Hand function decreases with age in both men and women, especially after the age of 65 years. A review is presented of anatomical and physiological changes in the aging hand. The age-related changes in prehension patterns (grip and pinch strength) and hand dexterity in the elderly population are considered. Deterioration in hand function in the elderly population is, to a large degree, secondary to age-related degenerative changes in the musculoskeletal, vascular, and nervous systems. Deterioration of hand function in elderly adults is a combination of local structural changes (joints, muscle, tendon, bone, nerve and receptors, blood supply, skin, and fingernails) and more distant changes in neural control. These age-related changes are often accompanied by underlying pathological conditions (osteoporosis, osteoarthritis, rheumatic arthritis, and Parkinson's disease) that are common in the elderly population. Assessment of hand function and prehension patterns is needed in order to determine specific treatment approaches.