Sex-related differences in the association between grip strength and depression: Results from the Irish Longitudinal Study on Ageing
Introduction
Depression is identified by the World Health Organization (WHO) as one of the greatest contributors to overall global disease burden, affecting an estimated 350 million people worldwide (WHO, 2012). Depression is a critically important public health problem, particularly among older adults, that is associated with an increased risk of morbidity and suicide (Chapman and Perry, 2008) and decreased physical, social, and cognitive functioning (Blazer, 2003). Additionally, the financial burden associated with depression continues to grow, accounting for at least 1% of the total European economy (Sobocki et al., 2006).
Despite the clear negative consequences of depression, just 56.4% of 12-month cases of DSM-IV mood disorders had received some treatment in the past 12 months (Wang et al., 2005b); however, the vast majority of people with lifetime disorders eventually make treatment contact (Wang et al., 2005a). Among those who do make treatment contact, delays range from six to eight years (Wang et al., 2005a), depression persists in approximately 70% after first-line treatment, and at least 30% remain depressed after four rounds of distinct treatments (Gaynes et al., 2008). Thus, there is a continued need to identify risk factors for depression that can be targeted for prevention.
Engagement in physical activity has been associated with the prevention of late-life depression (Chang et al., 2016), although most examinations of the protective effects of specific physical activity modes focus on aerobic exercise (e.g., walking) and not resistance exercise. On the basis that the quantification of cardiorespiratory fitness is more objective than physical activity, there has been some interest in the predictive role of aerobic fitness for depression (Åberg et al., 2012; Sui et al., 2009). Similarly, research has examined the benefits of maintaining strength, as measured by grip strength, in older age (Arvandi et al., 2016; Peterson et al., 2017). Grip-strength tests are convenient, safe, and reliable, do not require large or expensive equipment, and minimise the burden placed on participants (Leong et al., 2015). Consequently, they are commonly used as an indicator of muscular strength (Bohannon, 2008; Cooper et al., 2010). Grip strength has predicted cardiometabolic disease risk, physical disabilities, and mortality in older adults (Arvandi et al., 2016; Peterson et al., 2017). Some studies have demonstrated the protective influence of grip strength on depression and depressive symptoms (Fukumori et al., 2015; Hamer et al., 2015; Taekema et al., 2010; Veronese et al., 2017), with stronger associations reported among females than males (Veronese et al., 2017); however, these sex-related findings were derived from somewhat small sample sizes and, as the data analysed were collected over 20-years ago, there is a need to demonstrate the replicability of these findings using more recent data from larger population samples.
Therefore, the key objectives of the study reported here was to investigate (1) associations between grip strength and both concurrent depressive symptoms and depression status and the development of depressive symptoms and depression two-years later, and (2) sex-related differences in these associations using data from the Irish Longitudinal Study on Ageing (TILDA). It was hypothesised that grip strength would be associated with lower odds of depression, and this association would be stronger among females than males.
Section snippets
Methods
This study used STROBE recommendations to guide reporting (Von Elm et al., 2008).
Participant characteristics
Compared to the analytic sample, a significantly greater proportion of excluded respondents were aged 50–59 years (47.0% vs 41.2%), smokers (17.2% vs 14.5%), and healthy (43.0% vs 36.3%; all p < 0.05). Excluded males were stronger than included males (2.41 kg, 95%CI: 1.54 to 3.28), and excluded females were stronger than included females (2.53 kg, 95%CI: 1.96 to 3.10). There were no significant differences in waist circumference, smoking status, and depression status.
Baseline participant
Discussion
This study investigated the association between grip strength and concurrent and subsequent development of depressive symptoms and depression status in a large, nationally-representative cohort of older Irish adults. Approximately 8.9% of the current sample reported depression, supporting previous findings among Irish adults (Gallagher and Hannigan, 2014). Consistent with previous reports, higher rates of depression were observed among females (11.1%) than males (6.1%). The key findings of the
Conclusion
The findings of the present study indicated that grip strength was inversely associated with depression in older adults. These findings reiterate the importance of maintaining strength levels in later life, with potentially greater benefits for depression found among females than males.
Acknowledgements
The authors disclose no conflicts of interest. The TILDA study was supported by the Irish Government, the Atlantic Philanthropies, and Irish Life PLC. This work was also supported by the Health Research Board (Grant reference: HRA_PHS/2012/30). The sponsors played no role in study design, methods, subject recruitment, data collection, analysis or preparation of the paper.
References (43)
- et al.
Risk factors for late-life depression: a prospective cohort study among older women
Prev. Med.
(2016) - et al.
Depression and chronic health conditions in parents of children with and without developmental disabilities: the growing up in Ireland cohort study
Res. Dev. Disabil.
(2014) - et al.
Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study
Lancet
(2015) - et al.
Resistance exercise for the aging adult: clinical implications and prescription guidelines
Am. J. Med.
(2011) - et al.
Prospective study of cardiorespiratory fitness and depressive symptoms in women and men
J. Psychiatr. Res.
(2009) - et al.
The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies
Gac. Sanit.
(2008) - et al.
Cardiovascular fitness in males at age 18 and risk of serious depression in adulthood: Swedish prospective population-based study
Br. J. Psychiatry
(2012) Progression models in resistance training for healthy adults
Med. Sci. Sports Exerc.
(2009)- et al.
Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: a randomized controlled trial
Geriatr Gerontol Int
(2015) - et al.
Gender differences in the association between grip strength and mortality in older adults: results from the KORA-age study
BMC Geriatr.
(2016)
Fifty Plus in Ireland 2011: First Results From the Irish Longitudinal Study on Ageing (TILDA)
Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in the Netherlands
Psychol. Med.
Depression in late life: review and commentary
J. Gerontol. Ser. A Biol. Med. Sci.
Hand-grip dynamometry predicts future outcomes in aging adults
J. Geriatr. Phys. Ther.
Sustained obesity and depressive symptoms over 6 years: race by gender differences in the health and retirement study
Front. Aging Neurosci.
Depression as a major component of public health for older adults
Prev. Chronic Dis.
A power primer
Psychol. Bull.
Objectively measured physical capability levels and mortality: systematic review and meta-analysis
Br. Med. J.
The new statistics: why and how
Psychol. Sci.
Sex differences in the response to resistance exercise training in older people
Physiol. Rep.
Sustained cognitive and economic benefits of resistance training among community-dwelling senior women: a 1-year follow-up study of the brain power study
Arch. Intern. Med.
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