Research Highlights:
- Muscle loss, weaker grip and a slower pace of walking were associated with a higher risk of stroke in an analysis of health records for more than 480,000 adults in the UK Biobank.
- People with low muscle strength had a 30% higher risk of any type of stroke; a 31% higher risk of an ischemic stroke; and a 41% higher risk of hemorrhagic stroke.
- Having lower grip strength was linked to a 7% higher chance of having a stroke.
- Slow walking pace was associated with a 64% increased risk of stroke compared to a brisk pace.
- The study results could lead to a simple and low-cost way to identify people with higher risk of stroke and help them with prevention strategies.
DALLAS, May 7, 2026 — Muscle loss, a weaker grip and a slower walking pace were associated with a higher risk of stroke in adults, according to new research published today in Stroke, the peer-reviewed scientific journal of the American Stroke Association, a division of the American Heart Association.
In the study, people with low muscle strength had a 30% higher risk of any type of stroke; a 31% higher risk of an ischemic stroke; and a 41% higher risk of hemorrhagic stroke. Having lower grip strength was linked to a 7% higher chance of having a stroke. Slow walking pace was associated with a 64% increased risk of stroke compared to a brisk pace.
In clinical practice, we often see that patients with lower levels of physical function tend to have worse overall health outcomes. However, these physical function indicators are currently not routinely incorporated into stroke risk assessment," said study author Lu-sha Tong, M.D., a neurologist at the Second Affiliated Hospital, Zhejiang University School of Medicine in Hangzhou, China. "
Researchers reviewed health data for more than 480,000 adults enrolled in the UK Biobank who had not had a previous stroke and found that lower measures of muscle strength, muscle loss and walking pace were associated with a higher risk of having a stroke.
"As people age, they often lose muscle strength and mass. This loss is associated with higher stroke risk by showing lower physical health, chronic inflammation and changes in metabolism. Weak muscles may be an early warning sign of a higher risk for stroke," she said.
Tong also noted that the finding about walking pace showed a stronger, more consistent association with stroke risk than grip strength. "Walking pace may be a good sign of overall health."
"Our findings suggest that quick, standard screenings for physical function, such as grip strength and walking pace, may help us identify adults with higher risk of stroke, potentially supporting earlier prevention strategies," she said.
According to the American Heart Association's Heart Disease and Stroke Statistics – 2026 Update, stroke is the fourth leading cause of death in the United States, and a leading cause of long-term disability.
The analysis found:
- About 4.7% of study participants were likely to have experienced muscle loss, while 0.4% had confirmed muscle loss.
- People with probable muscle loss (low muscle strength) had a 30% higher risk of any type of stroke; a 31% higher risk of an ischemic stroke; and a 41% higher risk of hemorrhagic stroke.
- Adults who had documented muscle loss were older (average age of 60.8 vs. 56.3 years, respectively), included fewer men (31.6% vs. 45.8%, respectively), had lower body mass index (average BMI of 21.0 vs. 27.4, respectively) and had lower-than-college education levels compared to peers without muscle loss.
- Among 11,814 participants who had a stroke, those with muscle loss had higher mortality rates, with increases of about 25% in probable cases and nearly 46% in confirmed cases compared with those without muscle loss.
- Having lower grip strength was linked to a 7% higher chance of having a stroke.
- Slow walking pace was associated with a 64% increased risk of stroke compared to a brisk pace.
- A method of analysis using genetic variants to estimate the potential causal effect of genetic exposure, known as Mendelian randomization, indicated that a faster walking pace was associated with a lower risk of stroke.
Study details, background and design:
- Researchers analyzed health records for 482,699 adults (ages 37 to 73 years) enrolled in the UK Biobank who had no history of stroke. The health data analyzed was from 2006 to 2022.
- During a median follow-up of almost 14 years, 11,814 stroke cases were documented, including 9,449 ischemic (clot-caused) strokes and 2,029 hemorrhagic (bleeding) strokes
- Average age for participants with and without muscle loss ranged from 56 to 61 years old; between 32% and 45% were men, and they were mostly white adults.
- Muscle strength was evaluated using guidelines for older adults – the European Working Group on Sarcopenia in Older People (EWGSOP2).
- Muscle loss (sarcopenia) was defined as an age-related decline in muscle mass. Grip strength was measured using standard handheld dynamometers. It was determined based on grip-strength measurements with sex-specific thresholds of 27 kg (60 pounds) for men and 16 kg (35 pounds) for women. Walking pace was self-reported as slow, average or brisk.
- Low muscle strength indicated "probable sarcopenia," while low muscle quantity/quality (measured with a body composition analyzer) led to a diagnosis of confirmed sarcopenia.
The study has several strengths. It includes a large number of participants, uses a forward-looking design and combines observational and genetic analysis. However, there are some limitations. Researchers could not control for some factors that might confuse the results, such as relying on self-reported data for certain variables. Additionally, the findings may not apply to everyone since the participants were healthy adults receiving routine care from the National Health Service in the United Kingdom.
Co-authors, disclosures and funding sources are listed in the manuscript.
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