Associations of Handgrip Strength with Bone Health and Mental Health in Postmenopausal Women: A Cross-Sectional Study

Background and Objectives: Handgrip strength (HGS) is a simple marker of muscular fitness that has been linked to adverse outcomes in older adults, while menopause is accompanied by skeletal deterioration and increased psychological vulnerability. Resilience and self-regulation may be associated with lower levels of these risks, but their relationship with bone microarchitecture has not been clarified. We aimed to examine the associations between HGS and trabecular bone score (TBS), bone mineral density (BMD), mental health, resilience, and self-regulation in postmenopausal women. Materials and Methods: In this study, 200 postmenopausal women were recruited. HGS was assessed with a dynamometer, BMD at the lumbar spine, total hip and femoral neck by DXA, and lumbar TBS was derived from spine images. Psychological distress was measured with the DASS-21, resilience with the Brief Resilience Scale (BRS), and self-regulation with the Short Self-Regulation Questionnaire (SSRQ). Results: TBS was significantly higher in women with higher HGS (p < 0.001). Higher HGS was also associated with lower anxiety and depression scores (p = 0.011 and p = 0.013), fewer self-reported mental health disorders, and greater resilience (p < 0.001) and self-regulation (p = 0.004). Resilience and self-regulation were inversely related to all DASS-21 subscales (all p < 0.001), and HGS correlated positively with BRS (p < 0.001) and SSRQ (p < 0.001). TBS correlated modestly with both BRS (p = 0.003) and HGS (p < 0.001). In multiple linear regression, both BRS (β = 0.018, p = 0.013) and HGS (β = 0.003, p = 0.006) remained independently associated with TBS after adjustment for age, BMI, menopause duration, and SSRQ. Conclusions: In postmenopausal women, higher handgrip strength is associated to better trabecular bone microarchitecture and a more favorable psychological profile. Incorporating HGS and brief psychosocial assessment alongside TBS may enrich fracture risk stratification and support more integrated musculoskeletal and mental health care.