Association Between Sarcopenia and Depressive Symptoms in Chinese Older Adults: Evidence From the China Health and Retirement Longitudinal Study

Abstract

Background: Little is known about whether sarcopenia predicts incident depressive symptoms in older adults. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted cross-sectional and longitudinal analyses to estimate the association between sarcopenia and depressive symptoms among older adults.Methods: The sample comprised 7,706 participants aged at least 60 years (50.6% women; mean age 68.0 ± 6.5) from the CHARLS 2015. Based on the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria, sarcopenia status was classified into three types: no-sarcopenia, possible sarcopenia, and sarcopenia. Depressive symptoms were assessed using the validated 10-items of the Center for Epidemiologic Studies Depression Scale. A cross-sectional analysis was used to examine the relationship between sarcopenia status and depressive symptoms. A total of 4,652 participants without depressive symptoms were recruited from the same cohort in 2015 and were followed up in 2018. Cox proportional hazards regression models were conducted to examine the effect of sarcopenia status on subsequent depressive symptoms with the report of hazard ratio (HR).Results: The prevalence of depressive symptoms in total populations, no-sarcopenia, possible sarcopenia, and sarcopenia individuals were 27.1% (2085/7706), 21.5% (927/4310), 33.6% (882/2627), and 35.9% (276/769), respectively. Both possible sarcopenia (OR: 1.75, 95% CI: 1.46–2.10) and sarcopenia (OR: 1.64, 95% CI: 1.23–2.19) were positively associated with higher odds of depressive symptoms (all p < 0.01). During the 3.7 years of follow-up, 956 cases (20.6%) with incident depressive symptoms were identified. In the longitudinal analysis, individuals with the diagnosed possible sarcopenia (HR: 1.27, 95% CI: 1.01–1.58) and sarcopenia participants (HR: 1.49, 95% CI: 1.06–2.09) were more likely to have new onset depressive symptoms than no-sarcopenia peers.Conclusions: Both possible sarcopenia and sarcopenia, assessed using the AWGS 2019 criteria, were independent predictors for the occurrence of depressive symptoms among Chinese older adults. Our findings provided new evidence supporting the longitudinal connection between sarcopenia and mental health problems, it also provides further justification for timely identification and management of both possible sarcopenia and sarcopenia as part of comprehensive strategies to fight against depressive symptoms.

Associations between sarcopenia and depression in middle-aged and older adults: The moderating effect of smoking

“…Our ndings were consistent with the results of several previous cross-sectional studies 14,15,27 and a prospective study with a mean follow-up of 3.7 years 11 . Compared to the previous prospective study 11 , the present study had a longer follow-up period of 5.42 years. More importantly, associations between sarcopenia and rate of change in depressive symptoms have not been explored previously.…”

Progress in overactive bladder: novel avenues from psychology to clinical opinions

“…To sum up, as a psychosomatic disease, OAB is closely related to psychological and social factors and can affect many aspects such as life, work, study and social activities. Mental health remains pivotal worldwide ( Gao et al, 2021 ; He et al, 2021a ; He et al, 2021b ). In today’s society, the pace of life is speeding up with fierce competition, and people’s life is becoming more and more stressful, in which many people feel physically and mentally exhausted.…”

Association between Possible Sarcopenia and Depressive Symptoms in Korean Older Adults: Results from the Korea National Health and Nutrition Examination Survey in 2018

“…A meta-analysis of 15 observational studies indicated that sarcopenia was independently and positively associated with depression both in the narrative review and quantitative analysis with and without adjustments for covariates [ 20 ]. Furthermore, China Health And Retirement Longitudinal Study 2015 reported that possible sarcopenia was associated with higher odds of depressive symptoms in 2,627 Chinese older people [ 14 ]. The Toyota Prevention Intervention for Cognitive Decline and Sarcopenia study reported that both low physical performance and muscle strength were significantly associated with depressive mood in 432 Japanese older adults; however, no association was noted with decreased muscle mass [ 13 ].…”

“…However, in the data from 2018 KNHANES, there was no information about physical performance as proposed by the AWGS 2019 guidelines. Although several studies have proven that low muscle strength, a component of possible sarcopenia, is independently associated with depressive symptoms, the diagnosis of possible sarcopenia based only on low muscle strength might have resulted in errors in identifying participants with possible sarcopenia [ 13 , 14 , 21 ]. Third, the study used a cross-sectional design; therefore, we could not determine causality.…”

“…Considering the various adverse outcomes associated with sarcopenia and depressive symptoms in older people, it is important to understand the association between these disorders. To our knowledge, some studies in Asia (e.g., China and Japan) have evaluated the association between sarcopenia and depressive symptoms; however, such studies are lacking in Korea [ 13 , 14 ]. Particularly, no studies have evaluated the relationship between possible sarcopenia and depressive symptoms in Korea.…”