Depression and Handgrip Strength Among U.S. Adults Aged 60 Years and Older from NHANES 2011–2014

Abstract

Objectives Sarcopenia is a gradual loss of muscle mass and strength that occurs with aging. This muscle deterioration is linked to increased morbidity, disability, and other adverse outcomes. Although reduced handgrip strength can be considered a marker of sarcopenia and other aging-related decline in the elderly, there is limited research on this physical health problem in at-risk groups with common biopsychosocial conditions such as depression. Our primary objective was to ascertain level of combined handgrip strength and its relationship with depression among adults aged 60 years and older. Design Unadjusted and adjusted linear regression models were conducted with a cross-sectional survey dataset. Setting Secondary dataset from the 2011–2014 National Health and Nutrition Examination Survey (NHANES). Participants Community-dwelling, non-institutionalized adults ≥ 60 years old (n=3,421). Measurements The predictor variables included a positive screen for clinically relevant depression (referent=PHQ-9 score <10). The criterion variable of combined handgrip strength (kg) was determined using a dynamometer. Results Mean age and BMI were 69.9 years (51.5% female) and 28.8 kg/m2, respectively. Mean combined handgrip strength in the overall cohort was 73.5 and 46.6 kg in males and females, respectively. Three hundred thirty-six (9.8%) reported symptoms of depression. In unadjusted and fully adjusted models, depression was significantly associated with reduced handgrip strength (B = −0.26±0.79 and B = −0.19±0.08, respectively; p<0.001). Conclusion Our findings demonstrate handgrip strength has a significant inverse association with depression. Future longitudinal studies should investigate the causal processes and potential moderators and mediators of the relationships between depression and reduced handgrip strength. This information may further encourage the use of depression and handgrip strength assessments and aid in the monitoring and implementation of health care services that address both physical and mental health limitations among older adult populations.

Normative data and associated factors of hand grip strength among elderly individuals: The Yilan Study, Taiwan

“…However, mental status has often been overlooked as one of the associated factors of HGS in elderly people. Depression has ever been observed to be negatively associated with HGS 25,30 . Pasco suggested that sarcopenia with resultant decreased strength and depression possibly shared a common pathophysiological pathway 31 .…”

The Effect of Muscular Strength on Depression Symptoms in Adults: A Systematic Review and Meta-Analysis

“…Results demonstrated significant differences in all indicators of depression after completing 12 weeks of training [35], that low muscle strength increased depression symptomatology in patients with fibromyalgia [37], and that strength training intervention significantly decreased depressive symptoms [36]. The other observational studies showed that independently of sex, age, and country, depression symptoms were significantly associated with a reduced handgrip strength [11,21,22,24,[27][28][29][30][38][39][40]. Furthermore, adults in the lower tertile or quartile for muscle strength had a significantly higher risk for depressive symptoms compared with those in the third tertile or fourth quartile [23,25,26,31].…”

“…For the five clinical trial studies, the instruments used to assess the muscular strength or the depression symptoms were different among the studies. From the 16 observational studies, the data from 9 were used for meta-analysis [11,[21][22][23][24][25][26][27][28]. The seven studies not included were eliminated based on the heterogeneity of the association measure between muscular strength and depression symptoms.…”

“…A moderate heterogeneity among studies was detected (I 2 =55%; χ 2 = 17.96, df = 8; p = 0.02). Based on nine observational studies [11,[21][22][23][24][25][26][27][28], including 62,831 cases, the presence of depression symptoms was negatively associated with muscular strength. The pooled odds ratio from the random-effects model was 0.85 (95% CI: 0.80, 0.89).…”

Trajectories in muscular strength and physical function among men with and without prostate cancer in the health aging and body composition study

“…Active surveillance is a promising approach for low risk PC, yet a significant number of men still opt for more aggressive treatments such as surgery and radiation that often result in sexual, bowel and urinary dysfunction [3]. These significant ongoing health-related quality of life (HRQL) challenges may cause men to become depressed, less-active and dis-engaged from activities of daily living (ADL's) [4][5][6], which could further influence their physical HRQL. Furthermore, disease progression and treatment-related factors can exacerbate already compromised functioning.…”