Bidirectional Associations between Handgrip Strength and Depressive Symptoms: A Longitudinal Cohort Study.

J Am Med Dir Assoc

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Shandong University Center for Suicide Prevention Research, Jinan, China. Electronic address:

Published: August 2021

Objectives: This study aimed to examine the bidirectional associations between handgrip strength and depressive symptoms in a nationally representative sample.

Design: Cohort study with a 4-year follow-up.

Setting And Participants: A total of 13,208 participants from the China Health and Retirement Longitudinal Study were included in the analyses.

Methods: Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies-Depression Scale. Separate generalized estimating equations were used to analyze the cross-sectional and longitudinal associations between handgrip strength and depressive symptoms. Restricted cubic spline models were performed to explore the shape of the dose-response relationship.

Results: Decreased handgrip strength was related to subsequent increased risk of depressive symptoms, such that participants in the lowest quartile of handgrip strength were found to have an approximately 36% increased in their risk of depressive symptoms compared with those in the highest quartile [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.17, 1.58]. There was a linear dose-response relationship between handgrip strength and risk of depressive symptoms (P = .25), in that a 5-unit increment in handgrip strength may lead to an 11% decrease in the risk of depressive symptoms (OR 0.89, 95% CI 0.85, 0.92). Conversely, depressive symptoms were prospectively associated with subsequent decreased handgrip strength (β = -0.84, 95% CI -1.13, -0.55). An approximatively L-shaped dose-response pattern was found for the association between depressive symptoms level and handgrip strength (P = .02).

Conclusions And Implications: The present study identified bidirectional associations between handgrip strength and depressive symptoms, and the associations were found to have a dose-response pattern. It provides important insights into integrated mental and physical health intervention strategies that simultaneously promote handgrip strength and depressive symptoms.

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http://dx.doi.org/10.1016/j.jamda.2021.04.006DOI Listing

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