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

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.