Association between Sarcopenia and Depressive Symptoms in Community-Dwelling People Aged 40 Years and Older

Association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China: the mediation effect of activities of daily living (ADL) disability

BACKGROUND

Depressive symptoms and sarcopenia, often observed among middle-aged and elderly individuals, are significant health concerns in China, particularly given the country's rapidly aging population. Depressive symptoms, characterized by persistent feelings of sadness and loss of interest, can significantly impact quality of life. Little is known about the underlying pathway connecting these two conditions.

METHODS

The data for this study were derived from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were evaluated using the Centre for Epidemiological Studies Depression (CSED) scale. Logistic regression analyses were employed to investigate the association between depressive symptoms, activities of daily living (ADL) disability, and sarcopenia, while adjusting for potential confounding factors. The selection of predictor variables, including social activity, chronic diseases, demographic factors, and lifestyle habits, was based on their known associations with mental health, physical functioning and sarcopenia. These variables were included to ensure a comprehensive adjustment for potential confounding factors and to provide a more accurate estimation of the relationship between depressive symptoms and sarcopenia. Additionally, mediation analysis was conducted to assess the mediating role of ADL disability in the relationship between depressive symptoms and sarcopenia.

RESULTS

A comprehensive study was conducted on a total of 8,238 participants aged 45 years and older, comprising 3,358 men and 4,880 women. Logistic regression analyses were conducted to identify significant associations between depressive symptoms (OR = 1.30, P = 0.0269,95%CI = 1.03-1.63), ADL disability (OR = 1.94, P < 0.001,95%CI = 1.37-2.75) and sarcopenia. The results revealed significant relationships among these variables. Furthermore, mediation effect analyses demonstrated that ADL disability partially mediated the association between depressive symptoms and sarcopenia (estimated indirect effect: 0.006, 95% CI: 0.003, 0.008, proportion of mediation effect: 20.00%).

CONCLUSIONS

The study underscores a significant association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China, with ADL disability acting as a mediator. These findings offer novel insights for targeted health interventions. Future interventions should effectively combat sarcopenia by integrating psychological support with muscle-strengthening exercise programs. By addressing both depressive symptoms and ADL disability, clinicians and public health professionals can enhance outcomes for this demographic. Collaborative efforts across disciplines are essential for providing comprehensive health management tailored to the needs of middle-aged and elderly individuals. Future research should longitudinally assess the impact of such integrated interventions on sarcopenia prevention and depressive symptom alleviation. Additionally, investigating the role of social and environmental factors in mediating this relationship is crucial for developing more effective health strategies for this vulnerable population.

Prevalence of sarcopenia and depressive symptoms among older adults: a scoping review

Sarcopenia causes a loss of skeletal muscle mass and decreases muscle strength and function. Depressive symptoms are a common cause of distress among geriatrics, significantly affecting the quality of life of older adults. Recently, studies have shown that a correlation exists between sarcopenia and depression. To determine the prevalence of sarcopenia and depressive symptoms and identify the factors associated with sarcopenia, we systematically searched the SCOPUS, Science Direct, and PubMed databases for papers on sarcopenia and depressive symptoms published from 2012 to 2022. We reviewed the literature on sarcopenia, depressive symptom prevalence, the prevalence of subjects with both sarcopenia and depressive symptoms, and the factors associated with sarcopenia. Only cross-sectional studies were included. Nineteen articles met the inclusion criteria for review, with overall sarcopenia prevalence ranging from 3.9% to 41.7%. The prevalence of depressive symptoms was reported in seven studies, ranging from 8.09% to 40%. The most commonly used tools to diagnose sarcopenia and depressive symptoms were the European Working Group on Sarcopenia in Older People consensus and the Geriatric Depression Scale, respectively. Being aged, malnourished, obese, having comorbidities (hypertension and diabetes), having impaired cognitive function, and having polypharmacy were found to be the factors associated with sarcopenia. Sarcopenia and depressive symptoms have been found to cause adverse health outcomes among older people. Appropriate nutritional assessments and interventions should be taken to manage these two geriatric conditions. Further studies should be planned, considering multidomain intervention strategies to improve sarcopenia and older people's mental health.

Genetically Proxied Sarcopenia-Related Muscle Traits and Depression: Evidence from the FinnGen Cohort

BACKGROUND

Sarcopenia and depression are common and often coexist in the elderly. This study aims to determine the impact of sarcopenia-related muscle traits on depression.

METHODS

A two-sample Mendelian randomization (MR) study was performed on the summary-level data from the FinnGen cohort to estimate the causal association of appendicular lean mass (ALM), walking pace, or low hand grip strength with depression. Additionally, multivariable MR (MVMR) was performed to assess the dependence of each muscle trait in the causality and adjust the effect of body mass index (BMI). Supplementary backward MR analyses were performed to estimate the effect of depression on sarcopenia-related muscle traits.

RESULTS

Univariable MR analyses demonstrated that there were causal associations of ALM (odds ratio [OR]: 0.94; 95% confidence interval [CI]: 0.88-0.99), walking pace (OR: 0.53; 95% CI: 0.32-0.88), and low hand grip strength (OR: 1.20; 95% CI: 1.05-1.38) with depression. MVMR analyses showed that ALM was the only trait that had a significant causal relationship with depression (OR: 0.91; 95% CI: 0.85-0.98) after accounting for the other two muscle traits. Moreover, the independent association of ALM with depression remained (OR: 0.92; 95% CI: 0.85-0.99) after being adjusted by BMI. The backward MR analyses showed no causal associations of depression with any sarcopenia-related muscle traits.

CONCLUSION

Low muscle mass independently increases the risk of depression. This study determined the muscle-related risk factors of depression, which may help establish the causality between sarcopenia and depression and provide evidence-based recommendations for improving mental health in the elderly.