increased disability,” wrote Sayer. "However, the findings from [the study] suggest that associations with cardiovascular disease and its risk factors might be an additional pathway.” In other words, Sayer explained, the link between muscle strength and heart health suggests some kind of “mechanistic explanation” for how one lifts the other, but no one has yet uncovered it. Currently, the hand grip test is not standard in clinical exams, but Leong thinks that the cheap, simple hand grip test can be especially useful to assess risk of death in people with pneumonia, cancer or heart disease, as his study found that low grip strength in these patients was linked to a high risk of dying from their disease, but high grip strength indicated a better outcome. "We also expect it may be a useful test in low-resource settings, where access to more sophisticated tests is limited," Leong concluded. "One of the challenges in knowing where to use it lies in not knowing what we can do to improve it, so we really need to undertake more research."