Association Between Anaemia and Handgrip Strength: A Systematic Review and Meta-Analysis

Abstract

Introduction: Anaemia impairs oxygen delivery to tissues, potentially compromising muscle function. Handgrip strength (HGS) is validated marker of muscle function, frailty, and health outcomes. Objective: To synthesize evidence on the association between anaemia and HGS in adults across diverse settings. Methods: MEDLINE, JSTOR, and Google Scholar were searched up to May 2025 using MeSH terms and keywords related to anaemia and handgrip strength. Of 510 identified records, 12 studies met the inclusion criteria. Two reviewers independently screened studies, extracted data, and assessed risk of bias using Joanna Briggs Institute checklists. Random-effects meta-analysis was performed in RevMan(v4.3.0) to pool odds ratios for weak handgrip strength among anaemic versus non-anaemic individuals. Results: Across studies, anaemia was consistently associated with poor HGS. Meta-analysis included three studies that provided comparable effect estimates and sufficient quantitative data for pooling; the remaining studies were synthesized narratively indicated that individuals with anaemia had 59% greater odds of weak grip strength (OR=1.59, 95%CI,1.07–2.37), with considerable heterogeneity. Subgroup analysis revealed stronger associations in men (OR=2.13, 95%CI,1.35–3.34) than in women (OR=1.30, 95%CI,1.05–1.78), and the effects were more pronounced in older adults (particularly in >65 years). Conclusion: Anaemia is associated with reduced handgrip strength, particularly among men and older adults in our findings. These findings suggest that handgrip strength may reflect functional impairment related to anaemia and could be useful as simple functional assessment measure in resource-limited settings. Further longitudinal studies are needed to clarify causality and the impact of anaemia treatment on muscle strength and functional outcomes.