Association of Handgrip Strength Weakness and Asymmetry with Cognitive Decline and Depressive Symptoms in Older Chinese Adults

Abstract This study investigated the association betweenhandgrip strength (HGS) asymmetry and weakness with cognitive function and depressive symptoms among 920 adults aged above 60 years in suburban Shanghai. Participants were selected using a multistage cluster-stratified sampling approach. Assessments included HGS measured with a dynamometer, the Montreal Cognitive Assessment (MoCA) for cognition, and the Geriatric Depression Scale (GDS) for depressive symptoms. Restricted cubic splines revealed a positive association between dominant HGS and MoCA scores, indicatingbetter cognitive performance, and a negative association with GDS scores, suggesting fewer depressive symptoms. The association between the HGS ratio and MoCA scores and the HGS ratio and GDS scores varied by sex. Women with HGS weakness alone (odds ratio (OR)=2.00, 95% confidence interval (CI)=1.17–3.37), asymmetry alone (OR=1.93, 95% CI=1.14–3.29), or both had a significantly increased risk of mild cognitive impairment, with no such associations observed in men. These findings suggest that a sufficiently dominant and symmetrical HGS may be associated with a lower risk of cognitive decline and depressive symptoms, particularly in women. This study emphasizes the need for sex-specific assessments and prevention strategies to address cognitive and mental health issues among older adults.