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. 2025 Feb 18:13:1496641.
doi: 10.3389/fpubh.2025.1496641. eCollection 2025.

Longitudinal association between handgrip strength and depressive symptoms in middle-aged and older Chinese adults: mediating role of functional limitation

Yanchang Liu #  1 , Junling Cui #  1 , Xin Luo #  1 , Zhuzhu Wang  1 , Ziyi Shen  1 , Yan Fang  1 , Chengcheng Li  1 , Jingfang Hong  1
Affiliations

Longitudinal association between handgrip strength and depressive symptoms in middle-aged and older Chinese adults: mediating role of functional limitation

Yanchang Liu et al. Front Public Health. .

Abstract

Background: The relationship between handgrip strength (HGS) at baseline and subsequent depressive symptoms among middle-aged and older Chinese adults remains highly uncertain. This research endeavored to investigate the effect of functional limitation on the association between these two variables.

Methods: A total of 5,684 participants aged ≥45 years from the China Longitudinal Study of Health and Retirement (CHARLS) were enrolled, using data from the 2015 and 2018 waves. Functional limitation was evaluated based on participants' self-reported basic activities of daily living (BADL) and instrumental activities of daily living (IADL). Logistic regression models were utilized to analyze the relationship between HGS and subsequent depressive symptoms, and bootstrap analysis was performed to explore the potential mediating role of functional limitation.

Results: After adjusting for confounders, an inverse correlation was detected between HGS and functional limitation (B = -0.885, p < 0.001), a positive correlation was found between functional limitation and subsequent depressive symptoms (B = 1.054, p < 0.001). The mediated effect size of HGS on depressive symptoms through functional limitation was a*b = -0.933 (BCa 95% CI: -1.224, -0.642). Functional limitation had a significant impact on 18.9% of the overall association.

Conclusion: Among the Chinese middle-aged and senior population, functional limitation accounted for 18.9% of the connection between HGS and depressive symptoms. Interventions targeting the enhancement of muscle strength should be regarded as crucial elements for maintaining physical function and preventing depressive symptoms.

Keywords: CHARLS; China; depressive symptoms; functional limitation; handgrip strength; mediation analysis; middle-aged and older adults.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participant selection.
Figure 2
Figure 2
Path diagram of the association between functional limitation and depressive symptoms as a mediator. *** p < 0.001. Gender, age, education, marital status, residence, drinking status, smoking status, chronic disease, BMI, physical activity, and working status were controlled.
See this image and copyright information in PMC

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