Association of depression with incident sarcopenia and modified effect from healthy lifestyle: The first longitudinal evidence from the CHARLS

Abstract

Background: The prospective association of depression with incident sarcopenia remains unknown, as does whether such an association is modified by a healthy lifestyle. Thus, the goal of this study was to determine whether depression is independently related to the risk of developing sarcopenia and to detect the effect of a healthy lifestyle on its modification.

Methods: The prospective study included 9486 participants from the China Health and Retirement Longitudinal Study who were followed from 2011 to 2015. We calculated a lifestyle score based on body mass index, drinking, smoking, social activities, and sleeping time. Cox proportional hazards regression models with hazard ratios (HRs) and 95 % confidence intervals were used to estimate the effect of depression on the risk of sarcopenia and the modification effect of lifestyle (CIs).

Results: During a mean of 3.53 years of follow-up, 1373 individuals developed sarcopenia. After adjusting for confounding factors, depression was significantly associated with a higher risk of incident sarcopenia (HR = 1.34; 95 % CI: 1.19, 1.50). In addition, we observed that individuals adhering to a healthy lifestyle had an 18 % lower risk of sarcopenia onset, compared with individuals with an unhealthy lifestyle.

Limitations: We couldn't completely rule out potential residual bias due to its observational design. Second, ascertainment of the history of diseases in CHARLS was based on self-reported information, which may introduce recall bias or misclassification.

Conclusions: Depression was associated with a higher risk of sarcopenia in Chinese adults, and such a risk may be alleviated by adhering to a healthy lifestyle.

Keywords: Depression; Epidemiology; Healthy lifestyle; Primary prevention; Sarcopenia.