Sarcopenic obesity and risk of new onset depressive symptoms in older adults: English Longitudinal Study of Ageing.

M Hamer,G D Batty,M Kivimaki

doi:10.1038/ijo.2015.124

Abstract

Background:We examined the role of sarcopenic obesity as a risk factor for new-onset depressive symptoms over 6-year follow-up in a large sample of older adults.Methods:The sample comprised 3862 community dwelling participants (1779 men, 2083 women; mean age 64.6±8.3 years) without depressive symptoms at baseline, recruited from the English Longitudinal Study of Ageing. At baseline and 4-year follow-up, handgrip strength (kg) of the dominant hand was assessed using a hand-held dynamometer, as a measure of sarcopenia. The outcome was new onset depressive symptoms at 6-year follow-up, defined as a score of ⩾4 on the 8-item Centre of Epidemiological Studies Depression scale. Sarcopenic obesity was defined as obese individuals (body mass index ⩾30 kg m−2) in the lowest tertile of sex-specific grip strength (<35.3 kg men; <19.6 kg women).Results:Using a multivariable logistic regression model, the risk of depressive symptoms was greatest in obese adults in the lowest tertile of handgrip strength (odds ratio (OR), 1.79, 95% confidence interval (CI), 1.10, 2.89) compared with non-obese individuals with high handgrip strength. Participants who were obese at baseline and had a decrease of more than 1 s.d. in grip strength over 4-year follow-up were at greatest risk of depressive symptoms (OR=1.97, 95% CI, 1.22, 3.17) compared with non-obese with stable grip strength.Conclusions:A reduction in grip strength was associated with higher risk of depressive symptoms in obese participants only, suggesting that sarcopenic obesity is a risk factor for depressive symptoms.

Highlights

In comparison with the overall baseline sample, the sub-group used in the present analyses were younger (68.9 vs 64.6 years, P o0.001), had higher mean grip strength (28.3 vs 30.4 kg, P o 0.001), and better health behaviours including lower rates of smoking (19.1 vs 14.8%, Po 0.001) and greater physical activity (23.0 vs 32.6%, P o 0.001, vigorously active ⩾ 1/week)
This study demonstrates an association between sarcopenic obesity and new onset depressive symptoms in older adults
Our indicator of sarcopenic loss of muscle mass, was associated with depressive symptoms, an effect that was marked in obese participants

Summary

Introduction

The association between two disorders of major public health importance, obesity and mental health, remains unclear.[1,2,3,4,5,6]A recent meta-analysis containing prospective cohort studies showed an association between body mass index (BMI) and risk of depressive symptoms,[1] some individual studies have found no association[2] and others suggest that greater body weight may confer protection against future mental health problems and suicide.[3,4] the discordant results remain unclear when using an unconfounded instrument variable for obesity (adiposity-related genetic variants).[5,6]Different obesity phenotypes may exist,[7] and in particular variation in skeletal muscle mass across obese individuals may confer different health risks.[8]. A recent meta-analysis containing prospective cohort studies showed an association between body mass index (BMI) and risk of depressive symptoms,[1] some individual studies have found no association[2] and others suggest that greater body weight may confer protection against future mental health problems and suicide.[3,4] the discordant results remain unclear when using an unconfounded instrument variable for obesity (adiposity-related genetic variants).[5,6]. We examined the role of sarcopenic obesity as a risk factor for new-onset depressive symptoms over 6-year followup in a large sample of older adults. Sarcopenic obesity was defined as obese individuals (body mass index ⩾ 30 kg m−2) in the lowest tertile of sex-specific grip strength ( o35.3 kg men; o 19.6 kg women). CONCLUSIONS: A reduction in grip strength was associated with higher risk of depressive symptoms in obese participants only, suggesting that sarcopenic obesity is a risk factor for depressive symptoms

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