Dose-response association of handgrip strength and risk of depression: a longitudinal study of 115 601 older adults from 24 countries

The association of depressive symptoms with handgrip strength and gait speed in community-dwelling older adults: data from the baseline phase of Birjand Longitudinal Aging Study

BACKGROUND

Depression is a multifaceted condition with a high prevalence and burden to society. Handgrip strength (HGS) and gait speed (GS) are indices of physical health, which is linked to mental health. Previous studies have shown heterogeneity among countries in the association of physical parameters and depression. In this study, we aimed to investigate the association of HGS and GS with depressive symptoms in older adults.

METHODS

This is a cross-sectional study analyzing data from the Birjand Longitudinal Aging Study, a cohort of community-dwelling older adults (≥ 60 years old). Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. HGS was measured with a hand dynamometer in a sitting position, and GS was estimated by a 15-foot walk test at usual pace.

RESULTS

Compared to participants in the first quartile, those in the second quartile of HGS had significantly lower odds of suffering from depressive symptoms, while GS was not significantly associated with depressive symptoms. A higher HGS was associated with a lower risk of moderate depressive symptoms, while a higher GS was related to a lower risk of moderately severe and severe symptoms.

CONCLUSIONS

Our findings suggest that older people residing in Birjand, Iran with a moderate HGS are less likely to suffer from depressive symptoms than those with lower HGS.

Associations between muscular strength and mental health in cognitively normal older adults: a cross-sectional study from the AGUEDA trial

Objective

To examine the associations between muscular strength and mental health.

Design

We used baseline data of 91 cognitively healthy older adults (71.69 ± 3.91 years old, 57 % women) participating in the AGUEDA randomized controlled trial.

Methods

Muscular strength was assessed using both objective (i.e., handgrip strength, biceps curl, squats, and isokinetic test) and perceived (i.e., International Fitness Scale) indicators. Psychological ill-being indicators: anxiety, depression, stress, and loneliness; and psychological well-being indicators: satisfaction with life, self-esteem, and emotional well-being) were assessed using a set of valid and reliable self-reported questionnaires. Linear regression analyses were performed adjusting for sex, age, years of education, body mass index , alcohol, diet, and smoking (model 1), and additionally by cardiorespiratory fitness (model 2).

Results

Elbow extension was positively associated with stress in model 1 (β = 0.252, 95 % Confidence Interval [95 % CI] = 0.007 to 0.497, p = 0.044), and even after further adjustment for cardiorespiratory fitness (β = 0.282, 95 % CI = 0.032 to 0.532, p = 0.028). Perceived strength was negatively associated with depressive symptoms in model 1 (β = -0.271, 95 % CI = -0.491 to -0.049, p = 0.017) and model 2 reported associations tending towards significant (β = -0.220, 95 % CI = -0.445 to 0.005, p = 0.055). Handgrip strength was positively associated with self-esteem in model 1 (β = 0.558, 95 % CI = 0.168 to 0.949, p = 0.006) and model 2 (β = 0.546, 95 % CI = 0.135 to 0.956, p = 0.010). No further associations were found among other muscular strength and mental health variables.

Conclusion

Handgrip had a moderate association with self-esteem and there was a small association between perceived strength with depressive symptoms and elbow extension with stress. No other associations were observed between muscular strength and mental health outcomes in cognitively normal older adults.

Association between handgrip strength and depressive symptoms in patients undergoing hemodialysis: a cross-sectional study from a single Chinese center

BACKGROUND

The relationship between handgrip strength (HGS) and depression in patients undergoing hemodialysis (HD) was unknown. Therefore, we aimed to clarify this association in a cohort of patients.

METHODS

HGS was used as a representative indicator of muscle strength and was measured with a handheld dynamometer. Depressive symptoms were assessed with the self-reported Patient Health Questionnaire-9. A multivariable logistic regression model and restricted cubic spline analysis were used to assess the relationship between HGS and depression.

RESULTS

The prevalence of depression in our study was 34% in 568 Chinese patients undergoing HD. Compared with patients in the lowest tertiles of absolute and weighted HGS, patients in the highest tertiles of HGS had an approximately 59% lower [odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.24-0.68; OR = 0.41, 95%CI = (0.24-0.69)] prevalence of depressive symptoms after multivariate adjustments. Besides, the risk of depression in hemodialysis patients decreased by 33% (OR = 0.67, 95%CI = 0.53-0.85) and 32% (OR = 0.68, 95%CI = 0.54-0.85) for each standard deviation increase in absolute HGS and weighted HGS, respectively. The prevalence of depressive symptoms decreased with both increasing absolute HGS and weighted HGS after multivariate adjustments (p for trend < 0.05). Furthermore, a linear dose-response relationship was observed between absolute HGS and weighted HGS and the prevalence of depressive symptoms (pnonlinearity>0.05).

CONCLUSIONS

This study suggests that lower handgrip strength, a simple and modifiable parameter, is associated with a higher prevalence of depression in Chinese patients undergoing HD. Considering that depression is often unrecognized or underdiagnosed in HD patients, lowered muscle strength should be an important indicator and incentive for medical staff to screen for depression.

Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study

BACKGROUND

Evidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature.

METHODS

In this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world's most extensive and India's first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley's Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders.

RESULTS

Compared to those between the ages of 60-64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength.

CONCLUSIONS

The results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.

Depression and sarcopenia-related traits: A Mendelian randomization study

BACKGROUND

Observational studies have suggested that depression is associated with sarcopenia. However, the causal relationship between depression and sarcopenia remains unclear.

AIM

To investigate the causal relationship between depression and sarcopenia.

METHODS

We performed a Mendelian randomization (MR) analysis to identify the bidirectional relationship between depression and sarcopenia-related traits. Summary-level data and independent variants used as instrumental variables came from large genome-wide association studies of depression (414055 cases and 892299 controls), of appendicular lean mass (ALM, 450243 participants), and of hand grip strength (exposure: 360000 participants; outcome: 334925 participants).

RESULTS

We identified a negative association of depression with lower ALM [odds ratio (OR): 0.932, 95% confidence interval (95%CI): 0.889-0.979, P = 0.005]. In the reverse MR analysis, we also observed an inverse association of hand grip strength with depression (OR: 0.200, 95%CI: 0.108-0.370, P < 0.001). Similar results were obtained in sensitivity analyses.

CONCLUSION

Depression was causally related to decreased muscle mass, and declined muscle strength might lead to a higher risk of depression.

Is Handgrip Strength Associated With Parkinson's Disease? Longitudinal Study of 71 702 Older Adults

BACKGROUND

To date, no study has longitudinally assessed the dose-response association between handgrip strength and incidence of Parkinson's Disease (PD).

OBJECTIVES

to investigate the longitudinal association between handgrip strength and the development of PD within a representative European population of older adults.

METHODS

Individuals aged 50 years and older from 27 European countries and Israel participated. We retrieved data from the Survey of Health, Ageing and Retirement in Europe waves 1, 2, 4, 5, 6, 7, and 8. Handgrip strength was measured using a hand dynamometer and participants reported whether they had a medical PD diagnosis. Time-varying exposure and covariates were modeled using both Cox regression and restricted cubic splines.

RESULTS

A total of 71 702 participants (mean age 65.2 years) were followed over a median period of 5.0 years. Among them, 314 participants developed PD. In the fully adjusted model, we observed a higher risk (hazard ratio [HR]: 2.50; 95% CI:1.92-3.32) of PD for participants with lower handgrip strength (third 1) and a lower risk of PD for participants in the second third (HR: 1.41; 95% CI: 1.06-1.87). In dose-response analyses, men showed lower risk of PD from 27 kg (HR:0.94; 95% CI: 0.91-0.97) to 59 kg (HR:0.10; 95% CI: 0.04-0.22), whereas women showed significant reductions from 24 kg (HR:0.68; 95% CI: 0.46-0.99) to 38 kg (HR:0.44; 95% CI: 0.22-0.88).

CONCLUSIONS

Handgrip strength ought to be incorporated as one of the measures in the prognostic toolbox for the screening of older adults who are possibly at risk of developing PD.