Table 1.
Studies’ characteristics.
| Author, Year | Study Design | Country and Sample’s Characteristics | Depression Measure | Muscular Strength Measure | Main Results | Study Quality |
|---|---|---|---|---|---|---|
| Krogh et al., 2009 | Clinical trial | Denmark n = 165, 122 women, age range = 18–55, mean age 38.9 ± 9.46; strength training (n = 55); aerobic training (n = 55); relaxation training (n = 55). |
Hamilton Depression Rating Scale (HAM-D17) | Knee extension; Chest press; Leg press | (Ø) At 4 months, the mean change in the HAM-D17 score was –1.3 (−3.7–1.2; p = 0.3) for the strength group vs. the relaxation group. At 12 months, the mean differences in the HAM-D17 score were −0.2 (−2.7–2.3) for the strength group vs. the relaxation group. Findings do not support a biologically mediated effect of strength exercise on symptom severity in depressed patients. | Strong |
| Suija et al., 2013 | Prospective | Finland n = 5497, 51% women, age = 31 (all participants were born in 1966). |
Hopkins’ Symptom Checklist (HSCL-25) | Trunk extension test; Hand dynamometer | (+) Depressive symptoms were most common among males and females in the lowest quintile group of the trunk extension test and among the males in the lowest quintile group of the handgrip strength compared to the middle quintile group. | Strong |
| Vancampfort et al., 2013 | Cross-sectional | Belgium n = 120; schizophrenia: n = 80, mean age 36.8 ± 10.0; control: n = 40, mean age 37.1 ± 10.3. |
Psychosis Evaluation Tool for Common use by Caregivers (PECC) | Standing broad jump; Sit-ups; Handgrip strength | (+) Standing broad jump (−0.35, p < 0.01), handgrip strength (−0.28, p < 0.01) and sit-ups (−0.33, p < 0.01) were inversely associated to depressive symptoms. Low physical fitness was associated with depressive symptoms. | Moderate |
| Aidar et al., 2014 | Clinical trial | Brazil Control group: n = 24, 6 men, mean age = 51.7 ± 0.8 Experimental group: n = 13, 9 men, mean age = 52.5 ± 7.7. |
Beck Depression Inventory (BDI) | Squat; Bench press; Horizontal leg press; Military press; Abdominal crunch; Front lat pull-downs; Lunges | (+) There were significant differences in all indicators of depression between the experimental group and the control group after completing 12 weeks of training. A negative correlation between the strength gains as determined with the one-repetition maximum test and the levels of depression was found. | Weak |
| Fukumori, 2015 | Prospective | Japan n = 4314, 58.5% women, age range 40–79, mean age 66.3 ± 9.0. |
Mental Health Inventory (MHI-5) | Digital dynamometer (Takei Scientific Instruments Co., Ltd.) | (+) Men and women with lower handgrip strength had higher odds of having depressive symptoms at baseline. Lower handgrip strength was associated with the longitudinal development of depressive symptoms after 1 year (odds ratio (OR) = 1.13, 95%CI = 1.01, 1.27). | Strong |
| Sener et al., 2016 | Clinical trial | Turkey n = 79; experimental group: n = 39 women with fibromyalgia; mean age 42 ± 10.3 years; control group: n = 40 women; mean age 38.3 ± 8.4 years. |
Beck Depression Inventory (BDI) | Digital Grip Dynamometer (T.K.K.5401) | (+) In the fibromyalgia group, right and left handgrip strength were moderately negatively correlated with depression scores (r = 0.263 p = 0.025; r = 0.233 p = 0.048). Low muscle strength increased depression and anxiety symptomatology in patients with fibromyalgia. | Moderate |
| Soriano-Maldonado et al., 2016 | Cross-sectional | Spain n = 444 were included in the analysis; mean age 52.0 ± 8.0 years. |
Beck Depression Inventory II (BDI II) | Digital Grip Dynamometer (T.K.K. 5101) | (+) The odds of severe symptoms of depression were 4.8% (95% CI: 8.2% to 1.2%; p = 0.010) lower for each additional kilogram in the handgrip test among women with fibromyalgia. | Weak |
| Gopinath et al., 2017 | Cross-sectional | Australia n = 947 men and women; aged ≥65 years. |
Center for Epidemiologic Studies Depression Scale (CES-D-10) | Jamar hand dynamometer (Sammons Preston Inc.) | (Ø) Handgrip strength was not associated with depressive symptoms and quality of life. | Weak |
| Wu et al., 2017 | Cross-sectional | China n = 1046, 486 men, 560 women, aged ≥60. |
Geriatric Depression Scale (GDS) | Dynamometer (EH101; CAMRY, Guangdong) | (+) Men and women in the lower quartile for muscle strength had a significantly higher risk for depressive symptoms compared with those in the fourth quartile. Muscle strength are inversely associated with depressive symptoms in elderly Chinese. | Weak |
| Brooks et al., 2018 | Cross-sectional | USA n = 3421 community-dwelling, non-institutionalized adults; 1660 men, 1761 women; aged ≥60 years, mean age was 69.9 ± 6.9 years. |
Patient Health Questionnaire (PHQ-9) | Dynamometer | (+) Depression was significantly associated with reduced handgrip strength in older adults. | Weak |
| Lee, 2018 | Cross-sectional | South Korea n = 4810, 2167 men, 2643 women; mean age 50.9 ± 16.7 years. |
Depressive mood was assessed using one question: ‘During the past year, did you ever feel so sad or hopeless for 2 weeks or more in a row that you stopped performing usual activities? | Digital Grip Dynamometer (T.K.K.5401) | (+) Handgrip strength was negatively associated with depressive mood (OR = 0.82, 95% CI: 0.69–0.99) and suicidal ideation (OR = 0.73, 95% CI: 0.54–0.99). In a sex-specific relationship, handgrip strength was negatively associated with depressive mood and suicidal ideation among women (OR = 0.71, 95% CI: 0.55–0.93) but not men. | Moderate |
| Lee et al., 2018 | Cross-sectional | South Korea n = 4298, 1860 men, 2438 women; age range (19–80 years); subjects were divided into three groups (young adult (19–39 years), middle aged (40–59 years), and elderly (60–80 years). |
Patient Health Questionnaire (PHQ-9) | Digital Grip Dynamometer (T.K.K.5401) | (+) Handgrip strength was inversely associated with the PHQ-9 score. The odds ratios of depression symptoms were statistically significant for the participants in the first and second quartile of handgrip strength compared to those with the highest quartile. There was about a 50% mediation effect of EQ5D in the relationship between handgrip strength and depression. | Moderate |
| McDowell et al., 2018 | Prospective | Ireland n = 4505, 2544 men, 1961 women; aged ≥50 years. |
EuroQol Five-Dimension Questionnaire (EQ5D) | Baseline hydraulic dynamometer | (+) In the total sample, the middle- and high-strength tertiles were significantly associated with 31.5% (p = 0.04) and 34.1% (p = 0.02) reduced odds of developing depression, respectively. The interaction between sex and strength was not statistically significant. | Strong |
| Smith et al., 2018 | Cross-sectional | USA n = 2812, 1380 men, 1432 women, mean age 68.9 ± 0.3 and 69.5 ± 0.3 |
Center for Epidemiological Studies Depression Scale (CES-D) | Takei Digital Grip Strength Dynamometer | (+) Women with moderate to major depressive symptoms had 1.60 kg (95% CI: 0.91 to 2.30) lower handgrip strength compared to women with minimal or no depressive symptoms. No association was observed in men. Obese men (-3.72 kg, 95% CI:−7.00, −0.43) and women (−1.83 kg, 95% CI:−2.87, −0.78) with moderate to severe depressive symptoms had lower handgrip strength. | Moderate |
| Ashdown-Franks et al., 2019 | Cross-sectional | China, Ghana, India Mexico, Russia, South Africa n = 34,129, China 13,175, Ghana 4305, India 6560, Mexico 2313, Russia 3938, South Africa 3838; mean age 62.4 ± 16 years |
Patient Health Questionnaire (PHQ-9) | Smedley Handgrip Dynamometer | (+) Individuals with weak handgrip strength had a higher prevalence of depression than those without (8.8% vs. 3.8%; p < 0.001). In all countries, weak handgrip strength was associated with a 1.45 (95% CI:1.12–1.88) times higher odds for depression, although some between country differences were noted (particularly in Ghana). Age and sex-stratified analysis showed similar results. | Strong |
| Han et al., 2019 | Cross-sectional | South Korea n = 3169, 1451 men, 1718 women; aged 59–69 years, mean age 55 ± 6.25 years. |
Patient Health Questionnaire (PHQ-9) | Digital Grip Dynamometer (T.K.K.5401) | (+) Older adults in the lowest tertile of handgrip strength measures were more likely to have experienced depressive symptoms compared to those in the highest tertile. | Moderate |
| Kim et al., 2019 | Clinical trial | South Korea n = 21 women, aged 67–81 years, mean age 76.40 ± 3.27 years; control group (n = 10; mean age 76.40 ± 3.27 years) and intervention group (n = 11, mean age 76.10 ± 3.85 years). |
Korean version of the Short form of the Geriatric Depression Scale (SGDS-K) | The exercise program was 3 times/week for 24 weeks. Part I from 1–4 weeks, Part II from 5–8 weeks, Part III from 9–15 weeks, and advanced long-term training from 16 to 24 weeks. The exercise program consists of warm-up (for 10 min), main exercise (for 30–60 min) and warm-down (for 10 min). | (Ø) In neurotransmitter factor, serotonin, dopamine, epinephrine, and norepinephrine were significantly decreased in the strength exercise group but not for the control group. There were no significant differences for both the strength exercise group and control group. | Weak |
| Laredo-Aguilera et al., 2019 | Cross-sectional | Spain n = 38 active women, aged >65 years, mean age 72.29 ± 5.21 years. |
Spanish version of the Short form of the Geriatric Depression Scale (SGDS-S) | Digital Grip Dynamometer (T.K.K. 5101) | (+) The group with a higher handgrip strength result had a better total score for depression. Significant and negative correlations were found between the handgrip strength and depression. | Weak |
| Moraes et al., 2019 | Clinical trial | Brazil n = 27 older adults with major depressive disorder; aerobic training (n = 9, 1 man and 8 women, aged 60–78; 70.88 ± 5.94 years), strength training (n = 9, 8 men, 1 woman, aged 60–81; 72.89 ± 7.06 years), control group (n = 7, 2 men and 5 women, aged 61–77; 69.28 ± 5.28 years). |
Hamilton Depression Rating Scale (HAM-D), and Beck Depression Inventory (BDI) | The 1-repetition maximum test was applied. The scale of perception of effort from 6 to 20 was used to quantify the subject’s effort during activity. | (+) The aerobic training and strength training intervention groups showed significant reductions in depressive symptoms from pre to post intervention when compared to the control group. | Moderate |
| Park et al., 2019 | Prospective | South Korea n = 13,901, 5996 men, 7905 women; aged > 60 year, mean age 69.54 ± 7.06 years. |
Korean version of the Short form of the Geriatric Depression Scale (SGDS-K) | Handgrip Dynamometer (TANITA No. 6103, Tokyo) | (+) Individuals with depression only and individuals with low handgrip strength plus depression had significantly higher risks of all-cause mortality. Men and women with higher handgrip strength had significantly lower depression scores. | Strong |
| Smith et al., 2019 | Cross-sectional | United Kingdom n = 3741 community-dwelling, 1257 men, 2484 women; aged 54–89 years, mean age 68.4 years. |
Center for Epidemiologic Studies Depression scale (CES-D8) | Hand-held dynamometer | (+) Grip strength was negatively associated with depressive symptoms, when the analysis was adjusted for sex and age. When fully adjusted, the association remained significant but was weaker. | Strong |