Handgrip Strength and Depression Among Older Chinese Inpatients: A Cross-Sectional Study

Xiao-Ming Zhang,1,* Jing Jiao,1,* Jing Cao,1 Na Guo,1 Chen Zhu,1 Zhen Li,1 Xinjuan Wu,1 Tao Xu2 1Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, 100730, People’s Republic of China; 2Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, 100005, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xinjuan Wu; Tao Xu Tel +86 18612671300, Fax +86 1069156114Email wuxinjuan@sina.com; xutaosd@126.comObjective: There have been studies exploring the association between handgrip and depression among community-dwelling adults; however, evidence for this association among hospitalized older adults is scarce. We aimed to use a larger-scale population from multiple centers to explore the association between low handgrip strength and depression.Methods: This was a cross-sectional study that included hospitalized patients aged 65 years or older from different hospitals in China. Depression was assessed by a short-form Chinese Geriatric Depression Scale (GDS-15) with a cutoff value of 5 points or more. Dominant hand handgrip strength was assessed by a dynamometer. A generalized additive model and multivariable regression analysis were conducted.Results: There were 9,368 participants, with an average age of 72.4 (SD=5.7) in the final analysis. The prevalence of low handgrip strength and depressive symptoms among older Chinese hospitalized patients was 50.3% and 16.3%, respectively. There seemed to be a nonlinear relationship between handgrip strength and depression, and curve fitting and threshold analyses indicated that when handgrip strength was less than 35.6 kg, the depression risk decreased significantly with increasing handgrip strength. However, this association between handgrip strength and depression was not significant when the handgrip strength was greater than 35.6 kg. In addition, after adjusting for potential confounders, older patients with low handgrip strength had an increased risk of depression compared to those with normal handgrip strength (OR=1.46; 95% CI=1.27– 1.68). The subgroup analysis found the results were unchanged.Conclusion: Our study indicates that low handgrip strength was associated with a higher risk of depression among older Chinese hospitalized patients, implying that early patient screening for handgrip strength and initiating effective intervention programs, such as resistance training and nutritional supplements, could be helpful for older patients.Keywords: handgrip strength, depression, hospitalized, older adults