Skip to main content
Log in

The handgrip strength and risk of depressive symptoms: a meta-analysis of prospective cohort studies

  • Review
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Many studies have investigated the association between handgrip strength (HGS) and depressive symptoms, but the conclusion remain controversial. We performed a meta-analysis to evaluate the longitudinal association between HGS and risk of depressive symptoms.

Methods

PubMed, PSYCINFO and EMBASE databases were searched for eligible publications up to April 2020. Pooled relative risks (RRs) with 95% confidence intervals were calculated using random-effects model. Publication bias was estimated using Egger’s test and the funnel plot. Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of eligible studies.

Results

The present meta-analysis included 8 cohort studies with 30,727 participants. Overall, higher HGS was related to a decreased risk of depressive symptoms: the pooled risk ratio (RR) of 0.74 [95% confidence intervals (CI) 0.65–0.85] with a moderate heterogeneity (I2 = 60.5%, P = 0.013). HGS was significantly associated with a reduced risk of depressive symptoms in males (RR = 0.69; 95% CI 0.50–0.94), but not in females.

Conclusions

Lower HGS was associated with an increased risk of depressive symptoms. Further studies are needed to confirm these findings and to investigate the sex differences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159), 1789–1858. https://doi.org/10.1016/s0140-6736(18)32279-7

  2. Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442. https://doi.org/10.1371/journal.pmed.0030442

    Article  PubMed  PubMed Central  Google Scholar 

  3. Farmer, M. E., Locke, B. Z., Moscicki, E. K., Dannenberg, A. L., Larson, D. B., & Radloff, L. S. (1988). Physical activity and depressive symptoms: The NHANES I Epidemiologic Follow-up Study. American Journal of Epidemiology, 128(6), 1340–1351. https://doi.org/10.1093/oxfordjournals.aje.a115087

    Article  CAS  PubMed  Google Scholar 

  4. Kritz-Silverstein, D., Barrett-Connor, E., & Corbeau, C. (2001). Cross-sectional and prospective study of exercise and depressed mood in the elderly: The Rancho Bernardo study. American Journal of Epidemiology, 153(6), 596–603. https://doi.org/10.1093/aje/153.6.596

    Article  CAS  PubMed  Google Scholar 

  5. Galper, D. I., Trivedi, M. H., Barlow, C. E., Dunn, A. L., & Kampert, J. B. (2006). Inverse association between physical inactivity and mental health in men and women. Medicine and Science in Sports and Exercise, 38(1), 173–178. https://doi.org/10.1249/01.mss.0000180883.32116.28

    Article  PubMed  Google Scholar 

  6. Vallance, J. K., Winkler, E. A., Gardiner, P. A., Healy, G. N., Lynch, B. M., & Owen, N. (2011). Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005–2006). Preventive Medicine, 53(4–5), 284–288. https://doi.org/10.1016/j.ypmed.2011.07.013

    Article  PubMed  Google Scholar 

  7. Yanagita, M., Willcox, B. J., Masaki, K. H., Chen, R., He, Q., Rodriguez, B. L., Ueshima, H., & Curb, J. D. (2006). Disability and depression: Investigating a complex relation using physical performance measures. The American Journal of Geriatric Psychiatry, 14(12), 1060–1068. https://doi.org/10.1097/01.jgp.0000224364.70515.12

    Article  PubMed  Google Scholar 

  8. Agudelo, L. Z., Femenia, T., Orhan, F., Porsmyr-Palmertz, M., Goiny, M., Martinez-Redondo, V., Correia, J. C., Izadi, M., Bhat, M., Schuppe-Koistinen, I., & Pettersson, A. T. (2014). Skeletal muscle PGC-1alpha1 modulates kynurenine metabolism and mediates resilience to stress-induced depression. Cell, 159(1), 33–45. https://doi.org/10.1016/j.cell.2014.07.051

    Article  CAS  PubMed  Google Scholar 

  9. Allison, D. J., Nederveen, J. P., Snijders, T., Bell, K. E., Kumbhare, D., Phillips, S. M., Parise, G., & Heisz, J. J. (2019). Exercise training impacts skeletal muscle gene expression related to the kynurenine pathway. American Journal of Physiology-Cell Physiology, 316(3), C444–C448. https://doi.org/10.1152/ajpcell.00448.2018

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Schlittler, M., Goiny, M., Agudelo, L. Z., Venckunas, T., Brazaitis, M., Skurvydas, A., Kamandulis, S., Ruas, J. L., Erhardt, S., Westerblad, H., & Andersson, D. C. (2016). Endurance exercise increases skeletal muscle kynurenine aminotransferases and plasma kynurenic acid in humans. American Journal of Physiology-Cell Physiology, 310(10), C836–C840. https://doi.org/10.1152/ajpcell.00053.2016

    Article  PubMed  Google Scholar 

  11. Leong, D. P., Teo, K. K., Rangarajan, S., Lopez-Jaramillo, P., Avezum, A., Jr., Orlandini, A., Seron, P., Ahmed, S. H., Rosengren, A., Kelishadi, R., & Rahman, O. (2015). Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet, 386(9990), 266–273. https://doi.org/10.1016/s0140-6736(14)62000-6

    Article  PubMed  Google Scholar 

  12. Kim, J. H. (2019). Effect of grip strength on mental health. Journal of Affective Disorders, 245, 371–376. https://doi.org/10.1016/j.jad.2018.11.017

    Article  PubMed  Google Scholar 

  13. Liu, Y., Cao, X., Gu, N., Yang, B., Wang, J., & Li, C. (2019). A prospective study on the association between grip strength and cognitive function among middle-aged and elderly Chinese participants. Frontiers in Aging Neuroscience, 11, 250. https://doi.org/10.3389/fnagi.2019.00250

    Article  PubMed  PubMed Central  Google Scholar 

  14. Loprinzi, P. D., Franklin, J., Farris, A., & Ryu, S. (2019). Handedness, grip strength, and memory function: Considerations by biological sex. Medicina (Kaunas, Lithuania), 55(8), 444. https://doi.org/10.3390/medicina55080444

    Article  Google Scholar 

  15. McGrath, R., Robinson-Lane, S. G., Cook, S., Clark, B. C., Herrmann, S., O’Connor, M. L., & Hackney, K. J. (2019). Handgrip strength is associated with poorer cognitive functioning in aging Americans. Journal of Alzheimer’s Disease, 70(4), 1187–1196. https://doi.org/10.3233/jad-190042

    Article  CAS  PubMed  Google Scholar 

  16. Cao, C., Liu, Q., Yang, L., Zheng, X., Lan, P., Koyanagi, A., Vancampfort, D., Soysal, P., Veronese, N., Stubbs, B., & Firth, J. (2020). Handgrip strength is associated with suicidal thoughts in men: Cross-sectional analyses from NHANES. Scandinavian Journal of Medicine & Science in Sports, 30(1), 92–99. https://doi.org/10.1111/sms.13559

    Article  Google Scholar 

  17. Arvandi, M., Strasser, B., Meisinger, C., Volaklis, K., Gothe, R. M., Siebert, U., Ladwig, K. H., Grill, E., Horsch, A., Laxy, M., & Peters, A. (2016). Gender differences in the association between grip strength and mortality in older adults: Results from the KORA-age study. BMC Geriatrics, 16(1), 201. https://doi.org/10.1186/s12877-016-0381-4

    Article  PubMed  PubMed Central  Google Scholar 

  18. Brown, W. J., Ford, J. H., Burton, N. W., Marshall, A. L., & Dobson, A. J. (2005). Prospective study of physical activity and depressive symptoms in middle-aged women. American Journal of Preventive Medicine, 29(4), 265–272. https://doi.org/10.1016/j.amepre.2005.06.009

    Article  PubMed  Google Scholar 

  19. Ashdown-Franks, G., Stubbs, B., Koyanagi, A., Schuch, F., Firth, J., Veronese, N., & Vancampfort, D. (2019). Handgrip strength and depression among 34,129 adults aged 50 years and older in six low- and middle-income countries. Journal of Affective Disorders, 243, 448–454. https://doi.org/10.1016/j.jad.2018.09.036

    Article  PubMed  Google Scholar 

  20. Lee, M. R., Jung, S. M., Bang, H., Kim, H. S., & Kim, Y. B. (2018). The association between muscular strength and depression in Korean adults: A cross-sectional analysis of the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI) 2014. BMC Public Health, 18(1), 1123. https://doi.org/10.1186/s12889-018-6030-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Smith, L., White, S., Stubbs, B., Hu, L., Veronese, N., Vancampfort, D., Hamer, M., Gardner, B., & Yang, L. (2018). Depressive symptoms, handgrip strength, and weight status in US older adults. Journal of Affective Disorders, 238, 305–310. https://doi.org/10.1016/j.jad.2018.06.016

    Article  PubMed  Google Scholar 

  22. Wiegand, A., Zieger, A., Staiger, R. D., Egli, A., Freystatter, G., Bischoff-Ferrari, H. A., & Chocano-Bedoya, P. O. (2019). Association of depression with malnutrition, grip strength and impaired cognitive function among senior trauma patients. Journal of Affective Disorders, 247, 175–182. https://doi.org/10.1016/j.jad.2019.01.013

    Article  CAS  PubMed  Google Scholar 

  23. Jeong, M., Kang, H. K., Song, P., Park, H. K., Jung, H., Lee, S. S., & Koo, H. K. (2017). Hand grip strength in patients with chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 12, 2385–2390. https://doi.org/10.2147/copd.s140915

    Article  PubMed  PubMed Central  Google Scholar 

  24. Suija, K., Timonen, M., Suviola, M., Jokelainen, J., Jarvelin, M. R., & Tammelin, T. (2013). The association between physical fitness and depressive symptoms among young adults: Results of the Northern Finland 1966 birth cohort study. BMC Public Health, 13, 535. https://doi.org/10.1186/1471-2458-13-535

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hamer, M., Batty, G. D., & Kivimaki, M. (2015). Sarcopenic obesity and risk of new onset depressive symptoms in older adults: English Longitudinal Study of Ageing. International Journal of Obesity (London), 39(12), 1717–1720. https://doi.org/10.1038/ijo.2015.124

    Article  CAS  Google Scholar 

  26. McDowell, C. P., Gordon, B. R., & Herring, M. P. (2018). Sex-related differences in the association between grip strength and depression: Results from the Irish Longitudinal Study on Ageing. Experimental Gerontology, 104, 147–152. https://doi.org/10.1016/j.exger.2018.02.010

    Article  PubMed  Google Scholar 

  27. Hartling, L., Milne, A., Hamm, M. P., Vandermeer, B., Ansari, M., Tsertsvadze, A., & Dryden, D. M. (2013). Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers. Journal of Clinical Epidemiology, 66(9), 982–993. https://doi.org/10.1016/j.jclinepi.2013.03.003

    Article  PubMed  Google Scholar 

  28. Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Fukumori, N., Yamamoto, Y., Takegami, M., Yamazaki, S., Onishi, Y., Sekiguchi, M., Otani, K., Konno, S. I., Kikuchi, S. I., & Fukuhara, S. (2015). Association between hand-grip strength and depressive symptoms: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS). Age and Ageing, 44(4), 592–598. https://doi.org/10.1093/ageing/afv013

    Article  PubMed  Google Scholar 

  30. Stessman, J., Bursztyn, M., Gershinsky, Y., Hammerman-Rozenberg, A., & Jacobs, J. M. (2017). Hypertension and its treatment at age 90 years: Is there an association with 5-year mortality? Journal of the American Medical Directors Association, 18(3), 277.e13–277.e19. https://doi.org/10.1016/j.jamda.2016.12.076

    Article  Google Scholar 

  31. Milligen, B. A., Vogelzangs, N., Smit, J. H., & Penninx, B. W. (2012). Physical function as predictor for the persistence of depressive and anxiety disorders. Journal of Affective Disorders, 136(3), 828–832. https://doi.org/10.1016/j.jad.2011.09.030

    Article  PubMed  Google Scholar 

  32. Veronese, N., Stubbs, B., Trevisan, C., Bolzetta, F., De Rui, M., Solmi, M., Sartori, L., Musacchio, E., Zambon, S., Perissinotto, E., & Baggio, G. (2017). Poor physical performance predicts future onset of depression in elderly people: Progetto Veneto Anziani Longitudinal Study. Physical Therapy, 97(6), 659–668. https://doi.org/10.1093/ptj/pzx017

    Article  PubMed  Google Scholar 

  33. Zhao, Z., Ji, C., Liu, Y., Gao, S., & Xia, Y. (2020). Higher handgrip strength predicts a lower risk of depressive symptoms in rural Chinese populations. Journal of Affective Disorders, 269, 12–17. https://doi.org/10.1016/j.jad.2020.03.028

    Article  PubMed  Google Scholar 

  34. Sandanger, I., Moum, T., Ingebrigtsen, G., Dalgard, O. S., Sorensen, T., & Bruusgaard, D. (1998). Concordance between symptom screening and diagnostic procedure: The Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I. Social Psychiatry and Psychiatric Epidemiology, 33(7), 345–354. https://doi.org/10.1007/s001270050064

    Article  CAS  PubMed  Google Scholar 

  35. Yamazaki, S., Fukuhara, S., & Green, J. (2005). Usefulness of five-item and three-item Mental Health Inventories to screen for depressive symptoms in the general population of Japan. Health and Quality of Life Outcomes, 3, 48. https://doi.org/10.1186/1477-7525-3-48

    Article  PubMed  PubMed Central  Google Scholar 

  36. Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13(3), 595–605.

    Article  CAS  PubMed  Google Scholar 

  37. Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.

    Article  CAS  PubMed  Google Scholar 

  38. Hamer, M., Batty, G. D., & Kivimaki, M. (2012). Risk of future depression in people who are obese but metabolically healthy: The English longitudinal study of ageing. Molecular Psychiatry, 17(9), 940–945. https://doi.org/10.1038/mp.2012.30

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Wittchen, H. U. (1994). Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): A critical review. Journal of Psychiatric Research, 28(1), 57–84. https://doi.org/10.1016/0022-3956(94)90036-1

    Article  CAS  PubMed  Google Scholar 

  40. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4

    Article  PubMed  Google Scholar 

  41. Taekema, D. G., Gussekloo, J., Maier, A. B., Westendorp, R. G., & de Craen, A. J. (2010). Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age and Ageing, 39(3), 331–337. https://doi.org/10.1093/ageing/afq022

    Article  PubMed  Google Scholar 

  42. Gariballa, S., & Alessa, A. (2018). Association between muscle function, cognitive state, depression symptoms and quality of life of older people: Evidence from clinical practice. Aging Clinical and Experimental Research, 30(4), 351–357. https://doi.org/10.1007/s40520-017-0775-y

    Article  PubMed  Google Scholar 

  43. Osada, H., Shibata, H., Haga, H., & Yasumura, S. (1995). Relationship of physical condition and functional capacity to depressive status in person aged 75 years. Nihon Koshu Eisei Zasshi, 42(10), 897–909.

    CAS  PubMed  Google Scholar 

  44. Noh, H. M., & Park, Y. S. (2020). Handgrip strength, dynapenia, and mental health in older Koreans. Science and Reports, 10(1), 4004. https://doi.org/10.1038/s41598-020-60835-4

    Article  CAS  Google Scholar 

  45. Lee, K. (2018). Relative handgrip strength in relation to depressive mood and suicidal ideation in Koreans using the 2015 KNHANES data. Journal of Musculoskeletal & Neuronal Interactions, 18(3), 333–338.

    Google Scholar 

  46. Volaklis, K., Mamadjanov, T., Meisinger, C., & Linseisen, J. (2019). Association between muscular strength and depressive symptoms: A narrative review. Wiener Klinische Wochenschrift, 131(11–12), 255–264. https://doi.org/10.1007/s00508-019-1491-8

    Article  PubMed  Google Scholar 

  47. Akbaraly, T. N., Kumari, M., Head, J., Ritchie, K., Ancelin, M. L., Tabák, A. G., Brunner, E., Chaudieu, I., Marmot, M. G., Ferrie, J. E., & Shipley, M. J. (2013). Glycemia, insulin resistance, insulin secretion, and risk of depressive symptoms in middle age. Diabetes Care, 36(4), 928–934. https://doi.org/10.2337/dc12-0239

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Adriaanse, M. C., Dekker, J. M., Nijpels, G., Heine, R. J., Snoek, F. J., & Pouwer, F. (2006). Associations between depressive symptoms and insulin resistance: the Hoorn Study. Diabetologia, 49(12), 2874–2877. https://doi.org/10.1007/s00125-006-0500-4

    Article  CAS  PubMed  Google Scholar 

  49. Gale, C. R., Kivimaki, M., Lawlor, D. A., Carroll, D., Phillips, A. C., & Batty, G. D. (2010). Fasting glucose, diagnosis of type 2 diabetes, and depression: The Vietnam experience study. Biological Psychiatry, 67(2), 189–192. https://doi.org/10.1016/j.biopsych.2009.09.019

    Article  PubMed  Google Scholar 

  50. Claes, S., Myint, A. M., Domschke, K., Del-Favero, J., Entrich, K., Engelborghs, S., De Deyn, P., Mueller, N., Baune, B., & Rothermundt, M. (2011). The kynurenine pathway in major depression: Haplotype analysis of three related functional candidate genes. Psychiatry Research, 188(3), 355–360. https://doi.org/10.1016/j.psychres.2011.03.012

    Article  CAS  PubMed  Google Scholar 

  51. Andrews, J. S., Trupin, L., Hough, C. L., Daikh, D. I., Yelin, E. H., & Katz, P. P. (2017). Serum biomarkers of inflammation and muscle strength among women with systemic lupus erythematosus. Cytokine, 90, 109–112. https://doi.org/10.1016/j.cyto.2016.11.003

    Article  CAS  PubMed  Google Scholar 

  52. Sousa, A. C., Zunzunegui, M. V., Li, A., Phillips, S. P., Guralnik, J. M., & Guerra, R. O. (2016). Association between C-reactive protein and physical performance in older populations: Results from the International Mobility in Aging Study (IMIAS). Age and Ageing, 45(2), 274–280. https://doi.org/10.1093/ageing/afv202

    Article  PubMed  Google Scholar 

  53. Ribeiro, A., Deminice, R., Schoenfeld, B., Tomeleri, C., Padilha, C., Venturini, D., Barbosa, D. S., Sardinha, L. B., & Cyrino, E. S. (2017). Effect of resistance training systems on oxidative stress in older women. International Journal of Sport Nutrition and Exercise Metabolism, 27(5), 439–447. https://doi.org/10.1123/ijsnem.2016-0322

    Article  CAS  PubMed  Google Scholar 

  54. Howard, C., Ferrucci, L., Sun, K., Fried, L., Walston, J., Varadhan, R., Guralnik, J. M., & Semba, R. D. (2007). Oxidative protein damage is associated with poor grip strength among older women living in the community. Journal of Applied Physiology (Bethesda, Md.: 1985), 103(1), 17–20. https://doi.org/10.1152/japplphysiol.00133.2007

    Article  CAS  Google Scholar 

  55. Osimo, E. F., Baxter, L. J., Lewis, G., Jones, P. B., & Khandaker, G. M. (2019). Prevalence of low-grade inflammation in depression: A systematic review and meta-analysis of CRP levels. Psychological Medicine, 49(12), 1958–1970. https://doi.org/10.1017/s0033291719001454

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Chunxia Jing or Guang Hao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was not required for conducting this review.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 525 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, X., Ma, J., Ying, Y. et al. The handgrip strength and risk of depressive symptoms: a meta-analysis of prospective cohort studies. Qual Life Res 30, 2467–2474 (2021). https://doi.org/10.1007/s11136-021-02858-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-021-02858-6

Keywords

Navigation