Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Shandong University Center for Suicide Prevention Research, Jinan, China; Department of Health Management, The First Affiliated Hospital of Shandong First Medical University, Jinan, China; Shandong Provincial Qianfoshan Hospital, Shandong Engineering Laboratory for Health Management, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, China; Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
The Fourth People's Hospital of Jinan City, Jinan, China.
J Am Med Dir Assoc. 2021 Aug;22(8):1744-1750.e1. doi: 10.1016/j.jamda.2021.04.006. Epub 2021 May 7.
This study aimed to examine the bidirectional associations between handgrip strength and depressive symptoms in a nationally representative sample.
Cohort study with a 4-year follow-up.
A total of 13,208 participants from the China Health and Retirement Longitudinal Study were included in the analyses.
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.
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 (P = .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 (P = .02).
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.
本研究旨在考察握力与抑郁症状在全国代表性样本中的双向关联。
具有 4 年随访的队列研究。
共纳入来自中国健康与退休纵向研究的 13208 名参与者进行分析。
采用 10 项中心流行病学研究抑郁量表评估抑郁症状。分别采用广义估计方程分析握力与抑郁症状之间的横断面和纵向关联。采用限制性三次样条模型探索剂量-反应关系的形状。
握力下降与随后发生抑郁症状的风险增加有关，与握力最强四分位组相比，握力最低四分位组发生抑郁症状的风险增加了约 36%[比值比（OR）1.36，95%置信区间（CI）1.17，1.58]。握力与抑郁症状风险之间存在线性剂量-反应关系（P=0.25），握力增加 5 个单位可能导致抑郁症状风险降低 11%（OR 0.89，95%CI 0.85，0.92）。相反，抑郁症状与随后握力下降呈前瞻性相关（β=-0.84，95%CI-1.13，-0.55）。抑郁症状水平与握力之间的关联呈近似 L 形剂量-反应模式（P=0.02）。
本研究确定了握力与抑郁症状之间的双向关联，并且发现这种关联具有剂量-反应模式。它为同时促进握力和抑郁症状的综合心理和身体健康干预策略提供了重要的见解。
