Non-Hispanic

black

Non-Hispanic

white

Intermediate

strength

Weak

strength

Figure 3. Age-adjusted percentage with reduced muscle strength in adults aged 60 and over, by race and Hispanic origin: 

United States, 2011–2012 Percent

1,25

1,213

15

9

23

1

6

1,213

1

Significantly different from non-Hispanic Asian persons in the same muscle strength category, p < 0.05. 2

Significantly different from Hispanic persons in the same muscle strength category, p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

25
NCHS Data Brief ■ No. 179 ■ January 2015

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Did the prevalence of older adults who had difficulty rising from an armless 

chair differ by muscle strength status in 2011–2012? 

The prevalence of adults aged 60 and over who reported difficulty in rising from an armless chair 

differed by muscle strength status (Figure 4). The percentage reporting difficulty rising from an 

armless chair increased with decreasing strength. Fifty-five percent of those with weak strength 

reported difficulty rising from an armless chair, compared with 26% of those with intermediate 

strength, and 13% of those with normal strength. 

0

10

20

30

40

50

60

Normal Intermediate Weak

Muscle strength3

Figure 4. Percentage of adults aged 60 and over with difficulty rising from a chair, by muscle strength: United States, 

2011–2012 Percent

13

1,255

1

Significantly different from those in the normal strength category, p < 0.05. 2

Significantly different from those in the intermediate strength category, p < 0.05. 3

p < 0.05 for linear trend.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

1

26
NCHS Data Brief ■ No. 179 ■ January 2015

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Summary

Five percent of adults aged 60 and over had weak muscle strength and 13% had intermediate 

muscle strength, as defined by the new FNIH criteria (1). Weak muscle strength is clinically 

relevant because it is associated with slow gait speed, an important mobility impairment (1,2). 

It is also linked to an increased risk of death (2). The prevalence of reduced muscle strength 

increased with age and was higher in non-Hispanic Asian and Hispanic persons than in 

non-Hispanic white or non-Hispanic black persons. Decreasing muscle strength was linked with 

increased difficulty in rising from an armless chair, which is another important type of mobility 

impairment (1).

Definitions

Weak muscle strength: A value for maximum hand grip strength less than 26 kilograms (kg) for 

men and less than 16 kg for women (1,3).

Intermediate muscle strength: A value for maximum hand grip strength between 26 kg–31.9 kg 

for men and 16 kg–19.9 kg for women (3). 

Normal muscle strength: A value for maximum hand grip strength greater than or equal to 32 kg 

for men and greater than or equal to 20 kg for women (3). 

Difficulty rising from a chair: Self-reported difficulty in rising from an armless straight chair 

without assistance. Respondents who reported “some difficulty,” “much difficulty,” or “unable to 

do” were defined as having difficulty. 
NCHS Data Brief ■ No. 179 ■ January 2015

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Data source and methods

National Health and Nutrition Examination Survey (NHANES) data were used for these analyses. 

NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the 

civilian noninstitutionalized U.S. population (4). The survey consists of interviews conducted 

in participants’ homes and standardized physical examinations that include an isometric grip 

strength test using a Takei Digital Grip Strength Dynamometer (5). The maximum value of any of 

six grip strength tests (three tests performed on each hand) was used in the present analyses.

The NHANES sample is selected through a complex, multistage design that includes selection of 

primary sampling units (counties), household segments within the counties, and finally sample 

persons from selected households. In 2011–2012, non-Hispanic black, non-Hispanic Asian, and 

Hispanic persons, among other groups, were oversampled to obtain reliable estimates for these 

population subgroups. Estimates for race and Hispanic origin groups reflect individuals reporting 

only one race; those reporting more than one race are included in the total, but are not reported 

separately. 

Sample weights, which account for the differential probabilities of selection, nonresponse, 

and noncoverage, were incorporated into the estimation process. The standard errors of the 

percentages were estimated using Taylor series linearization, a method that incorporates the 

sample design. Prevalence estimates were age-adjusted to the 2000 U.S. standard population 

using the following age groups: 60–69, 70–79, and 80 and over. Differences between groups 

were evaluated using a t statistic at the p less than 0.05 significance level. Tests of trends were 

done using the p less than 0.05 significance level. All results presented have a relative standard 

error of less than 30%. All differences reported are statistically significant unless otherwise 

noted. Statistical analyses were conducted using the SAS System for Windows, release 9.3 (SAS 

Institute Inc., Cary, N.C.) and SUDAAN, release 11.0.1 (RTI International, Research Triangle 

Park, N.C.).
NCHS Data Brief ■ No. 179 ■ January 2015

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About the authors

Anne C. Looker and Chia-Yih Wang are with CDC’s National Center for Health Statistics, 

Division of Health and Nutrition Examination Surveys. 

References

1. Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The

FNIH Sarcopenia Project: Rationale, study description, conference recommendations, and final 

estimates. J Gerontol A Biol Sci Med Sci 69(5):547–58. 2014.

2. McLean RR, Shardell MD, Alley DE, Cawthon PM, Fragala MS, Harris TB, et al. Criteria for

clinically relevant weakness and low lean mass and their longitudinal association with incident 

mobility impairment and mortality: The Foundation for the National Institutes of Health (FNIH) 

Sarcopenia Project. J Gerontol A Biol Sci Med Sci 69(5):576–83. 2014.

3. Alley DE, Shardell MD, Peters KW, McLean RR, Dam TT, Kenny AM, et al. Grip strength

cutpoints for the identification of clinically relevant weakness. J Gerontol A Biol Sci Med Sci 

69(5):559–66. 2014.

4. NCHS. NHANES 2011–2012 overview. Available from: http://www.cdc.gov/nchs/nhanes/

nhanes2011-2012/overview_g.htm.

5. NCHS. National Health and Nutrition Examination Survey (NHANES) Muscle Strength

Procedures Manual. 2011. Available from: http://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/

Muscle_Strength_Proc_Manual.pdf.
NCHS Data Brief ■ No. 179 ■ January 2015

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Suggested citation

Looker AC, Wang CY. Prevalence of 

reduced muscle strength in older U.S. adults: 

United States, 2011–2012. NCHS data brief, 

no 179. Hyattsville, MD: National Center 

for Health Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director