Grip strength may help predict depression

Lower grip strength was associated with an increased odds of depression in middle-aged and older adults, according to results of a study published in Scientific Reports.

However, the predictive value of grip strength for depression was “weak” and should not be used alone to screen for depression, Adilson Marques, PhD, MPH, a professor of human kinetics at the University of Lisbon, and colleagues wrote.

“Several studies reported the significant and inversely association of grip strength and depression symptoms. Still, the specific threshold of muscle weakness that leads to depression symptoms was never explored,” Marques and colleagues wrote. “Identifying cut-off values of [grip strength] for discriminating the presence of depression would provide a physical measurement that can help identify those at risk for clinical practice and epidemiological studies. In this sense, the present study aimed to explore this important topic.”

Using information from the population-based Survey of Health, Aging and Retirement in Europe database, the researchers assessed the accuracy of grip strength cut-off values in predicting depression. The study included 20,598 men and women (mean age, 64.7 years) from 14 European countries. Marques and colleagues evaluated grip strength using a dynamometer, with measurements taken twice on each hand. They assessed for depression symptoms using the EURO-D scale from 0 to 12, with higher scores indicating higher depression levels. Data on grip strength and self-reported diseases and perceived health were collected in 2011 and 2015.

The mean EURO-D for all participants was 2.2 in 2011 and 2.19 in 2015. On average, women had higher scores than men in 2011 (2.6 vs. 1.82) and 2015 (2.5 vs. 1.84). About 30% of women and 16.5% of men had depression in 2011, and 28.8% of women and 17.1% of men had depression in 2015. Nearly 40% of patients reported “good” self-perceived health, while 25.1% reported “fair” health, 5.6% reported “poor” health, 21% reported “very good” health and 8.9% reported “excellent” health. Almost half of all men (42.6%) and women (45.3%) had more than one chronic disease, according to Marques and colleagues.

The average grip strength score was 44.6 kg for men and 27.9 kg for women. The cut-off values for differentiating the presence of depression were 43.5 kg for men aged 50 to 64 years, 39.5 kg for men older than 64 years, 29.5 kg for women aged 50 to 64 years and 22.5 kg for women aged older than 64 years.

A measurement of grip strength above the cut-off value was associated with lower odds of depression in 2011 and in 2015 for men and women from both age groups, according to the researchers.

Among participants who had a grip strength above the cut-off value, men aged 50 to 64 years were 25% less likely in 2011 and 24% less likely in 2015 to have depression; men older than 64 years were 29% less likely in 2011 and 16% less likely in 2015 to have depression; women aged 50 to 64 years were 32% less likely in 2011 and 44% less likely in 2015 to have depression; and women aged older than 64 years were 20% less likely in 2011 and 31% less likely in 2015 to have depression.

However, the results showed that grip strength “had a weak discriminant capacity for depression, with the area under the curve varying between 0.54 and 0.6,” Marques and colleagues wrote. Therefore, grip strength cut-off values “are not enough to screen for depression rigorously,” they added.

“Nonetheless, our findings suggest that health programs should incorporate grip strength in their users’ assessment because it is an outcome to assess the strength and an indicator of mental health,” Marques and colleagues wrote. “In addition, health care practitioners should be alert to the potential of depression in patients below the grip strength cut-off values.”