Depression is Associated With Sarcopenia Due to Low Muscle Strength: Results From the ELSA-Brasil Study

J Am Med Dir Assoc. 2019 Dec;20(12):1641-1646. doi: 10.1016/j.jamda.2018.09.020. Epub 2018 Nov 5.


Objectives: To investigate the association of sarcopenia and its defining components with depression in Brazilian middle-aged and older adults.

Design: Cross-sectional study.

Setting and participants: This analysis included 5927 participants from the ELSA-Brasil Study second data collection, aged 55 years and older, with complete data for exposure, outcome, and covariates.

Measures: Muscle mass was evaluated by bioelectrical impedance analysis and muscle strength by hand-grip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health (FNIH) criteria. Depression was assessed using the Clinical Interview Scheduled Revised (CIS-R). Information on sociodemographic characteristics, lifestyle, and clinical comorbidities were also obtained.

Results: The frequencies of sarcopenia, presarcopenia, low muscle mass, low muscle strength, and low muscle strength without loss of muscle mass was 1.9%, 18.8%, 20.7%, 4.8%, and 2.9%, respectively. After adjustment for sociodemographic characteristics, clinical conditions, and lifestyle factors, depression was associated with sarcopenia (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 1.11-4.48, P = .024) and low muscle strength (OR = 1.94, 95% CI = 1.20-3.15, P = .007), but it was not associated with presarcopenia, low muscle mass, and low muscle strength without loss of muscle mass.

Conclusions: Depression is associated with sarcopenia defined by the FNIH criteria mainly because of its association with weakness. Future studies are needed to clarify the temporal relationship between both conditions.

Keywords: Sarcopenia; depression; muscle strength; older adult.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brazil
  • Cross-Sectional Studies
  • Depression / etiology*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Qualitative Research
  • Sarcopenia / psychology*