Association Between Changes in Depressive Symptoms and Sarcopenia: Findings From a Nationwide Cohort Study

Abstract

ObjectivesThe aim of this study was to investigate the association between changes in depressive symptoms and sarcopenia by repeated measures of depressive symptoms at a follow-up visit every 2 years. DesignCross-sectional design and longitudinal design. Setting and ParticipantsWe conducted a cross-sectional and longitudinal study using data from the China Health and Retirement Longitudinal Study, which is a representative national survey. A total of 12,287 participants were included in Wave 1 (2011–2012) for the cross-sectional analysis, followed by a total of 5285 participants in Wave 2 (2013–2014) and Wave 3 (2015–2016) for the longitudinal analysis based on the cross-sectional analysis. MethodsDepressive symptoms were measured by the 10-item Center for the Epidemiological Studies of Depression Short Form. Sarcopenia was defined according to the Asian Sarcopenia Working Group criteria (AWGS 2019). Changes in depressive symptoms in Wave 1 and Wave 2 were used as exposure, and sarcopenia in Wave 3 was used as outcome. Cox proportional hazards regression model was used to test the relationship between changes in depressive symptoms and sarcopenia. ResultsIn cross-sectional analysis, depression was significantly associated with sarcopenia (odds ratio, 1.27; 95% CI, 1.10–1.48). In subsequent longitudinal analyses, a total of 174 sarcopenia events occurred, and those with increased depressive symptoms and persistent depressive symptoms were at higher risk for sarcopenia than those without depressive symptoms, with multivariable-adjusted hazard ratios of 1.65 (95% CI, 1.00–2.73) and 1.68 (95% CI, 1.06–2.68), respectively. Conclusions and ImplicationsPeople with increased depressive symptoms and persistent depressive symptoms may have a higher risk of developing sarcopenia over time. In the future, more research is needed to confirm the mechanism by which long-term changes in depression contribute to the risk of sarcopenia, and to propose preventive measures accordingly.