Handgrip strength reference values and dynapenia risk thresholds in an urban adult sample from Lima, Peru

Handgrip strength is widely recognized as a practical biomarker of muscle function and an important screening tool for sarcopenia and functional decline. However, most di-agnostic thresholds currently used in clinical practice were developed in European or North American populations, which may limit their applicability in other ethnic groups. Evidence suggests that muscle strength varies substantially across populations, potentially leading to misclassification when universal cut-off points are applied.

The objective of this study was to establish age- and sex-specific reference values for handgrip strength in Peruvian adults and to propose locally derived thresholds for identifying individuals at risk of dynapenia.

A cross-sectional analytical study was conducted in 439 adults aged 20-70 years recruited from a respiratory rehabilitation center in Lima, Peru. Handgrip strength was measured using a calibrated digital dynamometer following standardized procedures recommended by the American Society of Hand Therapists. Descriptive statistics and percentile curves (p10-p90) were generated stratified by age and sex. The 10th percentile was considered a preliminary threshold for potential dynapenia. Associations between age and muscle strength were examined using Pearson correlation and simple linear regression models.

Men demonstrated higher mean handgrip strength than women (dominant hand: 29.97 ± 7.52 kg vs. 26.87 ± 4.66 kg; p < 0.005). Strength declined progressively with age, with regression models indicating an estimated reduction of approximately 2.3-2.5 kg per decade. Normative percentile distributions revealed lower absolute strength values compared with commonly used international reference standards. When contrasted with EWGSOP2 diagnostic thresholds, these differences suggested that international cut-off values may not fully reflect the physical characteristics of this population, underscoring the need for population-adapted benchmarks and further validation studies before drawing diagnostic conclusions.

This study provides the first age- and sex-specific reference values for handgrip strength in a Peruvian adult population. The findings support the importance of population adapted thresholds for screening muscle weakness and suggest that locally derived percentiles may improve the identification of individuals at risk of functional decline in clinical and public health settings.