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Peer-reviewedCC BY-NC-NDDiscover mental health

Interaction effects of handgrip strength and depressive symptoms on the risk of functional disability among middle-aged and older adults.

  • Tianmeng Wang1,2
  • Yaping Wang2
  • Luyao Xu2
  • Yanqing Kang2
  • Jingbo Liang2
  • Shuangyan Lei3
  • Zhaozhao Hui4
  • Xiaoqin Wang5,6
  • Ronghua Wang7
7 affiliations
  1. 1Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road 277, Xi'an, Shaanxi, China.
  2. 2School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  3. 3Department of Radiotherapy, Shaanxi Provincial Cancer Hospital, Xi'an, China.
  4. 4School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  5. 5Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road 277, Xi'an, Shaanxi, China. [email protected].
  6. 6School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China. [email protected].
  7. 7Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road 277, Xi'an, Shaanxi, China. [email protected].
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Abstract

Background

Evidence regarding the combined effects of handgrip strength (HGS) and depressive symptoms on functional disability remains scarce. This study aimed to examine the additive interaction between HGS and depressive symptoms on functional disability among Chinese middle-aged and older adults.Methods

Data were extracted from 8,594 participants in the 2015-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Abnormal HGS was defined using the cut-off points recommended by the Asian Working Group for Sarcopenia (AWGS). Depressive symptoms and functional disability were measured using the Center for Epidemiologic Studies Depression Scale and an 11-item ADLs scale, respectively. Logistic regression models were employed to evaluate the additive interaction between abnormal HGS and depressive symptoms on functional disability.Results

Over a 5-year follow-up, 2,658 (30.9%) participants developed functional disability. Compared with those with normal HGS and without depressive symptoms, participants with abnormal HGS and depressive symptoms showed significantly increased risks of functional disability (ADL: adjusted OR = 4.87, 95% CI: 3.58-6.65; BADL: OR = 3.74, 95% CI: 2.82-4.97; IADL: OR = 4.23, 95% CI: 3.18-5.62). Moreover, the synergistic interaction effect between abnormal HGS and depressive symptoms on functional disability was observed by attributable proportion due to interaction (AP = 0.35, 95% CI: 0.13-0.56), particularly among males (AP = 0.36, 95% CI: 0.07-0.66) and middle-aged adults (AP = 0.44, 95% CI: 0.14-0.74).Conclusions

Abnormal HGS and depressive symptoms synergistically increased the risk of functional disability, highlighting the need for integrated interventions that simultaneously preserve muscle strength and promote psychological well-being to prevent or delay functional decline in middle-aged and older adults.

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Cite

BibTeXRIS
BibTeX
@article{wang2026interaction,
  title = {{Interaction effects of handgrip strength and depressive symptoms on the risk of functional disability among middle-aged and older adults.}},
  author = {Tianmeng Wang and Yaping Wang and Luyao Xu and Yanqing Kang and Jingbo Liang and Shuangyan Lei and Zhaozhao Hui and Xiaoqin Wang and Ronghua Wang},
  journal = {Discover mental health},
  year = {2026},
  month = aug,
  doi = {10.1007/s44192-026-00567-5},
  url = {https://europepmc.org/article/MED/43009694},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Interaction effects of handgrip strength and depressive symptoms on the risk of functional disability among middle-aged and older adults.
AU  - Tianmeng Wang
AU  - Yaping Wang
AU  - Luyao Xu
AU  - Yanqing Kang
AU  - Jingbo Liang
AU  - Shuangyan Lei
AU  - Zhaozhao Hui
AU  - Xiaoqin Wang
AU  - Ronghua Wang
PY  - 2026
DA  - 2026/08/15
JO  - Discover mental health
DO  - 10.1007/s44192-026-00567-5
UR  - https://europepmc.org/article/MED/43009694
AB  - Background  Evidence regarding the combined effects of handgrip strength (HGS) and depressive symptoms on functional disability remains scarce. This study aimed to examine the additive interaction between HGS and depressive symptoms on functional disability among Chinese middle-aged and older adults.Methods  Data were extracted from 8,594 participants in the 2015-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Abnormal HGS was defined using the cut-off points recommended by the Asian Working Group for Sarcopenia (AWGS). Depressive symptoms and functional disability were measured using the Center for Epidemiologic Studies Depression Scale and an 11-item ADLs scale, respectively. Logistic regression models were employed to evaluate the additive interaction between abnormal HGS and depressive symptoms on functional disability.Results  Over a 5-year follow-up, 2,658 (30.9%) participants developed functional disability. Compared with those with normal HGS and without depressive symptoms, participants with abnormal HGS and depressive symptoms showed significantly increased risks of functional disability (ADL: adjusted OR = 4.87, 95% CI: 3.58-6.65; BADL: OR = 3.74, 95% CI: 2.82-4.97; IADL: OR = 4.23, 95% CI: 3.18-5.62). Moreover, the synergistic interaction effect between abnormal HGS and depressive symptoms on functional disability was observed by attributable proportion due to interaction (AP = 0.35, 95% CI: 0.13-0.56), particularly among males (AP = 0.36, 95% CI: 0.07-0.66) and middle-aged adults (AP = 0.44, 95% CI: 0.14-0.74).Conclusions  Abnormal HGS and depressive symptoms synergistically increased the risk of functional disability, highlighting the need for integrated interventions that simultaneously preserve muscle strength and promote psychological well-being to prevent or delay functional decline in middle-aged and older adults.
SN  - 2731-4383
ER  -