Handgrip Strength, Depressive Symptoms, and Subsequent Falls Among Middle‐Aged and Older Adults in China: Evidence From a Prospective Cohort Study
Shujun Chai, Dan Zhao, Xin Che, Chengchao ZhouIntroduction
The occurrence of falls among middle‐aged and older adults has become a major public health concern. However, the potential mechanisms linking handgrip strength and falls remain poorly understood. This study aimed to examine the mediating effect of depressive symptoms in the longitudinal association between handgrip strength and subsequent falls among Chinese middle‐aged and older adults using a nationally representative sample.
Methods
This study employed the China Health and Retirement Longitudinal Study (CHARLS) data in 2011, 2013, and 2015. A total of 5254 participants aged 45 years or above were included in an analysis. Mixed‐effects logistic regression models were used to examine the longitudinal association between handgrip strength and falls, and parametric g‐computation was used to assess the mediating role of depressive symptoms.
Results
Higher handgrip strength was associated with a lower likelihood of falls after adjustment for covariates (OR = 0.97, p < 0.001). Higher handgrip strength was also associated with fewer depressive symptoms, whereas greater depressive symptoms were associated with higher odds of falls. In the longitudinal mediation analysis, a 1‐SD increase in baseline handgrip strength was associated with a small but significant indirect reduction in subsequent fall risk through depressive symptoms. The natural direct effect and total effect were not statistically significant.
Discussion
Depressive symptoms may represent a small indirect pathway linking handgrip strength to subsequent falls, highlighting a potential psychological pathway linking physical decline to fall risk. These findings suggest the potential value of considering both muscle strength and psychological health in fall‐risk assessment and prevention.