To explore the relationship of impairment types to grip strength in the live-at-home frail elderly.All data in this cross-sectional study were collected in face-to-face interviews in subjects' homes by a nurse or occupational therapist. A total of 832 elders with activity limitations, as determined by the FIM instrument, participated in the study. Subjects were divided into three age groups (60-69, 70-79, and 80+ yrs) and four impairment groups: (1) minimally impaired, (2) visually impaired, (3) motor impaired, and (4) cognitively impaired. The outcome measures included the average (in kilograms) of three grip-strength trials per hand measured with the Jamar dynamometer at the second handle setting.There were significant differences in grip strength scores among all age groups, indicating that grip strength decreased with age. Among impairment groups, the minimally impaired and visually impaired groups had significantly greater grip strength scores than the motor-impaired and the cognitively impaired groups. There were no significant differences between the minimally impaired and visually impaired groups or between the motor-impaired and the cognitively impaired groups.Age and sex are not the only determining factors of grip strength in the frail elderly. The type of impairment affects grip strength as well. Thus, age-based norms may not be the only basis for interpreting evaluation data and establishing treatment goals with this population.