Bidirectional Associations between Handgrip Strength and Depressive Symptoms: A Longitudinal Cohort Study |
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| Affiliation: | 1. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China;2. Shandong University Center for Suicide Prevention Research, Jinan, China;3. Department of Health Management, The First Affiliated Hospital of Shandong First Medical University, Jinan, China;4. Shandong Provincial Qianfoshan Hospital, Shandong Engineering Laboratory for Health Management, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, China;5. Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Jinan, China;6. The Fourth People’s Hospital of Jinan City, Jinan, China;1. Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA;2. Division of Pulmonary, Allergy, and Critical Care Medicine, The University of Alabama at Birmingham, AL, USA;3. Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA;4. UT Southwestern Medical School, Dallas, TX, USA;5. Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA;6. Division of Hospital Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA;7. Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA;1. Department of Occupational Therapy, Kanagawa University of Human Services, Kanagawa, Japan;2. Department of Occupational Therapy, School of Health Science, Tokyo University of Technology, Tokyo, Japan;3. Graduate School of Health Management, Keio University, Kanagawa, Japan |
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| Abstract: | ![]()
ObjectivesThis study aimed to examine the bidirectional associations between handgrip strength and depressive symptoms in a nationally representative sample.DesignCohort study with a 4-year follow-up.Setting and ParticipantsA total of 13,208 participants from the China Health and Retirement Longitudinal Study were included in the analyses.MethodsDepressive 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.ResultsDecreased 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 ImplicationsThe 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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| Keywords: | Handgrip strength depressive symptoms bidirectional associations dose-response relationship |
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