Abstract
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 (Pnonlinearity = .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
(Pnonlinearity = .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.
Keywords
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Article info
Publication history
Published online: May 06, 2021
Footnotes
Funding: This work was supported by Shandong Provincial Key Research and Development Program (grant no. 2019GSF108196), Center of China–US Sports Economics and Health Engineering of Shandong (grant no. SDCA20191013), Academic Promotion Programme of Shandong First Medical University (grant no. 2019QL013), and Shandong Provincial Soft Science Research Program (grant no. 2020RKB14163). The funding sources had no role in study design, data analysis and interpretation, the writing of manuscript, or the decision to submit the paper for publication.
The authors declare no conflicts of interest.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
