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Temporal Dynamics and Bidirectional Longitudinal Association Between Physical Function and Depressive Symptoms in
Belayneh Mengist1,2, Mojtaba Lotfaliany1, Julie A Pasco1,3,4
1School of Medicine, Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), Geelong, Victoria, Australia.
Journal of Cachexia, Sarcopenia and Muscle
|January 30, 2026
Summary
Physical function decline and depressive symptoms in older adults are linked in a two-way relationship. Poor physical function increases depression risk, while depression worsens physical function over time.
Area of Science:
- Gerontology
- Public Health
- Epidemiology
Background:
- Physical function decline and depression are significant challenges for the aging population.
- The bidirectional relationship between physical function and depressive symptoms in older adults is not well understood.
Purpose of the Study:
- To investigate the bidirectional longitudinal association between physical function and depressive symptoms in older adults.
- To examine how physical function impacts depressive symptoms and vice versa over time.
Main Methods:
- Utilized data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and extended follow-up (2010-2022).
- Assessed depressive symptoms using the Center for Epidemiologic Studies Depression scale (CES-D).
- Measured physical function via gait speed and handgrip strength, categorized using EWGSOP2 criteria. Analyzed associations using generalized estimating equations and random-intercept cross-lagged panel models.
Main Results:
- Included 15,854 older adults (mean age 75 years) with a median follow-up of 8.4 years.
- Poor physical function (performance and strength) was associated with an 81% higher odds of developing depressive symptoms (OR=1.81).
- Depressive symptoms were associated with a 70% higher odds of reduced physical function (OR=1.70). Bidirectional associations were confirmed.
Conclusions:
- Reduced physical function and depressive symptoms exhibit a bidirectional association of similar magnitude over time in older adults.
- Understanding this reciprocal relationship is vital for developing integrated prevention and treatment strategies for physical and mental health.
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